Oncology Training - Tumors Flashcards
True / False - Normal cells become converted to cancer cells through a single alteration in a single cell.
False
The period of rapid, exponential tumor growth is called the _________________ phase, while the period at which tumor
growth levels off is called the ___________________ phase.
The period of rapid, exponential tumor growth is called the __log__ phase, while the period at which tumor growth levels off is called the __plateau__ phase.
Most tumor cells are not clinically detectable until they have grown to approximately _____ cells, at which time the tumor has usually entered the ________________ phase.
Most tumor cells are not clinically detectable until they have grown to approximately __10*9___ cells, at which time the tumor has usually entered the __plateau__ phase.
What is the clinical significance of the statement in question 3?
Many chemotherapeutic agents are more effective against tumor cells that are rapidly proliferating than tumor cells that have reached the plateau phase; thus, the efficacy of therapy may be limited.
List four factors that may be responsible for slowing tumor growth in the plateau phase.
inadequate oxygen and nutrient supply; contact with normal cells (crowding); growth-inhibiting
substances produced by the tumor; increased hormone levels
Match the following: \_\_\_\_ measures the proportion of cells that are actively dividing at any one time \_\_\_\_ measures the proportion of cells participating in cell division \_\_\_\_ measures the percentage of cells that die \_\_\_\_ measures the proportion of cells synthesizing DNA \_\_\_\_ measures the time it takes for number of tumor cells to double
A. labeling index B. doubling time C. cell death fraction D. mitotic index E. growth fraction
E. growth fraction____ measures the proportion of cells that are actively dividing at any one
time
D. mitotic index____ measures the proportion of cells participating in cell division
C. cell death fraction____ measures the percentage of cells that die
A. labeling index____ measures the proportion of cells synthesizing DNA
B. doubling time____ measures the time it takes for number of tumor cells to double
If a drug kills only cells that are actively dividing, which of the following would be most susceptible to it? A. tumor with large cell death fraction B. tumor with large growth fraction C. tumor with small mitotic index D. tumor with small labeling index
B. tumor with large growth fraction
Match the following:
____ the number of deaths from a disease over a specified time period
____ the number of new cases of a disease discovered each year
____ a general description of the severity of sickness
____ the number of total cases of a disease at a point in time
A. incidence
B. prevalence
C. mortality
D. morbidity
C.mortality____ the number of deaths from a disease over a specified time period
A. incidence____ the number of new cases of a disease discovered each year
D. morbidity____ a general description of the severity of sickness
B. prevalence____ the number of total cases of a disease at a point in time
True / False For most types of cancer, an individual inherits a susceptibility to that cancer, not the cancer itself.
TRUE
True / False Genetic and environmental factors together usually determine whether or not an individual develops cancer.
TRUE
What is an oncogene?
a gene that has been altered by a mutation to increase cell proliferation without regul
List three mechanisms by which a normal gene may be converted to an oncogene.
translocation;
amplification;
deletion
How can a mutation in a tumor suppressor gene lead to the development of cancer?
cause tumor suppressor genes inhibit cell proliferation and tumor development, a mutation in such a gene may lead to increased cell proliferation and cancer.
Give two reasons why the risk of most types of cancer might increase with age.
a weakening of the immune system with age;
further exposure to carcinogens
True / False Individuals with compromised immune systems due to disease or drug therapy are at increased risk of developing certain types of cancer.
True
True / False Viruses may contain DNA or RNA as their genetic material.
True
True / False Viruses require host cell machinery to reproduce.
True
True / False If viral DNA is incorporated into host DNA, this altered genetic material is duplicated when the host cell divides.
True
Explain how a virus can cause an oncogene from a normal cell to be expressed in a cancer cell.
A virus can incorporate an oncogene from a host cell into its RNA or DNA and copy it into a different location in the host DNA, which may lead to its expression and the development of cancer.
Explain how exposure to chemicals in the environment can lead to cancer.
Exposure to chemicals can cause a variety of genetic mutations. The carcinogenic chemical
component binds irreversibly to DNA and can then disrupt normal DNA replication in several different ways. The body is capable of repairing DNA that has been damaged by exposure to chemical carcinogens; however, some individuals carry genes which make them more susceptible to certain environmental carcinogens.
List the seven early warning signs of cancer. C: \_\_\_\_\_\_\_\_ A: \_\_\_\_\_\_\_\_ U: \_\_\_\_\_\_\_\_\_ T: \_\_\_\_\_\_\_\_\_ I: \_\_\_\_\_\_\_\_\_ O: \_\_\_\_\_\_\_\_\_ N: \_\_\_\_\_\_\_\_\_
Change in bowel or bladder habits; A sore that does not heal; Unusual bleeding or discharge; Thickening or lump in breast or elsewhere; Indigestion or difficulty in swallowing; Obvious change in wart or mole; Nagging cough or hoarseness
List three screening tests and the type of cancer for which they are used.
any three:
mammography (breast cancer);
PAP smear (cervical cancer);
digital rectal
examination (colon and rectal cancer, prostate cancer);
stool blood test (colon and rectal cancer);
prostate-specific antigen test (colon and rectal cancer)
List the five principal steps in the diagnosis of cancer.
clinical evaluation;
histological examination;
grading; staging;
performance status
Name two types of diagnostic imaging studies used to visualize masses inside the body.
any two:
conventional x-rays;
computerized tomography (CT) scans; ultrasonography;
magnetic resonance imaging (MRI)
What are tumor markers?
substances produced by cancers that circulate in the blood or accumulate in body fluids and can be analyzed by laboratory tests
What type of biopsy allows the most complete examination of tumor tissue?
excisional biopsy
Characteristics of malignancy that may be revealed from a biopsy include: A. highly ordered cells. B. loss of normal tissue boundaries. C. low rate of mitosis. D. cells in inappropriate places.
