Module 8b 0 Immune System Flashcards
Carcinogenesis
• Initiation/formation of cancer
Neoplasia
• Formation of new, abnormal growth that is not under physiological control
• Often referred to as a tumor
Tumor
• Abnormal growth of tissue in which the proliferation of cells is uncontrolled and progressive
• Can be benign or malignant
Benign
• Tumor, or growth that is not cancerous and does not spread to other parts of the body nor does it invade nearby
tissue
Malignant
• Tumor, or growth that is cancerous and spreads to other parts of the body and invades nearby tissues
Cancer
• A classification of malignant tumors that are caused by an uncontrolled division of abnormal cells in a part of the body that have the potential to invade or spread to other areas of the body
Metastasis
• The development of secondary malignant growths at a distance from a primary site of cancer
In situ
• Cancer in which abnormal cells have not spread beyond where they first formed
Oncology/Oncologist
• Study and treatment of cancer; one who specializes in the study and treatment of cancer
Carcinoma
• Malignant cancer that originates from epithelial tissue and cells that line glands
Lymphoma
• Malignant cancer that originates in the lymph tissue or blood cells
Sarcoma
• Malignant cancer that originates in connective tissue
Remission
• Partial remission means tests demonstrate tumor has shrunk (1/2 size) and isn’t growing
• Complete remission means diagnostic tests do not demonstrate any cancer cells within your body
Differentiation
• When cell changes from one type to another
• Typically, go from immature (unspecialized) cells to mature cells (specialized) with individual characteristics that have
specific form and function
Anaplasia
• Loss of the mature or specialized features of a cell or tissue, as in malignant tumors
Tumor Suppressor Genes
• Group of genes that slow down cell division, repair DNA, and initiate apoptosis
Proto-Oncogenes
• Group of genes that produce proteins that regulate cell growth and division, differentiation
Oncogenes
• Mutated or over expressed proto-oncogenes
This term refers to malignant cancer that originates from epithelial tissue or cells that line
glands?
• A. Sarcoma
• B. Metastasis
• C. Lymphoma
• D. Carcinoma
D. Carcinoma
A tumor can be malignant or benign.
• A. True
• B. False
A. True
Cancer is always classified as malignant tumors.
• A. True
• B. False
A. True
Malignant cancer in the bone would be labeled as a sarcoma.
• A. True
• B. False
A. True
What are the function of normal cell in regards to cellular division?
Normal Cell
• Progresses through cell cycle (when stimulated to)
• Mitosis causes cell proliferation (growth)
• Highly controlled process through expression of genes and cell mediators
• Stay in their location
• Cells at a point will undergo apoptosis
What is a tumor? What is cancer? How are cancer cells different?
Tumors are abnormal growth of tissue in which the proliferation of cells is uncontrolled and progressive
• Can be benign or malignant
• Something is allowing it to grow uncontrollably
• Increased physiological stimuli (stimulating signals)
• Unresponsive to various physiological stimuli (inhibitory signals)
• Cancer refers to malignant tumors and is an umbrella term for over 100
different diseases
• Diagnosed through screenings (mammograms, PSA) and diagnostic testing (X-
rays, MRIs, CT, PET)
What is the cause of tumor development?
• DNA abnormalities- lead to abnormal protein production
• Mutations caused by exogenous and endogenous stimuli
• Epigenetic changes- nongenetic influences on gene expression
• A genetic change in the DNA leads to tumor growth development
• Can be internal, external (viral), or inherited
Compare and contrast carcinoma, lymphoma/leukemias, and sarcomas
Carcinoma
• Refer to cancers that originate from epithelial tissue or cells that
line glands
• Skin/Epidermis, Glands, Intestines, Bronchus, Breast, Prostate, Pancreas, Thyroid, Kidney, Testis, Ovary, Adrenals, Liver, Cervix
• 1. Adenocarcinomas
• Form from glands (breast, prostate, ovary, colon, pancreas)
• 2. Squamous Cell Carcinoma
• Form epithelial tissue
Lymphomas
• Refer to cancers that originate from lymph tissue or blood cells
• Lymphoma Cancers (lymph tissue)
• Hodgkin Lymphoma
• Non-Hodgkin Lymphoma
• Leukemia Cancers (blood cells)
• Acute myeloid (or myelogenous) leukemia (AML)
• Chronic myeloid (or myelogenous) leukemia (CML)
• Acute lymphocytic (or lymphoblastic) leukemia (ALL)
• Chronic lymphocytic leukemia (CLL)
Sarcoma
• Refer to cancers that originate from connective tissue
• Osteosarcoma (bone)
• Chondrosarcoma (cartilage)
• Synovial cell sarcoma (joint)
• Liposarcoma (fat)
• Angiosarcoma (blood vessel)
• Rhabdomyosarcoma (skeletal muscle)
Identify the hallmark characteristics of cancer
Hallmark Characteristics of Cancer
• 1. Self-sufficiency in growth signals
• 2. Insensitivity to growth-inhibitory signals
• 3. Altered cellular metabolism
• 4. Evasion of apoptosis
• 5. Limitless replicative potential (immortality)
• 6. Sustained angiogenesis
• 7. Invasion and metastasis
• 8. Evasion of immune surveillance
What are the common signs and symptoms of malignant tumors?
