Oncology: Intro And Pathology Flashcards
What is cancer?
A group of diseases characterized by controlled cell proliferation and spread of abnormal cells
Non functioning cells taking up space
What is a benign neoplasm/tumor?
Differentiated cells encapsulated in one area with a high rate of growth
Does a benign tumor spread?
Not usually
Even though they don’t spread, how may benign tumors cause issues?
Bu compressing on other tissues
What is a malignant neoplasm/tumor?
Cancer with undifferentiated cells that are unencapsulated and grow uncontrollably
Do malignant tumors spread?
They can
What is the definition of differentiation?
Development of cells from stem cells to specialized cells
What is the definition of hyperplasia?
Increase in the number of normal cells
What is the definition of metaplasia?
First stage of dysplasia where one cell is transformed to a different cell
What is the definition of dysplasia?
Disorganization of cells that can be reversible
What is the definition of a tumor?
Abnormal new growth with no useful purpose
What is the second leading cause of death behind heart disease?
Cancer
What are the top 4 cancers in the US?
Breast
Prostate
Lung/bronchus
Colon/rectum
What are the most common CAs to cause death?
Lung/bronchus
Colon/rectum
Pancreas
Breast
Prostate
T/f: the etiology of CA is likely multifactorial?
True
What are common risk factors for CA?
Non modifiable factors like age, heredity, gender, ethnicity
Behaviors such as smoking, drinking, obesity, inactivity, diet, unsafe sex
Virus exposure
Related disease
Lifestyle (pollution, indoor smoke, occupation, SES)
What are non modifiable risk factors for CA?
AGE
Heredity
Gender
Ethnicity
What are behavioral risk factors for CA?
Smoking, drinking, obesity, inactivity, diet/nutrition, unsafe sex
What behavior risk factors are significant factors in the most common cancers?
Tobacco, alcohol, and obesity
What is the #1 cancer worldwide?
Lung cancer
How can we classify cancers?
Based on cell type, tissue of origin, deg of differentiation, anatomic site, whether it is benign or malignant
When tumors are classified based in cell type, they are named according to what?
According to the tissue from which the arise
What tissues do solid tumors come from?
Epithelial
Connective tissues
Nerve
What tissues do liquid tumors come from?
Lymphoid
Hematopoietic tissue
-sarcomas are generally ____ and -omas are generally _____
Malignant, benign
What stage of cancer has the best prognosis? Worst?
Best px: stage 0 (carcinoma in situ)
Worst px: stage 4 (distant metastasis)
What is stage 0 cancer?
Carcinoma in situ (located in one place and hasn’t moved)
What is stage 1 cancer?
Local to the primary tissue
What is stage 2 cancer?
High risk of regional spread
What is stage 3 cancer?
Regional spread
What is stage 4 cancer?
Distant metastasis
In the TNM tumor grading system, what does T mean?
Primary tumor
In the TNM tumor grading system, what does N mean?
Regional lymph node involvement
In the TNM tumor grading system, what does M mean?
Distant metastasis
In the TNM tumor grading system, what does Tx mean?
Primary tumor can’t be assessed
In the TNM tumor grading system, what does T0 mean?
No evidence of primary tumor
In the TNM tumor grading system, what does T1,2,3,4 mean?
Progressive increase in size
In the TNM tumor grading system, what does Nx mean?
Nodes can’t be assessed
In the TNM tumor grading system, what does N0 mean?
No metastasis to local lymph nodes
In the TNM tumor grading system, what does N1,2,3 mean?
Progressive involvement of local nodes
In the TNM tumor grading system, what does Mx mean?
Distant metastasis can’t be assessed
In the TNM tumor grading system, what does M0 mean?
No distant metastasis
In the TNM tumor grading system, what does M1 mean?
Presence of distant metastasis
What is carcinogenesis?
The process by which a normal cell undergoes malignant transformation
T/f: the pathogenesis of cancer is usually a multi step process involving progressive changes after a genetic damage to or alteration of cellular DNA
True
What is the order of dysplasia in cancer?
Hyperplasia—>metaplasia—>dysplasia—>carcinoma in situ—>invasive carcinoma
What is the somatic mutation theory of cancer?
Tumors begin with a single cell that acquired a genetic mutation or chromosomal changes in number or structure cause cancer
What chromosomal numerical changes can lead to cancer?
Addition or deletion of an entire chromosome
What chromosomal structural changes can cause cancer?
