neoplasms Flashcards
What is cancer?
- Cancer refers to a group of disorders and not a single disease. (more than 200 diseases)
- Cancer is a malignant tumor that will spread into adjacent tumors and eventually metastasis if not destroyed
Cancer Stats
- 76% of cases dx after age 55
- Cancer incidence is higher in males
- 2nd most common cause of death in US
- Cancer incidence and death rates highest in AA
- 5-year survival rate overall is 65%
What is Invasive Growth
- Cancer cells are able to invade into adjacent tissues and grow into adjacent tissues.
Differentiation
- an orderly process in which proliferating cells are transformed to different and specialized cell types
- for example hepatic cells, muscle cells, etc.
Apoptosis
- the normal “programmed” death of cells
Stem Cells: Why So Special?
- Stem cells are cells that remain incompletely differentiated throughout their lifetime.
- They can be thought of as “reserve cells” – quiescent until there is a need for proliferation.
- Stem cells have 2 important features: self-renewal and potency.
- Stem cells have a potential for treatment of a variety of health problems, including cancer.
Mode of growth for benign and malignant
- malignant tissues can invade other tissues, as well as the lymphatic system and the bloodstream.
- Benign tumors do not invade other tissues, they grow by expansion and are usually encapsulated.
Metastasis
- Benign tumors do not spread by metastasis; malignant tumors have that capability
Barrett’s esophagus
Pre-cursor to cancer
poorly differentiated
malignant
well differentiated
benign
metaplasia
Chronic injury or irritation
abnormal change in the nature of a tissue.
dysplasia
persistent cellular injury or irritation
the presence of cells of an abnormal type within a tissue, which may signify a stage preceding the development of cancer.
Carcinogenesis
Carcinogen that induces a genetic or cellular change (mutation) that starts process of carcinogen production
Angiogenesis
Tumor causing new blood vessels to be produced to enhance the growth of the tumor
6 hall marks of cancer
- Gene mutations cause (or allow):
1) Self- sufficiency in growth signals
2) Insensitivity to anti-growth signals
3) Evading apoptosis (evading “self-destruct”)
4) Limitless replication potential
5) Sustained angiogenesis
6) Tissue invasion and metastasis
1 type of cancer
Skin cancer
cell inhibition
- when cells touch other cells, they are inhibited from further growth. Cancer cells, however, disregard this normal function and “crowd out” normal cells.
Cancer Associated Genes
- Proto-oncogenes - normal genes that become cancer-causing if mutated. They encode for growth factors.
- Chromosomal translocations - are associated with Burkitt lymphoma and chronic myelogenous leukemia
- Gene amplification - multiple copies of the same gene can occur in one type of breast cancer.
Cell differentiation is usually an ______ ______; in cancer the cells can revert back to an __________ state.
orderly process
undifferentiated
Proliferation of cells becomes _______ (not faster) and we refer to time it takes to double tumor size.
continuous
Anatomic Classifications of cancer (4)
- Carcinomas – origin in epithelial, mucosal tissues
- Sarcomas – origin in bone, muscle, nerve
- Adenocarcinomas (adeno = glandular); also, lymphoma, melanoma
- Histologic Classification
grade 1 - 4
Most common sites (males):
- Prostate, lung, colorectal (colon and rectal)
common site doesnt mean common death
Most common sites (females):
- breast, lung, colorectal
common site doesnt mean common death
Early Warning Signs (American Cancer Society)
- Unusual bleeding/discharge
- A sore that does not heal
- Change in bowel or bladder habits
- Nagging cough or hoarseness
- Lump in breast or other part of the body
- Obvious change in moles
- Difficulty in swallowing
- Obvious change in moles
TNM
Tumor
Nodes
Metastasis
“carcinoma in situ”
An early stage cancer in which the cancerous growth or tumor is still confined to the site from which it started, and has not spread to surrounding tissue or other organs in the body
Stage and Grade of Cancer definitions
- Stage – how small, or large, is the tumor and has it spread?
Grade – pathologist determines from tissue slides – how abnormal are the cells? Grade 1 through 4. Low grade = slow growth, less aggressive. High grade = rapid growth, very poorly differentiated
Host and Environmental Factors
- Heredity
- Hormonal factors – estrogen/androgen
- Immunologic - AIDS related; Kaposi’s Sarcoma
- Environmental/ chemical carcinogens
- Oncogenic viruses (example, HPV)
Systemic Manifestations of Most Solid Tumors
(you can see the tumor unlike blood)
- Anemia
- Anorexia and cachexia
- Fatigue and sleep disorders
- Compression or obstruction of tissues/organs
- Pain (not usually an early symptom)
- Psychosocial integrity/ quality of life
Diagnostics
- Tissue biopsy – (essential!)
- Xrays, CT scans, endoscopies, etc
- Determination of Stage and Grade
- Tumor markers – useful in some types of cancer, primarily as monitors of progression or regression of the tumor. Examples: CEA (colon, pancreas, breast, etc), CA-125 (ovarian CA), PSA (prostate Cancer).
3 Cancer treatments
- surgery
- radiation
- chemotherapy
Radiation
with side effects
- A commonly used treatment, can be used alone or as adjuvant treatment with surgery, chemotherapy or both
- Can be used as palliative Rx
- Side effects of radiation include: Primary systemic effect is fatigue; others depend on where the source of radiation is being directed: xerostomia,bone marrow suppression, skin burns, hair loss
Chemotherapy
with side effects
- They are most effective against rapidly proliferating cells.
- Side effects are usually on normal cells that are also rapidly dividing, e.g. hair loss, bone marrow suppression, anorexia, nausea & vomiting (GI cells rapidly divide);
- Four Major Classifications of anticancer drugs:
o 1. Cytotoxic agents- kill cells directly
o 2. Hormones and hormone antagonists
o 3. Biological response modifiers- immunomodulators
o 4. Targeted drugs- bind to specific molecules (target) that promote cancer growth
Why do you use different methods of cancer treatment at once?
To target different stages of the cell cycle