• Weight loss without lifestyle changes
• Pain that doesn’t resolve with OTC
• Pain at night
• Fatigue
• Changes in other physiological processes (GI, bowel movements, urination)
• Depend on organ/area involved
Normal cell function does not require an outside signal or factor to initiate cell growth and replication
• A. True • B. False
B. False
All of the following are common major signs/symptoms of malignant tumors, except?
• A. Fatigue
• B. Pain at night
• C. Weight loss
• D. Pain that is relieved with pain medications
D. Pain that is relieved with pain medications
Cancer that originates from breast gland tissue would be classified as:
• A. Squamous cell carcinoma
• B. Lymphoma
• C. Sarcoma
• D. Adenocarcinoma
D. Adenocarcinoma
What is neoplasm?
Neoplasm (Tumor)
• Abnormal growth of tissue in which the proliferation of cells is uncontrolled
and progressive • Can be benign or malignant
What is the different between benign and malignant?
• Benign (not cancer)
• Malignant (cancer)
What is cancer?
• A classification of malignant tumors that are caused by an uncontrolled division of abnormal cells in a part of the body that have the potential to invade or spread to other areas of the body
What are characteristics of a benign tumor?
• Benign Tumors Appearance
• NOT CLASSIFIED AS CANCEROUS
• Encapsulated*
• Does not invade surrounding tissues and structures
• Cells still resemble normal cells form and function
• Do not metastasize
• Are not life threatening unless pressing upon an organ structure
What are characteristics of a malignant
tumor?
• Malignant Tumors Appearance
• CLASSIFIED AS CANCEROUS
• Non-encapsulated
• Invade surrounding tissues and structures
• Cells do not resemble normal cells form and function
• Metastasize to other areas of the body
• Life threatening
What are four fundamental characteristics how benign and malignant tumors are distinguished from one another?
• 1. Differentiation and anaplasia
• 2. Rate of growth
• 3. Local invasion
• 4. Metastasis
Parenchyma
• Functional tissue of an organ as distinguished from the connective and supporting
tissue
Stroma
• Supportive tissue of an organ consisting of connective tissues and blood vessels
Compare and contrast the characteristics of benign and malignant tumors in regards to differentiation and anaplasia
• Seen only in the parenchymal cells
• Differentiation refers to the extent to which they resemble their normal anatomy and physiology status
Benign
• Composed of well-differentiated cells
Malignant
• Characterized by a wide range of parenchymal cell differentiation, from well
that closely resemble their normal
differentiated to completely undifferentiated
counterparts
• Malignant neoplasms that are composed of undifferentiated cells are said to be
anaplastic
• Lack of differentiation, or anaplasia, is considered a hallmark of malignancy
• The term anaplasia literally means “backward formation”—implying dedifferentiation,
or loss of the structural and functional differentiation of normal cells
What are the characteristics Anaplastic cells display?
