neoplasms

Question 1

What is cancer?

Answer 1

• 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

Question 2

Cancer Stats

Answer 2

• 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%

Question 3

What is Invasive Growth

Answer 3

• Cancer cells are able to invade into adjacent tissues and grow into adjacent tissues.

Question 4

Differentiation

Answer 4

• an orderly process in which proliferating cells are transformed to different and specialized cell types
• for example hepatic cells, muscle cells, etc.

Question 5

Apoptosis

Answer 5

• the normal “programmed” death of cells

Question 6

Stem Cells: Why So Special?

Answer 6

• 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.

Question 7

Mode of growth for benign and malignant

Answer 7

• 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.

Question 8

Metastasis

Answer 8

• Benign tumors do not spread by metastasis; malignant tumors have that capability

Question 9

Barrett’s esophagus

Answer 9

Pre-cursor to cancer

Question 10

poorly differentiated

Answer 10

malignant

Question 11

well differentiated

Answer 11

benign

Question 12

metaplasia

Answer 12

Chronic injury or irritation

abnormal change in the nature of a tissue.

Question 13

dysplasia

Answer 13

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.

Question 14

Carcinogenesis

Answer 14

Carcinogen that induces a genetic or cellular change (mutation) that starts process of carcinogen production

Question 15

Angiogenesis

Answer 15

Tumor causing new blood vessels to be produced to enhance the growth of the tumor

Question 16

6 hall marks of cancer

• Gene mutations cause (or allow):

Answer 16

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

Question 17

1 type of cancer

Answer 17

Skin cancer

Question 18

cell inhibition

Answer 18

• when cells touch other cells, they are inhibited from further growth. Cancer cells, however, disregard this normal function and “crowd out” normal cells.

Question 19

Cancer Associated Genes

Answer 19

• 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.

Question 20

Cell differentiation is usually an ______ ______; in cancer the cells can revert back to an __________ state.

Answer 20

orderly process

undifferentiated

Question 21

Proliferation of cells becomes _______ (not faster) and we refer to time it takes to double tumor size.

Answer 21

continuous

Question 22

Anatomic Classifications of cancer (4)

Answer 22

• Carcinomas – origin in epithelial, mucosal tissues
• Sarcomas – origin in bone, muscle, nerve
• Adenocarcinomas (adeno = glandular); also, lymphoma, melanoma
• Histologic Classification
  grade 1 - 4

Question 23

Most common sites (males):

Answer 23

• Prostate, lung, colorectal (colon and rectal)

common site doesnt mean common death

Question 24

Most common sites (females):

Answer 24

• breast, lung, colorectal

common site doesnt mean common death

Question 25

Early Warning Signs (American Cancer Society)

Answer 25

- 1. Unusual bleeding/discharge - 2. A sore that does not heal - 3. Change in bowel or bladder habits - 4. Nagging cough or hoarseness - 5. Lump in breast or other part of the body - 6. Obvious change in moles 7. Difficulty in swallowing

Question 26

TNM

Answer 26

Tumor Nodes Metastasis

Question 27

“carcinoma in situ”

Answer 27

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

Question 28

Stage and Grade of Cancer definitions

Answer 28

- 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

Question 29

Host and Environmental Factors

Answer 29

- Heredity - Hormonal factors – estrogen/androgen - Immunologic - AIDS related; Kaposi’s Sarcoma - Environmental/ chemical carcinogens - Oncogenic viruses (example, HPV)

Question 30

Systemic Manifestations of Most Solid Tumors | (you can see the tumor unlike blood)

Answer 30

- 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

Question 31

Diagnostics

Answer 31

- 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).

Question 32

3 Cancer treatments

Answer 32

- surgery - radiation - chemotherapy

Question 33

Radiation with side effects

Answer 33

- 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

Question 34

Chemotherapy with side effects

Answer 34

- 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);

Question 35

- Four Major Classifications of anticancer drugs:

Answer 35

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

Question 36

Why do you use different methods of cancer treatment at once?

Answer 36

To target different stages of the cell cycle