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Clin Med 2 > Oncology 6 > Flashcards

Oncology 6 Flashcards

1
Q

What are some of the ways metastases can occur?

A
  • bloodstream (hematogenous or vascular)
  • lymphatics
  • direct extension into neighboring tissues
  • resection of tumors without clear margins
  • benign mechanical transport
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2
Q

What is a skip metastasis?

A
  • bypass local lymph

- form distant nodal metastases

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3
Q

Direct extension into neighboring tissues: How does metastasis occur with local invasion?

A
  • local invasion and tumor angiogenesis
  • venous drainage and further spread via metastatic cascade
  • skip metastasis
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4
Q

Patterns of these determine common metastatic patterns

A
  • regional venous drainage
  • blood flow
  • lymphatics
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5
Q

How does breast cancer metastasize?

A

spreads via lymphatics and vertebral venous system to bones in:

  • shoulder
  • hip
  • ribs
  • vertebrae
  • lungs
  • liver
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6
Q

How might resection of tumors without clear margins encourage metastasis?

A

new blood vessels form during healing process

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7
Q

Why does something like breast massage (benign mechanical transport) cause metastasis?

A
  • assisted sentinel lymph node (SLN) localization

- can cause a cell to get loose and metastasize

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8
Q

What steps are required for metastasis of cancer cells?

A
  • Spread of tumor within the tissue of origin through local invasion
  • spread into micro-vasculature by intravasation
  • circulate through vasculature before being trapped in the microvasculature of other organs
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9
Q

What is it called when tumor cells exit the blood vessel to other organs and form a secondary tumor? (not metastasis)

A

extravasation

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10
Q

Boundaries: Every normal tissue has boundaries. How do benign tumors act with boundaries?

A
  • don’t cross them

- press against only

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11
Q

Boundaries: How do malignant tumors behave?

A

They have boundary issues. Spread and invade healthy tissue

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12
Q

What must a metastasizing cell do in new environment?

A

Must have adaptation of its cellular membrane proteins

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13
Q

Why does differentiation impact metastasis?

A

If it’s poorly differentiated, it can easily adapt in another location of the body

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14
Q

What is selective metastasis?

A

Metastasis occurs in some tissues but not others in certain cancers

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15
Q

What is explanation for selective metastasis?

A

Certain cellular environments are conducive to particular tumor growth and others aren’t.

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16
Q

How does a cancer cell change to adapt?

A
  • Uses intercellular signaling

- Changes from one configuration to another in different environments

17
Q

What is the Hayflick limit?

A

Aside from being programmed to die, all cells have a limit to how many times they can divide before they can’t divide anymore

18
Q

Normal human fetal cells in a cell culture divide this many times

A

between 40-60x

19
Q

Once cells reach their limits of division, they enter this phase

A

Enter a senescence phase and stop

20
Q

Cell reproduction decreases with

A

physical age

21
Q

Each mitosis causes shortening of these

A

telomeres on the DNA

22
Q

Telomeres and aging

A
  • telomere shortening makes cell division impossible

- correlates with aging

23
Q

Cancer cells: immortal division

A

Have unlimited dividing potential

  • they never stop
  • they are true immortal cells
24
Q

What is a telomere?

A
  • region of repetitive DNA sequences at the end of a chromosome
  • disposable buffers blocking chromosome ends
25
Q

Telomeres are consumed during

A

cell division

26
Q

What would happen without telomeres?

A

cells would lose the ends of their chromosomes during division and the info they contain

27
Q

Telomeres protect the ends of the chromosome from:

A
  • deterioration

- fusion with neighboring chromosomes

28
Q

What replenishes telomeres?

A

TERT (telomerase reverse transcriptase)

29
Q

Why is TERT important in normal cells?

A

needed to extend lifespans of certain cells (i.e. fetal stem cells)

30
Q

TERT activation and cancer

A

TERT activation observed in more than 90% of all human tumors

31
Q

TERT is part of the reason for this (hallmark)

A

limitless reproductive potential

32
Q

What are the two main points that contribute to unlimited reproductive potential?

A
  • loss of cell cycle checkpoints

- TERT

Clin Med 2 (78 decks)

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