• Pleomorphism
• Variation in size and shape
• Nuclei are extremely hyperchromatic (dark-staining), large, variable and bizarre in size and shape
• Fail to develop recognizable patterns of orientation to one another
• The more rapidly growing and the more anaplastic a tumor, the less likely it is to have specialized functional activity
Dysplasia
• Alteration in size, shape, and organization of adult cells
Anaplasia
• Loss of differentiation of cells and of their orientation to one another
• An extremely advance form of dysplasia
Compare and contrast the characteristics of benign and malignant tumors in regards to rate of growth
• There are always exceptions, but in general benign tumors grow slowly and malignant tumors grow rapidly
• Malignant tumors are immortal and have limitless proliferative capacity, indicating that like normal tissues, they also must contain cells with “stemlike” properties
• Henrietta Lacks
Benign
• Commonly grow slowly
• Grow slowly over a period of months to years
Malignant
• Commonly grow fast, invade local tissue, and can even metastasize
• Rate is correlated inversely with their level of differentiation
• Poorly differentiated tumors grow much faster than well differentiated cells
Compare and contrast the characteristics of benign and malignant tumors in regards to local invasion
• In general, benign tumors remain localized while malignant tumors can metastasize to other areas of the body
Benign
• Remains localized at site of origin
• Commonly are encapsulated
• Does not have the capability to infiltrate, invade, or metastasize
Malignant
• Grow by progressive infiltration, invasion, destruction, and penetration of surrounding tissue
• Do not develop well defined capsules
• Surgical pathologists carefully examine the margins of resected tumors to ensure that they are devoid of cancer cells (clean margins)
• Next to the development of metastases, local invasiveness is the most reliable feature that distinguishes malignant from benign tumors
Compare and contrast the characteristics of benign and malignant tumors in regards to Metastasis
• Secondary implants of a tumor that are discontinuous with the primary tumor and located in remote tissues
• Only malignant tumors can undergo metastasis
Benign
• Do not undergo metastasis
Malignant
• More than any other attribute, the property of metastasis identifies a neoplasm as malignant
• Not all cancers have equivalent ability to metastasize
• Some hardly metastasis and other metastasis right away during growth
• The more anaplastic and larger the primary neoplasm, the more likely is metastatic spread
Both benign and malignant tumors can be deadly due to their ability to metastasize.
• A. True
• B. False
B. False
All of the options are true regarding tumors, except?
• A. Benign tumor cells commonly resemble normal cells in form and function
• B. Malignant tumors are encapsulated
• C. Both benign and malignant tumor cells are a result of DNA dysfunction
• D. Malignant tumors have the capability to metastasize
• B. Malignant tumors are encapsulated
What is TRUE of malignant tumors?
• A. They are non-encapsulated
• B. Generally, their rate of growth is very fast and aggressive
• C. Can lead to development of hemorrhaging in the location of the tumor site
• D. All the options are true
D. All the options are true
Epidemiology
The study (scientific, systematic, and data-driven) of the distribution (frequency, pattern)
and determinants (causes, risk factors) of health-related states and events (not just diseases) in specified populations (neighborhood, school, city, state, country, global).
How does geographic play a role in the epidemiology associated with cancer?
Geographic differences in death rates from specific forms of cancer • Death rates from breast cancer are about four to five times higher in the United States and Europe than in Japan
• Conversely, the death rate for stomach carcinoma in men and women is about seven times higher in Japan than in the United States
How does environmental variables play a role in the epidemiology associated with cancer?
• Environmental factors are the predominant cause of the most common sporadic cancers
• Infectious agents, smoking, alcohol consumption, diet, obesity, reproductive history, environmental carcinogens
• Infectious Agents
• Cause of about 15% of cancers worldwide
• Human papillomavirus (HPV)
• A lot of other virus have correlations with specific cancers
• Enough with your crap, viruses!
• Smoking
• Single most important environmental factor contributing to premature death in the United States
• Smoking, particularly of cigarettes, is implicated in cancer of the mouth, pharynx, larynx, esophagus, pancreas, and bladder and, most significantly, in about 90% of lung cancers
• Alcohol Consumption
• Increases the risk of carcinoma of the oropharynx, larynx, and esophagus and, by the development of alcoholic cirrhosis, hepatocellular carcinoma
• Diet
• Precise dietary factors that affect cancer risk remain a matter of debate, there are a lot of
correlations of diet and specific cancers
• Obesity
• In the U.S. population have 52% (men) to 62% (women) higher death rates from cancer
compared to individuals who are not categorized as overweight or obese
• Reproductive History
• Lifelong cumulative exposure to estrogen stimulation, particularly if unopposed by
progesterone, increases the risk of cancers of the breast and endometrium, tissues that are responsive to these hormones
• Carcinogens
• Any substance capable of causing cancer in living tissue
• Don’t freak out- but there are carcinogens all around you
• Home, Occupation, water, sun
How does age play a role in the epidemiology associated with cancer?
