neoplasia

Question 1

what type of neoplasia has an increased mitotic index

Answer 1

malignant

Question 2

define neoplasia

Answer 2

abnormal (excessive) cell growth and differentiation

Question 3

define neoplasm

Answer 3

an abnormal mass (tumor)

can be malignant or benign

Question 4

characteristics of malignant neoplasms

Answer 4

• undifferentiated cells (anaplasia)
• rapid, variable growth rate
• growth by invasion, infiltration of surrounding tissue
• metastasis

Question 5

characteristics of benign neoplasms

Answer 5

• well-differentiated
• slower growth rate, may stop or regress
• growth by expansion (doesn’t invade)
• usually encapsulated
• does not metastasize

Question 6

genes code for what

Answer 6

proteins, which have a function and do tasks

Question 7

DNA repair genes

Answer 7

• “spell check” genes
• continuously read genetic code looking for errors (insertion/deletion/substitution) and deletes mistake
• fixes the problem now instead of removing the cell later

Question 8

why do carcinogens target DNA repair genes

Answer 8

allows mutations to pass through

Question 9

what are the cancer associated genes

Answer 9

• proto-oncogenes (go)

- tumor suppressor genes (stop)

Question 10

proto-oncogenes

Answer 10

• go genes = promote cell growth

- mutation = excessive cell growth = tumors

Question 11

tumor suppressor genes

Answer 11

• stop genes = inhibit cell growth
• mutation = excessive cell growth = tumors
• ex. TP53

Question 12

what are oncogenes

Answer 12

any mutated cancer associated gene

Question 13

suffix for a benign tumor

Answer 13

oma

Question 14

suffix’s for malignant tumors

Answer 14

carcinoma

sarcoma

Question 15

carcinoma refers to

Answer 15

arising from the epithelial tissue

Question 16

sarcoma refers to

Answer 16

arising from mesenchyme origins (non-epithelial)

mesenchyme = embryonic tissue (present only in embryo)

Question 17

how long does it take for a tumor to double

Answer 17

120 days (4 months)

Question 18

how long does it take for a tumor to be clinically detectable

Answer 18

10 years

= 30 doublings, 1 cm in size, 1 billion cells

Question 19

the size of a tumor is directly related to what

Answer 19

the number of cells

Question 20

what does the TP53 gene code for

Answer 20

apoptosis of cells with DNA damage

Question 21

50% of cancers have what mutated gene and what does it cause

Answer 21

TP53

increased survival of DNA damaged cells

Question 22

methods of tumor spreading

Answer 22

• local = invasion of surrounding tissue
• seeding = distant spread within body cavities
• metastasis = distant spread through blood/lymph

Question 23

what is a primary site?

Answer 23

where the tumor first formed

Question 24

what is a secondary site? most common secondary site?

Answer 24

where the CA cells spread to and proliferate 
lymphatic tissue (lymph nodes)

Question 25

sentinel lymph node

Answer 25

first lymph node affected by cancerous cells

Question 26

after the secondary site, where do malignant cells usually travel to

Answer 26

liver, lungs, bones, brain

Question 27

stage 1 of metastasis

Answer 27

• cells invade local tissue aided by enzymes that break up cementing material between cells
• malignant cells enter blood/lymph (emboli)
• 1/1000 cells survive defenses (blood turbulance makes it easier by dislodging them), survival aided by platelets that cover/protect them

Question 28

stage 2 of metastasis

Answer 28

• cells travel until they reach an area of resistance (capillary beds)
• mediators (cytokines) scout and determine suitability of secondary site
• cells attach and proliferate (aided by cytokines and growth factor)

Question 29

what determines suitability of a secondary site

Answer 29

• resources for growth and division
• protection from defenses
• room to grow

Question 30

stage 3 of metastasis

Answer 30

• cell proliferation and angiogenesis

- requires resources (nutrients, energy, waste removal)

Question 31

grading of tumors

Answer 31

I to IV
I = restrictive growth, IV = extensive growth
subjective, based on histology
higher grade = more anaplasia (worse outcome)

Question 32

staging of tumors

Answer 32

TNM
T: 0-4 (size/measurement)
N: 0-3 (degree of lymph node involvement)
M: 0-1 (metastasis - spread to secondary site)
objective, clinical approach, global system

Question 33

T1N0M0

Answer 33

small tumor, no lymph node involvement, no metastasis

Question 34

T4N3M1

Answer 34

large tumor, many lymph nodes involved, metastases

Question 35

treatment of cancer

Answer 35

• surgery
• radiation
• chemotherapy
• immunotherapy
• hormone therapy
• combination therapy

Question 36

when can a tumor be surgically removed

Answer 36

• it must be restricted in growth and well defined
• not effective for advanced malignancy (multiple sites)
• direct, least SE

Question 37

why is radiation used for tumor treatment

Answer 37

• tumor cells proliferate uncontrollably, radiation prevents this by creating free radicals that destroy cells and disrupt/prevent DNA replication
• problem: also kills and prevents division of normal cells

Question 38

what does chemotherapy target

Answer 38

cell proliferation - rapidly growing cells

DNA, RNA, enzymes and protein synthesis

Question 39

what does immunotherapy do

Answer 39

• stimulates the immune system to target malignant cells
• CA cell destruction via cytokines, Ab, Ag
• ex. provide Ag that resembles malignant cells

Question 40

what does hormone therapy do

Answer 40

• disrupts hormonal supply that feeds the tumor

- disrupts cell fx

Question 41

what is combination therapy used for

Answer 41

advanced disease or difficult to cure CA

Question 42

problems with cancer treatment

Answer 42

• pressing side effects
• hard to restrict malignant cells
• normal rapidly proliferating cells also targetted
• recurrence of growth, despite previous cure