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Principles of Disease > Outline of Disease Processes in Cancer > Flashcards

Outline of Disease Processes in Cancer Flashcards

1
Q

How would you describe the development of cancer?

A

Multistage carcinogenesis.

Carcinogen -> Initiaion -> Promotion -> Tumour growth -> Progression

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2
Q

What gives rise to new therapeutic options?

A

Better understanding of molecular biology

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3
Q

What is increasing relevant for the therapy available for cancer?

A

Immnotherapy/ biological therapy

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4
Q

What factors cause initiation of cancer?

A

Chemical, physical, viral

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5
Q

What factors cause promotion of cancer?

A

Growth factors, oncogenes

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6
Q

What factors cause progression?

A

Metastasis

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7
Q

Cancer cells vs normal cells

A

CANCER:

  • frequent mitoses
  • loss of contact inhibiton
  • increase in secretion of growth factors
  • increase in oncogene expression
  • loss of tumour suppressor genes

NORMAL:

  • few mitoses
  • uniform arrangement
  • co-ordinated growth factor secretion
  • rare oncogene expression
  • presence of tumour suppressor genes
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8
Q

What causes initiation- Chemical.

In more detail?

A

Chemical i.e.

  • Analine dyes
  • Aflatoxin
  • Mustard gas
  • Alcohol and smoking
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9
Q

What causes initiation- Physical.

in more detail?

A

Ionising radiation:

  • Radon source is mainly buildings
  • risk increased by smoking
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10
Q

What is a carcinogen?

A

a substance capable of causing cancer in living tissue.

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11
Q

What causes promotion- Oncogenes.

In more detail- what are they and what do they do?

A
  • Pro cancer genes

- Represent a gain in function to transformed cells

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12
Q

What causes promotion- Growth factors.

In more detail- what are they, what do they do?

A
  • Polypeptide molecules
  • Regulate cell growth and regulation
  • Bind to cell membrane receptors and stimulate intracellular single transduction pathways
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13
Q

What causes initiation- physical.

In more detail? (2)

A

Viral carcinogens:
-Herpes virus
-Papillomavirus
Hep B

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14
Q

What are properties of metastasis?

A
  • Not random

- Cascade of limited sequential steps

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15
Q

How does metastasis occur?

A
  • Tumour invades through basement membrane
  • Moves into extracellular matrix/ connective tissue/surrounding cells
  • Invades blood vessels
  • Tumour cells “arrested” in distant organ
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16
Q

What molecules are involved when tumour invades through basement membrane, and move into Extracellular matrix?

A

-Many enzymes involved i.e. Matrix metalloproteinases (MMPs), Plasmin, Cathepsin

17
Q

What are the two types of stimulation?

A

Autocrine and Panacrine

18
Q

What is autocrine stimulation?

A
  • Cell carries receptors and secretes growth factor

- Cell escapes normal control mechanism

19
Q

What is paracrine stimulation?

A

Growth factors on a cell are produced locally by the cell or its immediate neighbours

20
Q

What is the most commonly altered gene in human tumours?

A

p53

21
Q

What is Angiogenesis and what does it involve?

A
  • Formation of new blood vessels

- involves degradation of the EM

22
Q

Why is angiogenesis relevant to tumour formation?

A
  • is a key factor in the maintenance and progression of malignant tumours
  • New blood vessel formation must form in order for a tumour mass to exceed 2mm in diameter
23
Q

What does cancer therapy involve?

A

Drugs to exploit our knowledge on specific growth factors on how it affects tumour growth and regulation.

24
Q

Example of drugs in cancer therapy?

A

-Anti-VEGF antibody Avastin binds VEGF on the surface of vascular endothelial cells.

It prevents:
- interaction with receptors

  • the activation of downstream signalling pathways, that would normally lead to the growth, proliferation, migration and survival of endothelial cells.
25
Q

What does Anti-VEGF antibody Avastin bind to VEGF ultimately lead to?

A
  • reduction in microvascular growth,
  • inhibits progression of metastatic disease
  • reduces intratumoral pressure, which may improve the delivery of cytotoxic agents.
26
Q

Why does our immune system not recognise foreign cancer cells?

A

Cancer cells hide from T cells

27
Q

What is the increasingly relevant immunotherapy do?

A

Immunotherapy:

  • PD1 (programme death receptor) is present on T lymphocytes
  • Ligand (PDL-1) is on tumour cells.
  • Interaction of these suppresses T cell action
  • This is a therapeutic opportunity to block PD1 or PDL-1, as it causes immune damage to tumour
28
Q

How does PD1 receptor on T lymphocytes work?

A
  • blocks the pathways with specific antibodies called immune checkpoint inhibitors.
  • Once the immune system is able to find and respond to the cancer, it can stop or slow cancer growth.

Principles of Disease (53 decks)

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