• Most carcinomas occur in adults older than 55 years of age
• Cancer is the leading cause of death among women aged 40 to 79 and among men aged 60 to 79
• Decline in cancer deaths after age 80 is due to the lower number of individuals who reach this age
• Cancer causes slightly more than 10% of all deaths among children younger than 15 years
How does heredity play a role in the epidemiology associated with cancer?
• Most cancers have environmental and genetic etiology
• Hereditary forms of cancer can be divided into three categories based on their pattern of inheritance:
1. Autosomal Dominant Cancer
• Inheritance of a single mutant gene greatly increases the risk of developing a tumor
- Autosomal Recessive Syndromes of Defective DNA Repair
• Predisposition to these tumors shows an autosomal recessive pattern of inheritance - Familial Cancers of Uncertain Inheritance
• Features that characterize familial cancers include early age at onset, tumors arising in
two or more close relatives of the index case, and sometimes multiple or bilateral tumors
What is an acquired preneoplastic lesion?
• Precancerous Conditions
• Referred to as preneoplastic lesions or precancer
• Condition or lesion that involves abnormal cells which have an
associated risk with developing cancer
Examples
• Squamous metaplasia and dysplasia of the bronchial mucosa
• Seen in habitual smokers—a risk factor for lung cancer
• Endometrial hyperplasia and dysplasia
• Seen in women with unopposed estrogenic stimulation—a risk factor for endometrial
carcinoma
Death rates and cancer incidences of specific types of cancers can vary from country to country.
• A. True
• B. False
A. True
All of the statements are true regarding cancer, except?
• A. Carcinogens only pertain to environmental toxins
• B. Cancer incidence is normally higher within individuals 55+ years of age
• C. Cancers can be associated with obesity
• D. Preneoplastic lesions involve dysplastic tissue
A. Carcinogens only pertain to environmental toxins
What are the four regulatory genes that are associated with the development of cancer?
- Genes that promote cell growth ( Proto-Oncogenes)
- Genes that inhibit growth ( Tumor Suppressor Genes)
- Genes that regulate apoptosis
- Genes that regulate DNA Repair
What is an oncogene?
Mutations of proto-oncogenes
What is the role of proto-oncogenes and tumor suppressor genes?
Proto-Oncogenes: Growth Promoting
• Group of genes that produce proteins that regulate cell growth, division, differentiation
• Ras, HER2, Cyclin D
• Mutations of proto-oncogenes are referred to as: ONCOGENES
Tumor Suppressor Genes: Growth Inhibiting
• Group of genes that slow down cell division allow for DNA repair
• p53, Rb, p21, and BRCA1/BRCA2
• Mutated p53 genes have been identified in more than one-half of all human
tumor cells
What are the two mechanisms that can alter regulatory genes?
Proto-Oncogenes: Growth Promoting
Tumor Suppressor Genes: Growth Inhibiting
How can epigenetic process influence the development?
• Changes in the way genes are switched on and off without changing the
actual DNA sequence
• No mutations
• Two types: DNA Methylation and Histone Modifications
• These changes can affect a person’s risk of disease and may be passed from
parents to their children
• How is this important?
What is the normal cell cycle and the role of the G1, G2, and metaphase checkpoints?
The role of G1, G2, and metaphase checkpoints is a stopping point to assure everything looks good. Without those checkpoints you lose the capability of actually checking to see if the DNA was replicated correctly.
Need cyclin proteins present to proceed with cell cycle steps
• Inhibit proteins that block DNA synthesis or replication from occurring
• Promote the production of proteins that are needed for mitosis
G1 Checkpoint
• Are internal/external factors good for replication
• CDK4-Cyclin D activates the Rb (retinoblastoma) protein
• When Rb is activated, it CANNOT inhibit DNA replication
G2 Checkpoint
• Was replication completed?
• Check for DNA damage
Metaphase Checkpoint
• Chromosomal attachment to spindles?
How are cyclin dependent kinases (CDK) and cyclin involved in normal cell cycle?
Cyclin Dependent Kinases (CDKs)
• Always present in an inactive form
• Need to be activated by a specific cyclin
Cyclin
• Proteins that controls the progression of a cell through the
cell cycle by activating cyclin-dependent kinase (CDK) enzymes
These two bind together to form CDK-Cyclin
molecules
• Become activated to regulate cell cycle steps
What is the importance of tumor heterogeneity and tumor progression with cancers?
