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Oncology > Oncology Patho > Flashcards

Oncology Patho Flashcards

1
Q

What are the 7 basic characteristics of cancer cell?

A

1.gene mutations
2.decreases apoptosis
3. anaplasia
4. pleomorphic
5. lack of contact inhibition
6. anchorage independence
7. metastasis

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2
Q

What are the 4 genomic hallmarks of cancer cells

A
  1. sustained proliferative signaling vis oncogenes
    2.Evade growth suppressors (anti-oncogenes/tumor suppressor genes (TSGs))
    3.Genomic instability
    4.Enabling Replication Immortality through telomerase enzyme
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3
Q

What are some examples of TSGs? (3 listed)

A

Retinoblastoma (RB)
P53
BRCA1/BRCA2

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4
Q

What are 3 examples of cellular adaptation in cancer cells?

A
  1. Induce Angiogenesis
  2. Reprogram Energy Metabolism (Warburg effect & aerobic glycolysis)
  3. Resistance to Death
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5
Q

What are 2 ways Cancer cells resist death

A

1.Tumor-promoting inflammation through TAM (tumor-associated macrophage
2.Evade Immune Detection

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6
Q

Define Metastasis

A

spread of cancer cells form site of original tumor to distant tissues and organs through body

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7
Q

What are the two mechanisms underlying tumor metastasis

A

Intravasation & Extravasation

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8
Q

What are key features of intravasion

A

Angiogenesis creates “leaky” new blood vessels that facilitate cancer cells entering vascular and lymphatic system
Epithelial-Mesenchymal transition (EMT)

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9
Q

What are the three main factors related to obesity and cancer?

A
  1. insulin/insulin-like growth factor axis - insulin stimulates growth in tumors via IR, hyperglycemia feeds Warburg effect, increased adiposity correlated with lower level of adiponectin (promotes apoptosis)
  2. High levels of circulating free sex hormones (estradiol) drive estrogen-dependent cancers (breast/endometrial)
    3.Adipokines/cytokines - enhance inflammatory factors, dysfunctional adipose tissue leads to cytokin production, inflammation and fibrosis (reduced response to chemo)
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10
Q

What is the difference between cancer screens and cancer tests?

A

screening - done as regular check for disease even in absence of symptoms (for early detection) - recommended more regularly if high risk for certain cancers (ie colonoscopy/PAP)
diagnostic procedures - investigating for CA in presence of signs/symptoms, diagnosis based on tumor size, site etc

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11
Q

Describe the staging system based on metastasis

A

1 - no mets
2 - local invasion
3 - spread to regional structures
4 - distant mets

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12
Q

Describe the TNM staging or solid tumors

A

T - primary tumor size & invasion (T1-4 tumor present, T2 = 2-5cm, T4= tumor broken skin or attached to chest wall)
N - lymphnode involvement (N0=none, N1-3 LN involved)
M - extent of distant mets (M0=none, M1=present)

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13
Q

What is the most common cancer for children?

A

leukemia

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14
Q

what is the most common cancer for women?

A

breast
*note white women more likely to be diagnosed, but WOC more likely to die due to SDH, lifestyle etc

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15
Q

what is the most common cancer for men?

A

prostate

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16
Q

what is the most common cancer for people age 15-29

A

thyroid

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17
Q

what is the most common cancer in people age 70-84

A

lung/bronchus

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18
Q

what is the most common cancer in people age 85+

A

colorectal cancer (followed closely by lung)

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19
Q

what is the difference between cancer screening and diagnosis

A

screening = regular check even in absence of symptoms
diagnosis = investigating for CA in presence of symptoms or follow up of abn screening; once tumour detected must be staged

20
Q

when would regular screenings be recommended?

A

in presence of risk factors (smoking, family hx, inflammatory bowel disease like ulcerative colitis or crohn’s disease) or at certain age (generally 40-50)

21
Q

what age does screening for colorectal CA begin for people with average risk (ie no risk factors)? How frequently should screening occur?

A

start at age 50, FIT test q2years
if choose to get colonoscopy, screened q10years

22
Q

What age does colorectal cancer screening start for people at high risk? how often should they be screened?

A

age 50 OR 10 years prior to age their relative was diagnosed
colonoscopy recommended (whichever comes first)
q5years recommended for people with relatives diagnosed before age 60, q10years if >60

23
Q

What age does screening for breast Ca start for women with no risk factors? How often?

A

50 years old, q2-3 years

24
Q

when is screening recommended for prostate cancer?

A

none at this time, Prostate specific antigen (PSA) blood test = high risk for over-diagnosis and over-treatment

25
Q

what age does screening start for cervical cancer? how often does it occur?

A

recommended start at age 21 (25 in new guidelines) if sexually active, q3years. stop at age 70 if prev 10 years negative

26
Q

what are the three treatments for cancer?

A

chemo, radiation, surgery

27
Q

what is the MOA for chemotherapy

A

cyctotoxic drug, destroys cancer cells by disrupting DNA synthesis or mitosis and prevents cell proliferation –> works best on cells that have high proliferation like cancer (also hair and skin)

28
Q

what are the three possible goals of treatment?

A
  1. cure
  2. control
  3. palliation
29
Q

What are the 4 different uses for chemotherapy?

A

1.induction
2.adjuvant
3.palliative
4.neoadjuvant

30
Q

what is induction chemotherapy

A

shrink/disappear tumor

31
Q

what is adjuvant chemo?

A

eliminate micrometastases after surgery

32
Q

what is palliative chemo

A

give relief to symptoms

33
Q

what is neoadjuvant therapy

A

given before surgery to shrink tumor

34
Q

what is the MOA for radiation

A

uses radiation to destroy cancer cells

35
Q

What is brachytherapy

A

radioactive material placed inside body (localized radiation)

36
Q

what are targeted cancer therapies

A

designed to address unique growth characteristics of a specific class of tumour & interfere with that process: ie inactivate oncogenes, block angiogenesis, affect cancer cell metabolism

37
Q

what is febrile neutropenia

A

fever in the presence of neutropenia - sign of infection with no immune response to fight it

38
Q

what are clinical manifestations of leukemia

A

pallor, fatigue, petechiae, purpura, bleeding, fever, bone pain

39
Q

how do you test for leukemia

A

bone marrow aspiration (blast cell)

40
Q

how is leukemia treated

A

combo chemo
radiation
cns irradiation

41
Q

what are examples of hematological malignancies

A

leukemia & lymphomas

42
Q

what is non-hodgkins lymphoma

A

associated with Epstein-Barr virus, manifests in lymph nodes in abdomen & chest

43
Q

what is the treatment for Non-Hodgkins lymphoma

A

chemo

44
Q

what is Hodgkin lymphoma

A

associated with infectious disease/immune deficits, also associated with EBV

45
Q

what is treatment for hodgkin lymphoma

A

combo chemo and radiation

46
Q

what are three examples of targeted therapies?

A
  1. tyrosine kinase inhibitor TKI - upregulate immune system to fight cancer cells
  2. Bevacizumab - stops angiogenesis; monoclonal antibodies, blocks ligands from binding cancer cell receptor, sparing normal cells
    3.Rituximab → decreases B-cells and CA associated with B-cells

Oncology (2 decks)

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