Neoplasms Flashcards
Neoplasia
New Growth or Tumor
Solid Tumors
Carcinoma - Epithelial tissue
Adenocarcinoma - Glandular tissue (lung, colon cancer)
Sarcoma - Connective or supportive tissue (osteosarcoma = bone cancer)
Hematologic Malignancies
Liquid Tumors - Liquid or blood cancers
Leukemia
Lymphoma (Hodgkin, non-hodgkin)
Myeloma - Originates in bone marrow
Carcinogen
Physical - Radiation/UV
Chemical - Asbestos, arsenic, benzene, ethylene oxide, tobacco smoke
Viruses - HPV, HIV, Flaviviruses, Retroviruses
Cancer Causing Factors
Host factors - genetics, obesity, aging, lifestyle
Environmental Factors - Pollution, smoking, alcohol, occupational exposure
Pro-oncogene
Genes that code for proteins involved in normal cell growth.
When mutated, enable cancer cell to grow uncontrollably
Tumor Suppressor Gene
Normally help control cell proliferation
When mutated, genes no longer suppress proliferation
(BRCA1 & 2)
DNA Repair Genes
Allow cell to repair DNA damage
5 pathways during each stage of cell cycle
If not corrected can lead to mutation that leads to cancer formation (BRCA1)
Epigenetic Changes
Mechanism that alters the physical structure of DNA
May change the activity of a gene without changing the sequence of DNA
Normally, tells genes when to turn on or off.
Newer area of cancer research.
Chromosome Translocation
Occurs when one piece of a chromosome moves to another chromosome.
This genetic alteration activates an oncogene (mutated gene that has potential to cause cancer).
Genetic Instability
Defective mechanisms that lead to increased rate of genetic alterations
Clonal evolution of tumor cells
Classic sign of cancer
Inflammation
Enhances the process of carcinogenesis
Pleiomorphism
Cells in various shapes and sizes
Cancer cell characteristic.
Hyperchromatism
Nuclear chromatin more pronounced with staining
Cancer cell characteristic
Polymorphism
Nucleus enlarges and variable in shape
Cancer cell characteristic
Abnormal Chromosome Arrangements
Translocations - exchange of chromosomal material
Deletions - Loss of chromosome segment
Amplification - Increased number of copies of a DNA sequence
Aneuploidy - Abnormal number of chromosomes
Cellular Differentiation and Grading
Grade 1 - well-differentiated (low grade)
Grade 2 - Moderate differentiated or intermediate grade
Grade 3 - Poorly differentiated or high grade
Grade 4 - Undifferentiated or unable to tell where cell came from
Anaplasia
Lack of cell differentiation
Normal vs. Malignant Cell Differences
Shape: Well circumscribed vs pleiomorphic (different shapes/sizes)
Cell cohesiveness: Likes to stay with others in an organ vs move to other sites
Controlled growth: Don’t make cells if don’t need to vs make more cells even without need (tumors)
Well differentiated: Look like parent cell vs doesn’t (grading)
Mortal: Designated life span vs no apoptosis.
Metastasis
Spread of cancer cells from original site.
Spreads via bloodstream or lymphatic system.
Symptoms of metastatic disease: Shortness of breath, pain, headache, seizures
Clinical Manifestations of Cancer
Anorexia, bleeding, immunosuppression, infections, weight loss, fatigue, pain, sleep disorders.
Paraneopastic Syndrome
Paraneoplastic Syndromes
Caused by cancer
May be presenting sign
Types: Syndrome of inappropriate anti diuretic hormone (SIADH), cushing’s, HYPERCALCEMIA, venous thrombosis
Treatments of Cancer
Surgery
Radiation Therapy
Chemo Therapy
Targeted Therapy/Biotherapy
Immunotherapy
Chemotherapy
Systemic Therapy, works at cellular level on cells.
Some drugs are cell cycle specific while others are not.
Toxicities and adverse effects based on its effect on particular cells.
Drugs grouped into classes based on cellular activity and pharm properties specific to cancer being treated.
Biotherapy/Immunotherapy
Use of natural and manufactured substances derived from the body to: Stimulate or restore the ability of the immune system, use antibodies to fight cancer, change or modify relationship between cancer and host.
Targeted therapy - Blocks specific receptor, attaches to receptor to assist immune cells to kill caner, carries chemotherapy into cell.
Immunotherapy - helps effector cells in body become activated or enhanced, targeted cancer cell death
Neoadjuvant Therapy
Treatment prior to primary therapy to shrink tumor
Adjuvant Therapy
Follows primary treatment. Goal to target minimal disease or micro metastasis
Conditioning or Preparative Therapy
Empty marrow space prior to transplant or to eliminate residual disease
Immunosuppression
To blunt immune response.
Goals of Cancer Therapy
Prevention
Cure
Control
Palliation - Relief of symptoms