Tumor Heterogeneity
• Tumor cells are actually very diverse
• Once tumor cells start to replicate, they undergo Darwinian selection
Tumor Progression
• Over a period of time tumors can become more aggressive and acquire greater malignant potential
• Basically, tumor cells evolve as they grow by immune and nonimmune
selection pressures
Genetic evolution and selection can explain two of the most main
properties of cancers:
• 1. Become more aggressive
• 2. Less responsive to therapy over time
The main role of tumor suppressor genes is to produce proteins that
regulate cell growth, division, and differentiation.
• A. True
• B. False
B. False
All of the following options are true regarding carcinogenesis, except?
• A. Epigenetics can influence regulatory gene influence
• B. Proto-oncogenes are mutated oncogenes that can lead to cancer
• C. G1 checkpoint determines if internal/external factors are present to allow for cell
replication
• D. Normal cell cycle function is dependent upon proper kinase function
B. Proto-oncogenes are mutated oncogenes that can lead to cancer
Tumor cells have the capability to evolve and become more aggressive.
• A. True
• B. False
A. True
Carcinogen
• Any cancer-producing substance; often a distinction is made between epigenetic
and genotoxic carcinogens
Epigenetics
• Altering the activity of DNA gene expression without changing the DNA sequence
Genotoxic
• Damage to the DNA changing the DNA sequence
What are the three classes of carcinogens?
• Chemicals
• Radiant energy
• Microbial agent
What are the two types of chemical carcinogens?
Direct-Acting Agents
• Require no metabolic conversion to become carcinogenic
• Can be chemotherapeutic drugs
Indirect-Acting Agents
• Chemicals that require metabolic conversion to become a carcinogen
What are the variables associate with radiant carcinogens?
Radiant energy is high intensity energy transferred by electromagnetic radiation
Source of Energy
• Ultraviolet Radiation
• X-Rays
• Nuclear Fission
• Radiation Therapy
Leads to severe DNA damage and mutations
What are viruses associated cancer infections?
• Oncogenic DNA Viruses (Four Main Types)
• Human papillomavirus (HPV)
• Epstein-Barr virus (EBV)
• Kaposi sarcoma herpesvirus (KSHV)
• Hepatitis B virus (HBV)
• Epstein-Barr Virus (EBV)
• The first virus linked to a human tumor: Burkitt lymphoma
• Discovered with the cells of a surprisingly diverse list of cancers including
various lymphomas (Hodgkin lymphoma), nasopharyngeal carcinoma, gastric carcinomas
• Causes infectious mononucleosis (mono)
• Spreads through direct contact from an infected person (bodily fluids)
Kaposi Sarcoma Herpesvirus (KSHV)
• Also known as human herpesvirus 8 (HHV8)
• Causes Kaposi sarcoma
— Cancer of the soft tissues of connective tissues
— Associated with what condition?
What is the role of human papillomavirus virus with cancer development?
Human Papillomavirus (HPV)
• Numerous strains of this virus- each having different effects on body
— Benign and Malignant tumors
• Some cause benign squamous papillomas (warts) tumors
• Others cause several cancers
— Squamous cell carcinoma of the cervix and anogenital region
• Sexual and physical contact is an ability to contract it
What are the cancers associated with the hepatitis B and C viruses?
Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV)
• Epidemiologic evidence linking chronic HBV and HCV infection with
hepatocellular carcinoma is strong
— Estimated that 70% to 85% of hepatocellular carcinomas worldwide are due to
infection with HBV or HCV
• Hepatitis B virus contraction occurs when blood, semen, or other body
fluid infected with the hepatitis B virus enters the body of someone who is
not infected
— Even a toothbrush- gross, don’t share your toothbrush
• Hepatitis C virus contraction occurs with contact of infected blood
All of the following are classified as carcinogens, except?
• A. X-Ray exposure
• B. Chemotherapeutic treatments
• C. Human papillomavirus virus (HPV)
• D. Radiation therapy
• E. All of the options are a possible source of a carcinogen
E. All of the options are a possible source of a carcinogen
This type of virus is associated with the development of liver cancer
development?
• A. Epstein-Barr Virus (EBV)
• B. Hepatitis viruses
• C. Kaposi sarcoma herpesvirus
• D. All of the above can lead to the development of liver cancer
B. Hepatitis viruses
What are the hallmark characteristics of cancer?
- Self-sufficiency in growth signals
- Insensitivity to growth-inhibitory signals
- Altered cellular metabolism
- Evasion of apoptosis
- Limitless replicative potential (immortality)
- Sustained angiogenesis
- Invasion and metastasis
- Evasion of immune surveillance
What are the two variables that can accelerate the hallmark characteristics of cancer?