B. loss of normal tissue boundaries.
D. cells in inappropriate places.
The evaluation of tumor size and extent of metastasis is called:
staging
Grading measures:
the degree of anaplasia and number of proliferating cells
Match the following:
____ human chorionic gonadotropin (HCG), carcinoembryonic antigen (CEA)
____ Ann Arbor Classification System
____ TNM System
____ G1 = well differentiated; G2 = moderately well differentiated; G3, G4 = poorly to very poorly differentiated
A. tumor markers
B. staging system for solid tumors
C. example of histologic grade
D. staging system for Hodgkin’s disease
A. tumor markers____ human chorionic gonadotropin (HCG), carcinoembryonic antigen (CEA)
D. staging system for Hodgkin’s disease ____ Ann Arbor Classification System
B. staging system for solid tumors ____ TNM System
C. example of histologic grade ____ G1 = well differentiated; G2 = moderately well differentiated; G3, G4 = poorly to very poorly differentiated
In the diagnosis of cancer, what is the performance status?
the degree to which a neoplasm affects a patient’s health and daily activities
Define morphology in terms of its use in cancer diagnosis.
In oncology, morphology refers to the study of individual cells or clusters of cells, also known as cytology or cytopathology.
In immunohistochemistry (IHC), cell samples are stained using a special solution containing ____________.
antibodies
Number each of the following steps in flow cytometry.
____ the cell sample is suspended in fluid
____ the cell sample is passed under a laser light source
____ results are recorded electronically and interpreted in a color-coded visual display
____ cells specific to the fluorescent dyes give off light
____ the cell sample is stained with one or more fluorescent dyes
- the cell sample is stained with one or more fluorescent dyes
- the cell sample is suspended in fluid
- the cell sample is passed under a laser light source
- cells specific to the fluorescent dyes give off light
- results are recorded electronically and interpreted in a color-coded visual display
Cytogenetic testing may be used to: A. confirm the presence of a neoplasm. B. identify a specific disease. C. determine prognosis. D. all of the above.
A. confirm the presence of a neoplasm.
Match each of the following molecular genetic tests with the appropriate description.
____ amplifies specific sequences of DNA
____ examines DNA using electrophoresis and DNA probes
____ amplifies specific sequences of RNA
____ examines RNA using electrophoresis and DNA probes
____ examines chromosomes that have been painted with fluorescent molecules of various
colors
A. fluorescencein situ hybridization (FISH) B. Southernblotting C. Northern blotting D. polymerase chain reaction (PCR) E. reversetranscriptase PCR (RT-PCR)
A. fluorescencein situ hybridization (FISH)____ examines chromosomes that have been painted with fluorescent molecules of various
colors
B. Southernblotting____ examines DNA using electrophoresis and DNA probes
C. Northern blotting____ examines RNA using electrophoresis and DNA probes
D. polymerase chain reaction (PCR) ____ amplifies specific sequences of DNA
E. reversetranscriptase PCR (RT-PCR)____ amplifies specific sequences of RNA
Carbohydrate antigen 15-3 (CA 15-3) is elevated in
______________________.
women with breast cancer
Briefly describe the role of testing for epidermal growth factor receptor (EGFR) in cancer diagnosis, including at least one type of cancer for which EGFR testing is used.
EGFR is found in increased amounts in tumor tissue in many types of cancer.
Answer should include any one of the following: glioblastoma, cancer of the head and neck, colon,
breast, or pancreas, lung cancer
True/ False HER-2/neu is overexpressed in at least 25% of breast cancers.
True
A microarray is a small, flat chip containing:
A. fluorescent dyes specific to a single coding sequence of a human gene.
B. thousands of probes, each specific to a coding sequence of a human gene.
C. complementary DNA from specific coding sequences of a human gene.
D. all of the above
B
Lifestyle factors that can increase an individual’s risk of developing cancer include:
tobacco use; high-fat diet; alcohol consumption; exposure to sunlight; sedentary lifestyle
List five general guidelines for cancer prevention.
Don’t smoke or use tobacco;
if you drink alcoholic beverages, do so in moderation;
limit your intake of high-fat foods, particularly from animal sources and especially red meat;
the majority of your food should come from plant sources; exercise.
Existing hormones and agents that have an antihormone effect can:
disrupt or block the effects of hormones that contribute to the growth and spread of some cancers
How might NSAID use aid in cancer prevention?
NSAID use may inhibit the production of certain enzymes that affect cell proliferation, tumor growth, and immune function.
What are three major goals of cancer therapy?
remove all known tumors; prevent the cancer from recurring or spreading; balance the possibility of achieving a cure against the potential for side effects
The treatment of recurrent or rapidly growing cancer should
focus on:
controlling the tumor’s growth and spread for as long as possible; treating and relieving symptoms if cancer is determined to be incurable
What is the survival rate?
the ratio of the number of patients alive at the end of a specified time period to the number of patients diagnosed with the disease at the beginning of that time period
Hormones, metabolites, and immunological markers released by the tumor are all examples of:
tumor products