Neoplasia Flashcards
(39 cards)
Describe the classification & staging of cancer (the 4 stage system)
Stage 1 – confined to the organ of origin
Stage 2 – locally invasive
Stage 3 – Spread to regional structures, such as lymph nodes
Stage 4 – spread to distant sites, liver to lung, prostate to bone
Explain how bacteria & viruses can increase the chance of developing cancer
- 15-20% of tumours have a viral cause
- Link between H Pylori & gastric cancer
- Herpes virus also increases the risk of nasopharyngeal cancer
- Hepatitis B & C increase the risk of liver cancer
Explain why chronic inflammation increases the chance of developing cancer
- Cytokine release from inflammatory cells
- Free radicals
- Mutation promotion
- Decreased response to DNA damage
(Lifestyle/environmental risk factors) This factor is associated with high risk occupations that expose the individual to a variety of carcinogenic agents, such as ionizing radiation, diesel engine exhaust, asbestos, arsenic compounds, cadmium, formaldehyde, wood dust, & lead compounds.
Explain why these carcinogenic agents cause cancer
Occupational hazards
- Bladder (diesel exhaust), Bone, Esophagus, & Brain (Ionizing radiation), Colon & Lung (asbestos, arsenic compounds), Mesothelioma (covering many organs) – (Asbestos – most common in lungs), Liver (hepatitis), & breast (circadian rhythm)
(Lifestyle/environmental risk factors) Explain why a lack of physical inactivity increases cancer risk
Physical inactivity
- Increases insulin & insulin-like growth factors: Which higher insulin levels trigger rapid cell division, decreasing in DNA regulator genes which Inhibits cells from initiating steps towards cell death (apoptosis)
- Increases obesity = increased risk for cancer
- Increases inflammatory mediators & free radicals: Therefore creates cellular proliferation, genomic instability, angiogenesis, resistance to apoptosis, invasion, & metastasis
(Lifestyle/environmental risk factors) This factor is sourced from nutrient intake, such as toxic, mutagenic, and carcinogenic chemicals in food.
Provide examples of said factor.
Diet
- High fat content, preservatives, smoked, & low fibre foods.
- Chemicals found in tobacco smoke, plastic, refined flour & sugars
(Lifestyle/environmental risk factors) This factor primarily comes from sunlight & promotes skin inflammation & the release of free radicals
What does it cause? (3 main types of malignant skin lessions)
Ultraviolet radiation
- Causes basal cell carcinoma, squamous cell carcinoma, & melanoma
(Lifestyle/environmental risk factors) This factor has enough energy to damage DNA & cause cancer (gene mutation). With exposure causing cell death, gene mutations, & chromosome aberrations.
Provide examples of sources of this kind of factor
Ionizing radiation
- Emission from x-rays, radioisotopes, and other radioactive sources
(Lifestyle/environmental risk factors) This term refers to sexual promiscuity, and how it increases the chance of developing cancer.
List & describe the 3 examples where this behaviour can be detrimental
Sexual reproductive behaviour
- Age of first sexual intercourse: Before the age of puberty increases the risk, since the cervix is changing in puberty & more vulnerable to damage
- Having multiple sexual partners increased risk of exposure to carcinogenic types of human papillomavirus (hpv) & also increased chance of STIs
- Late age of first pregnancy or no pregnancy: Since breast cells don’t fully mature until the first pregnancy (in no pregnancy) & cells take longer to fully mature increasing chance of cancer (in late age)
(Lifestyle/environmental risk factors) The consumption & then subsequent metabolism of this drug creates a toxic chemical called acetaldehyde, which is a human carcinogen, that damages the DNA & protein
State the areas in the body at risk for developing cancer due to the consumption of this drug
Alcohol consumption
- Risk factor for oral cavity, pharynx, hypopharynx, larynx, esophagus, liver, breast, & colorectal cancers
What are some biological risk factors for developing cancers?
Age: Since the median age for cancer diagnosis is 66 years
Hereditary: Born with a gene mutation that may make you more likely to develop certain cancers (5-10% of cancers are hereditary). Most common is colorectal cancer, such as lynch syndrome, which can develop noncancerous polyps, & may develop into cancer. Down syndrome – more likely to develop acute lymphocytic leukemia
Hormones: Post menopausal women taking hormone replacement therapy are at an increased risk of developing breast cancer, since estrogen promotes growth in breast & uterus
(Clinical manifestations of cancer) The majority of patients with advanced cancer present with a multiple of symptoms of this syndrome, including, anorexia, early satiety, weight loss, asthenia (physical weakness), taste alterations, & altered protein, lipid, & carbohydrate metabolism. What is this term called?