• Starts with the development of genetic and
epigenetic alterations
These hallmarks can be accelerated by
• 1. Cancer Promoting Inflammation
• 2. Genomic Instability
Considered enabling characteristics
• Promote cellular transformation and
subsequent tumor progression
What are the inflammatory tumor microenvironment?
CANCER PROMOTING INFLAMMATION
• Cancer cells hijack inflammatory mechanisms to promote their own growth
and survival
• Form an Inflammatory Tumor Microenvironment (TME)
— Initiates carcinogenesis and involved with the hallmarks of cancer
What are the roles the inflammatory tumor microenvironment can have with carcinogenesis?
Inflammatory Tumor Microenvironment (TME) Leads To:
• Release of factors that promote proliferation
• Removal of growth suppressors
• Enhanced resistance to cell death
• Angiogenesis
Cancer cells can induce inflammation.
• A. True
• B. False
A. True
All of the options are outcomes of the inflammatory tumor
microenvironment (TME), except?
• A. Stimulates angiogenesis
• B. Increases growth suppressor molecules
• C. Increase tumor cells resistance to apoptosis
• D. Releases growth factors
B. Increases growth suppressor molecules
What is the association and relationship between mutations of proto-oncogenes and self-sufficiency in growth signals or factors?
Self-sufficiency in growth that characterizes cancer cells generally stems from mutations that convert proto-oncogenes to oncogenes
• Oncogenes encode proteins called oncoproteins
• Promote cell growth, even in the absence of normal growth-promoting
signals
Normal cells require stimulation by growth factors to undergo proliferation
• Various factors that can be altered that lead to cancer cells to become self-sufficient
with growth
- Growth Factors
• A) Acquire the ability to synthesize own growth factors
• B) Acquire the ability to stimulate the ECM to produce growth factors - Growth Factor Receptors
• A) Up-regulation of growth factor receptors - Downstream Signal-Transducing Proteins
• A) Mutations can lead to overactivation of secondary messenger system to stimulate growth
What is the term oncoproteins?
Oncogenes encode proteins
What is the term oncoproteins?
Oncogenes encode proteins
How can a mutation of RAS protein lead to cancer?
• Mutated RAS leads to a continuous signal to the nucleus for cell proliferation
— Despite external signals or stimuli
What are the main cancer associated with mutations in the ABL protein?
ABL
• Forms the BRC-ABL protein that activates all of the signals that are downstream of RAS
• Potent stimulator of cell growth
• Associated with Leukemia formation (NBCE loves this)
How can changes in the cyclin dependent kinases lead to cancer development?
• Mutations in genes regulating these checkpoints allow cells with damaged
DNA to divide, producing daughter cells carrying mutations
What is the role of tumor suppressor genes in normal cell function?
• Tumor suppressor genes apply brakes to cell proliferation
Tumor Suppressor Genes create antigrowth signals can
• Prevent cell proliferation by several complementary mechanisms
What is the association of tumor suppressor genes and insensitivity to growth inhibitory signals?
Two Major Tumor Suppressor Genes
• RB (Retinoblastoma) Gene: Governor of the Cell Cycle
• Produces Rb protein
• TP53 Gene: Guardian of the Galaxy Genome
• Produces the p53 protein
Two Other Well Known Tumor Suppressor Genes
• BRCA 1 (BReast CAncer gene 1)
• BRCA 2 (BReast CAncer gene 2)
• These genes help keep breast, ovarian, and other types of cells from growing and dividing too rapidly or in an uncontrolled way
What are the two major tumor suppressor genes?
• RB (Retinoblastoma) Gene: Governor of the Cell Cycle
• Produces Rb protein
• TP53 Gene: Guardian of the Galaxy Genome
• Produces the p53 protein
What is the role Rb protein has in normal cell function?
• Mutations of RB gene is found in breast cancer, small cell cancer of the lung, and bladder cancer
• Regulation of the G 1/S checkpoint- cells must pass before DNA
replication commences
— Reviews external “cues”
• Inactive form prevents cell growth by inhibiting cell cycle
progression until a cell is ready to divide
• Rb active form: hyperphosphorylated state and allows cell cycle
progress
What is the role Rb protein has in the development of cancer?