Translocation of parts of chromosomes
Deletion of parts of chromosomes
Inversion of parts of chromosomes
Insertion of parts of chromosomes
T/f: we know how chromosomal changes contribute to the malignant process
False, that is still unclear
What are the proposed mechanisms for how chromosome changes contribute to the malignant process?
Oncogene activation and tumor suppressors gene inactivation
What is a protooncogene?
A normal segment of DNA involved in cell division, replication, and death
What is the role of the protooncogene in oncogenesis?
It can become an oncogene through mutation
What is an oncogene?
A mutated segment of DNA associated with tumor formation
What is the role of the oncogene in oncogenesis?
Once activated by virus, carcinogen, etc, it can cause tumor growth
What is a tumor suppressor gene?
Segment of DNA that suppresses tumor formation by actively seeking and destroying CA genes
What is the role of tumor suppressor genes in oncogenesis?
If it becomes inactive, it allows tumor growth
What 3 factors contribute to oncogenesis?
Protooncogene transformation
Oncogene activation
Tumor suppressor gene inactivation
How does the immune system contribute to cancer?
Through immunosurveillance, the immune system constantly seeks out potentially cancerous cells to destroy
What is immunosurveillance?
The immune system constantly seeking out potentially cancerous cells to destroy
What immune cells are involved in immunosurveillance for cancer destruction?
NKCs
Macrophages
CD8 and T cells
B cells
For cancer to begin, there has to be a failure of what system?
There has to be a failure of the immune system to recognize cancer cells
How may a failure of the immune system cause cancer?
Bc the cancer cells doesn’t produce cancer antigens
The cell is MHC deficient and the body can’t recognize self from cancer
T cells are less active to recognize cancer cells
What is cancer immunotherapy?
Using the body’s own immune system to fight cancer in different ways
What are the three types of cancer immunotherapy?
Antibody therapy
Adoptive cell therapy
Cancer vaccines
What is antibody therapy?
A type of immunotherapy where we have to know what the tumor antigen is for it to work
What is adoptive cell therapy?
A cancer immunotherapy where blood is drawn out, the T cells are given antigen recognition to fight the cancer and the blood is reinfused
What is metastasis?
When tumors are able to spread from the primary site to other locations in the body
What will metastatic cells look like?
They will look like the cells of the primary location
How do tumors spread?
Cells break way from the primary tumor, travel through the body via the blood or lymphatic system, and become trapped in the capillaries of other organs
What are the most common sites of metastasis?
Liver, lung, lymph nodes, bone, brain
What are the clinical manifestations of pulmonary (lung) metastasis?
Persistent dry cough
Dyspnea, pleuritical pain, hemoptysis
What is often the first sign of lung metastasis?
Persistent dry cough
When would a persistent dry cough be missed as a sign of lung cancer?
When the person ordinarily has a persistent dry cough like with COPD
What is the most common metastasis?
Lung
What is the presentation of hepatic (liver) metastasis?
Jaundice
What is the presentation of skeletal system (bone) metastasis?
Deep pain
Increased pain with activity or weight bearing
What is the presentation of CNS metastasis?
Brain and SC symptoms (UMN/LMN)
What is the incidence of metastasis?
About 30% of clients with newly diagnosed cancers have clinically detectable metastases
At least 30-40% of the remaining clients who are clinically free of metastasis harbor occult (hidden) metastases
The ability of a tumor to grow beyond a very small mass depends on what?
The ability to gain access to an adequate supply of blood and in some cases the presence of hormonal factors
How do tumors break through the lymphatics?
They excrete acid like enzymes that dissolve the basement membrane and break through the lymphatics
How do cancer cells enter the blood?
They can enter the blood where lymph nodes drain into veins when enzymes from the tumor dissolve the basement membrane
How may pathologists be able to diagnose the metastasis?
Bc metastases usually reproduce the cellular structure of the primary growth well enough the be recognized as similar to the primary site cells
What factors affect cancer prognosis?
The type of cancer
The stage at dx
Characteristics of the tumor
Pre diagnosis health status
Availability of treatment
Response to treatment
What is remission?
No active signs of cancer
When is cancer relapse most likely to occur?
During the first 5 years in remission
What is cancer specific survival?
How long a patient lives with cancer diagnosis
Only looking at death bc of cancer
What is relative survival?
Ppl who would die for other reasons than the cancer
What is overall survival?
Survival regardless of the cause of death
What is disease free survival?
How long a pt lives without relapse
What is progression free survival?
How long someone lives with stable course of disease