Cancer Anorexia-Cachexia syndrome
(Clinical manifestations of cancer) Which term refers to the most significant complication and cause of death in people with a malignant disease, since malignancies are immunosuppressive?
List & describe the 3 variables that increase the rate of said term
Risk of infection (infection)
- Age: Older people have decreases immune function & inadequate nutrition
- Tumours: Depends on the type & location
- Surgical treatment/hospitalizations: Tissue removal = dead spaces, thus poor tissue perfusion causing infection & also greater risk of hospital acquired infections
(Clinical manifestations of cancer) Which term refers to a decrease of hemoglobin in the blood?
Describe the mechanisms that cause this manifestation, including:
- Chronic bleeding resulting in iron deficiency
- Severe malnutrition
- Cytotoxic chemotherapy
- Malignancy in blood-forming organs
Anemia
- Colorectal & genitourinary malignancy
- Gastric, pancreatic, or upper intestinal cancer = malabsorbed iron
- methotrexate treatments can cause large red cell anemia, called megaloblastic anemia, large RBC, but fewer – RBCs aren’t produced properly
- Bone marrow primarily, also the thymus, spleen & lymph nodes (lymphocyte production)
(Clinical manifestations of cancer)
Which term refers to decreased WBC count ?
Which term refers to direct invasion of bone marrow?
Which term refers to a lack of granulocytes - innate immune system
Which term refers to a decrease in platelets, where the tumour is invading bone marrow or our treatment with chemotherapy?
- Leukopenia
- Leukemia
- Granulocytopenia
- Thrombocytopenia
(Clinical manifestations of cancer) What is the #1 manifestation of cancer, characterized by less energy, weakness, depression tiredness, exhaustion, lethargy, inability to concentrate, sleepiness, boredom, and lack of motivation?
& what are some potential causes?
Fatigue
- Sleep disturbance, biochemical changes from circulating cytokines, secondary to disease and treatment, psychosocial factors, level of activity, nutritional status, & environmental factors
(Clinical manifestations of cancer) Little or no __ is associated with early stages of malignancy(cancer).
List the mechanisms that are responsible for this clinical manifestation
& what is can be influenced by as well
Pressure, obstruction, invasion of sensitive structures, stretching of visceral surfaces, tissue destruction, & inflammation
Influenced by fear, anxiety, sleep loss, fatigue, depression, & overall physical deterioration
Explain how cancers invade genes that control cell growth, replication & repair
Cancer cells have the ability to evade growth suppressors – there is an inactivation of tumour suppressor genes (growth factor brakes). As tumour-suppressor genes are inactivated, Oncogenes are activated in cancer (accelerators). Angiogenesis-promoting genes – stimulates the process of new vessel formation – creating its own blood supply (tumour)
How do cancers develop? & name & describe the characteristics of cancer cells
- There has a been a mutation in the genes that control growth/replication/repair
- Anaplasia: Poor cellular differentiation – losing the characteristics of the mature cells – advanced dysplasia – not reversible. They are primitive, and don’t wait until they mature
- Autonomy: independent, not following any normal rules, not regulated by normal physiological influences – no internal control for normal apoptosis, nor will it stop its growth when it butts up against another cell.
Describe the progression of cancer
– Change our terminology as we progress – but progression is not always from mutation to invasive cancer at the hyperplasia & dysplasia stage it can be reversed
– Cancer in situ are in epithelial cells – precancerous state – the cell growth is closely monitored – cervical cancer – repeated pap smear test to assess. Early stage they have not become invasive – not considered malignant. Seen in cervix, mouth, stomach, breast and large bowel
How are benign & malignant skin tumours differentiated?
Malignant skin tumours are asymmetrical, have disoganized borders, have diff colours, a larger diameter than 6mm, & is constantly evolving in size, shape, elevation, or colour
List the differences between benign & malignant tumours
Benign – named after location. Cells well differentiated, grows slowly, encapsulated, local effects, not invasive, & does not metastasize
Malignant – named after type of cell. Poorly differentiated, grows rapidly, non-encapsulated, generalized effects, greek word karkinoma for crab formation – ‘claw’ like formation that reach into other tissues
What are the 2 most common forms of cancers called?
Provide their description & their location
Sarcoma: Rising from mesenchymal, which grows in connective tissues, such as lymphatic, circulatory & musculoskeletal systems
Carcinoma: Rising from epithelial tissue , which grows in skin or tissue cells that line the body’s internal organs, such as the kidneys and liver
Malignant cells have 2 characteristics, what are they called & what doe they mean?
Anaplasia – loss of cellular differentiation
Pleomorphic – variability of size & shape
