oncology - patho E4

Question 1

the parts of the cell cycle

Answer 1

stage G0
stage G1
Stage S
Stage G2
Stage M

Question 2

cell cycle: G0

Answer 2

The cell is at rest and is not actively engaged in the cell cycle.

Question 3

cell cycle: G1

Answer 3

Cells enter the cell cycle and prepare for deoxyribonucleic acid (DNA) replication. Proto-oncogenes, genes that control cell replication, are activated.

Question 4

cell cycle: S

Answer 4

Synthesis of structures occurs and the structures move to opposite poles in preparation for division into two separate cells. The 46 chromosomes reorganize as two separate sets of 23 chromosome pairs arranged at opposite poles. Two nuclear membranes develop around the two separate sets of 23 pairs.

Question 5

cell cycle: G2

Answer 5

Cells prepare to divide

Question 6

cell cycle: M

Answer 6

Mitosis is completed and two daughter cells are created

Question 7

compared to a normal cell cycle, what does a cancer cell cycle not have

Answer 7

-a rest phase (G0) -> rapidly reproduction
-check points to make sure everything is normal and correct -> allows for lots of cell changes (no DNA errors recognized, no apoptosis)

Question 8

the goal of cancer treatment drugs is to do what

Answer 8

impact the cell cycle

Question 9

what do cancer cell disregard

Answer 9

the growth inhibitors released by neighboring cells -> as they proliferate, they accumulate on top, around & besides each other, take over boundaries of organs, crowd out normal cells and may even breakfree and travel to distant body sites

Question 10

immune surveillance

Answer 10

our immune system recognizes abnormal cells as “non self antigens” -> when discovered the immune system initiates an attack to destroy the substance
with age, this weakens -> increased risk of tumor development

Question 11

differentiation

Answer 11

refers to the extent that neoplastic cells resemble normal cells both structurally and functionally
Lack of differentiation is called anaplasia, a term that indicates total cellular disorganization, abnormal cell appearance, and cell dysfunction

Question 12

what does it mean when someone says “the cancer cell is well differentiated”

Answer 12

the cancer cell closely resembles & functions like the cell of origin

Question 13

do benign tumors tend to be more differentiated or anaplastic

Answer 13

well differentiated -> remain localized, don’t break away, do not invade and destroy surround tissues

Question 14

do malignant tumors tend to be more differentiated or anaplastic

Answer 14

anaplastic (or poorly differentiated)

Question 15

review cancer cells break rules chart & differences between normal and cancer cells

Question 16

tumor markers: what are they

Answer 16

biologic substances that some tumors put off that can be measured

Question 17

tumor markers: what type of substances

Answer 17

hormones
enzymes
antigens
genes

Question 18

tumor markers: where can they be found

Answer 18

blood
urine
cerebral spinal fluid
tumor plasma membrane

Question 19

tumor markers: what are they used for

Answer 19

screening or diagnostic
can help us follow the clinical course of the cancer during treatment

Question 20

tumor markers: are they diagnostic of cancer

Answer 20

not always but can help diagnose specific types of cancers

Question 21

examples of tumor markers:

Answer 21

prostate specific antigen
BRCA gene mutation
can be elevated with benign tumor

Question 22

maligant tumor grading

Answer 22

Grade I: cells are well-differentiated
Grade II: cells are moderately differentiated
Grade III: poorly differentiated or anaplastic cells

Question 23

Staging classifies the tumor according to size, invasiveness, and spread using a TNM system:

Answer 23

T - tumor size, location, and involvement.
N - lymph node involvement.
M - metastasis to distant organs.

Question 24

review TNM classification system

Answer 24

needs a biopsy

Question 25

four stage classification system

Answer 25

doesn’t give much info, better for gen pop
Stage 1: Confined to organ of origin
Stage 2: Locally invasive
Stage 3: Regional spread
Stage 4: Spread to distant sites

Question 26

four phases of carcinogenesis

Answer 26

initiation
promotion
progression
metastasis

Question 27

what is involved in carcinogenesis

Answer 27

genes
carcinogens
promoters

Question 28

carcinogenesis: intitation

Answer 28

the alteration, change or mutation of genes that arise spontaneously or induced by exposure to a carcinogenic agent

Question 29

carcinogenesis: promotion

Answer 29

actively proliferation cells accumulate
reversible with chemotherapy

Question 30

carcinogenesis: progression

Answer 30

when cells undergo further mutation & these cells tend to be more invasive with metastatic potential

Question 31

carcinogenesis: metastasis

Answer 31

the spread of cancer

Question 32

what are the two major classes of cancer genes

Answer 32

1) tumor suppressor genes (“car break doesn’t work” -> these cells are inactivated & nothing stops the proliferations of mutated genes and nothing tells the cell when to die)
2) oncogenes (“gas pedal controlling speed” -> mutated proto-oncogenes are permanently turned on and cells can keep dividing out of control)

Question 33

how to classify carcinogens

Answer 33

-known (smoking, alc, HPV, HIV)
-probable (night shift), evidenced based
-possible (engine exhaust), insufficient evidence

Question 34

what is a promoter

Answer 34

an agent that help the mutated gene proliferate
ex: high fat diet, alc, tobacco, hormones

Question 35

viral induced cancer

Answer 35

certain malignancies are associated with cancer inducing viruses (like hiv)
MOA: always involve the activation of growth promoting pathways or inhibition of tumors suppressors in infected cells

Question 36

how do tumors create their needed blood supply

Answer 36

they secrete vascular endothelial growth factor, a substance that gives them the capability to develop new blood vessels

Question 37

with cancer spread we can have:

Answer 37

seeding
implantation
metastasis

Question 38

cancer spread: seeding

Answer 38

the tumor erodes and sheds into the body cavities -> the “seed” can be planted in different body cavities

Question 39

cancer spread: implantation

Answer 39

refers to the direct expansion of the tumor to an adjoining tissue -> prostate is right next to bladder so the prostate cancer grows right into the bladder

Question 40

cancer spread: metastasis

Answer 40

2 primary routes are lymphatic & vascular
when the cancer moves to distant sites through the lymph or vas system

Question 41

lymphatic spread

Answer 41

the first stop is the lymph system & get trapped in the lymph leading to:
1) cell death in the lymph
2) cells can go dormant in the lymph
3) flourish / proliferate
if they survive then they can start traveling around the entire lymph system

Question 42

vascular spread

Answer 42

cancer cells can penetrate blood vessels that drain the tumor site and once they get into circulation, they can deposit anywhere
first stop is often the liver

Question 43

common metastatic sites for tumors: lung

Answer 43

bone, brain

Question 44

common metastatic sites for tumors: colon

Answer 44

liver

Question 45

common metastatic sites for tumors: breast

Answer 45

bone, brain, liver, lung

Question 46

common metastatic sites for tumors: prostate

Answer 46

vertebrae

Question 47

common metastatic sites for tumors: melanoma

Answer 47

brain