Neoplasia Flashcards
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
Name the 2 states that neoplasia occurs in & provide a description of each
Also provide examples if possible
- Benign: Which is a non-invasive, well-differentiated, well organized, & they are also encapsulated. Named for tissues where they arise e.g. lipoma is tumour of fat cells. & can become life threatening depending on the location
- Malignant: Proliferate rapid growth, loss of differentiation – not anymore similar to the original tissue – (very disorganized) absence of normal tissue organization, lack a capsule and grow to invade neighbouring tissues & even get into lymph or blood circulation and spread throughout our body
Which term refers to pre-invasive epithelial tumours: which are a group of abnormal cells that are found only in the place where they first formed in the body?
Carcinoma in Situ (CIS)
- These abnormal cells may become cancer and spread to nearby normal tissue, or can remain stable, & egress & disappear
How is metaplasia caused by chronic injury or irritation? & provide an example.
Metaplasia is reprogramming of stem cells in response to signals generated from cell’s environment – best example is the effect smoking has on the airway. Normal cells are replaced over time with squamous epithelial cells – don’t operate the same as original cells – if the person stops smoking the metaplasia can be reversed – if they don’t it can progress to dysplasia and cancer
What are some examples of pathological & physiological hyperplasia?
Physiological: There is a compensatory adaptive mechanism that allows for regeneration (e.g. in liver donation it grows back). Then there is a hormonal mechanism, where the endometrium thickens in anticipation of pregnancy, such a hyperplasia in the epithelial cells of the uterus
- Pathologically: Abnormal proliferation of normal cells, such as in heavy menstrual bleeding & enlargement of prostrate as the result of a hormonal imbalance
What are some examples of pathological & physiological hypertrophy?
Physiological: skeletal muscle due to exercise, uterus in pregnancy, kidneys when the body only has one kidney due to -disease, donation, injury - so the remaining kidney hypertrophies to accommodate
- Pathological: Extended period of time can lead to pathological hypertrophy, such as left ventricular hypertrophy
How can atrophy be caused pathologically & physiologically?
Pathologically: Decreases in workload (altered demand), decrease in blood supply & nutrition, decrease hormonal stimulation & decrease in/ lack of nervous system stimulation, pressure, & can also be due to neurological problems
Physiologically: Through not using skeletal muscles
Which term refers to Uncontrolled, abnormal growth of cells or tissues in the body?
Neoplasia
Which term refers to the presence of abnormal cells within a tissue or organ or the abnormal size, shape, and organization of cells? (also called an atypical hyperplasia) & provide an example of this occurring in the cervix
Dysplasia
- Cervical dysplasia is the abnormal growth of cells on the surface of the cervix. Considered a precancerous due to sexually transmitted infection (Human Papillomavirus (HPV).
Which term refers to the conversion of one adult tissue type into another, related and more durable, tissue type? The most prevalent examples areconversion of fibrous tissue into bone
Metaplasia
Which term refers to an increase in the number of cells in an organ or tissue?
Hyperplasia
Which term refers to an increase of cell size , common to think about increases in skeletal muscles (e.g. as a result of working out)
- Hypertrophy
Which term refers to a decreasing of cell size, not cell numbers, leading to a decrease in the size of the organ?
- Atrophy
What are some examples of cellular adaptations? & examples of non-adaptive ones?
- Atrophy, hypertrophy, hyperplasia, metaplasia
- Dysplasia & neoplasia
Which term refers to reversible functional and structural responses to physiologic stress and some pathogenic stimuli?
Cellular adaptation
A - …means
Troph - …means
- plasia … means
Dys - … means
Meta - … means
Neo - … means
- Without
- Nourishment
- Growth/ formation
- Disordered
- Beyond
- New