• Abnormal Rb protein- always in activated state • ALWAYS ALLOWS CELL TO PROGRESS THROUGH THE G1/S checkpoint
— Increase of cyclin-CDK complexes
— Loss of CDKIs
• HPV binds to the hyperphosphorylated state of Rb
— Preventing it it from inhibiting the E2F transcription factors
What is the role p53 protein has in normal cell function?
The p53 protein prevents neoplastic transformation by three interlocking mechanisms:
• Activation of temporary cell cycle arrest (termed quiescence)
• Induction of permanent cell cycle arrest (termed senescence)
• Triggering of programmed cell death (termed apoptosis)
• Activates DNA repair
• Arrest growth by holding the cell cycle at the G1/S regulation point on DNA damage recognition
— Gives cell time to repair itself
• Initiate apoptosis
— Irreversible DNA damage
• Initiate senescence
— Short telomeres, morphological changes
What is the role p53 protein has in the development of cancer?
Compare and contrast the terms ”governor of the cell cycle” and ”guardian of the genome”
What defines the normal function of RAS protein?
• A. It provides external stimulation of for cell proliferation
• B. Stimulates downstream signaling to stimulate the nucleus to proceed with cell proliferation
• C. It slows or even stops the cell cycle process to allow for DNA repair
• D. Receives internal cues to allow cell proliferation to continue
B. Stimulates downstream signaling to stimulate the nucleus to proceed with cell proliferation
If p53 protein is mutated, how could it lead to cancer?
• A. It could allow the cell to progress through cell proliferation with DNA damage
• B. Allows cyclin dependent kinases to stay active and lead to cell proliferation
• C. Allows the cell to undergo cell proliferation without outside signals
• D. None of the options are accurate
A. It could allow the cell to progress through cell proliferation with DNA damage
What mutated protein is associated with the development of leukemias?
• A. RAS protein
• B. Rb protein
• C. p53 protein
• D. ABL
D. ABL
What is the general hallmark characteristics of cancer discussed and how they influence carcinogenesis?
What is the Warburg effect?
What is the importance angiogenesis with carcinogenesis?
What are the steps associated with invasion and metastasis of neoplasia?
What are the importance malignant tumor characteristics, angiogenesis, and lymph nodes associated with metastasis?
How is the inflammatory tumor microenvironment associated with tumor cells evading the immune system?
Angiogenesis is a pathway for metastasis.
• A. True
• B. False
A. True
The Warburg effect is when tumor cells utilize sugar to encourage
angiogenesis.
• A. True
• B. False
B. False
Tumor cells have antigens that our immune system recognize and build
an immune response against.
• A. True
• B. False
A. True
What are the three categories associated with cancer diagnosis?
What are the characteristics associated with laboratory tests, imagining tests, and biopsies?
What is the importance of tumor markers for cancer diagnosis?
What is the mechanism, role, and importance of a positron emission tomography?
What is the various forms of a biopsy collection?
Compare and contrast the concepts of grading and staging cancer
What is the TNM system and is role in staging cancer?
Imaging scans are used to identify tumor markers.
• A. True
• B. False
B. False
Biopsies can be obtained through several different mechanisms.
• A. True
• B. False
A. True
All of the options are true regarding staging of cancer, except?
• A. It is has more clinical importance compared to grading cancer
• B. Partially depends on the extend of spreading to regional lymph nodes
• C. Focuses strictly on level of cellular differentiation
• D. Partially depends on presence of metastasis
• E. Partially depends on the level of cellular differentiation
C. Focuses strictly on level of cellular differentiation
Compare and contrast the three main types of cancer treatments
What are the main types of cancer treatments that are carcinogenic?
What are the new formats of cancer treatments mechanisms?
What are the complications and serious impacts associated with benign and malignant tumors?
What is cancer cachexia?
What is paraneoplastic syndromes?
What is the mechanism of paraneoplastic syndromes?
What is the most common paraneoplastic syndromes conditions?
What are the most common types of cancers associated with paraneoplastic syndromes?
Chemotherapy treatment can lead to the development of cancer.
• A. True
• B. False
A. True
Benign and malignant tumors can cause damage in the area of growth.
• A. True
• B. False
A. True
All of the following are true regarding paraneoplastic syndromes, except?
• A. Caused by the body’s own immune system attacking its own cells
• B. Cushing’s syndrome is a common paraneoplastic syndrome
• C. Commonly associated with bone cancers
• D. Can lead to a whole array of symptoms including difficulty walking and other fine
motor control
C. Commonly associated with bone cancers
