Pathophysiology and Pharmacology of Cancer Flashcards
What is cancer?
- Cancer is a genetic disorder at cellular level
- Chronic disease
- Uncontrolled proliferation of cells
Cancer
- Abnormal cells are not killed
- Abnormal cells divide/replicate
- Grow beyond normal tissue
Causes of cancer?
- genetic
- environmental
- behavioural
Caused by:
- Genetic: 10% of cancers
- Oncogenes trigger cancer characteristics
Abnormal genes, promote cell proliferation (BRCA1,
BRCA2)- Tumour-suppressor genes suppress oncogenes Encode proteins that in their normal state negatively regulate proliferation. deletion or mutation -> inactive -> allow tumour to grow
- Environmental factors: exposure to radiation/toxins
- Behavioural factors: diet, smoking, low exercise
describe the process of carcinogenesis
- initiation phase
- promotion phase
- progression phase
initiation phase:
the cell is exposed to the initiating factor/carcinogen
normal call -> DNA changes
promotion:
abnormal cell growth is promoted
- > failure of DNA repair -> genetic mutations ->
1) activation of growth-promoting oncogenes
2) inactivation of tumour suppressor genes
3) alterations in genes that regulate apoptosis - > unreguated cell prolifertion / decreased cell apoptosis
- > clonal expansion
progression:
cellular changes become irreversible and demonstrate malignant behaviour
-> tumour progression -> malignant neoplasm -> invasion and metastisis
Discuss the development of cancer on a cellular level
normal call -> genetic changes -> DNA becomes abnormal -> cell avoids apoptosis -> continued cel replication -> angiogenesis - > tumour growth -> tumour cells break away -> metastisis
Name the 2 types of tumour
Malignant (Neoplasm) - metastasis to surrounding tissue, not self-limiting
Benign - don’t spread or reoccur
describe some differences between the 2 types of tumours
Benign
Grow slowly, Well-defined capsule, Not invasive, Well-differentiated, Do not metastasise
Malignant
Grow rapidly, Not encapsulated, Invasive, Poorly differentiated, Can spread distantly (metastasis)
__________ must occur in order for a tumour to enlarge
Angiogenesis must occur in order for a tumour to enlarge
formation of new blood vessels
Primary tumour
A tumour that grows within a specific organ
common sites of metestesis
brain/CSF, lungs, liver, kidneys, bones, adrenal glands
Pharmaceutical therapy for cancer
Antineoplastic Drugs
- Cytotoxic drugs (Chemotherapy)
- Hormonal drugs
- Immunotherapy drugs
Cytotoxic drugs (Chemotherapy) Cell cycle has 5 phases: - \_\_\_\_\_\_\_\_\_\_\_\_ - \_\_\_\_\_\_\_\_\_\_\_\_ - \_\_\_\_\_\_\_\_\_\_\_\_ - \_\_\_\_\_\_\_\_\_\_\_\_ - \_\_\_\_\_\_\_\_\_\_\_\_ Cytotoxic drugs interfere in one or more phases
Cell cycle has 5 phases:
- Presynthesis gap phase
- DNA synthesis phase
- Premitotic phase
- Mitosis Phase
- Resting Phase
Cytotoxic drugs interfere in one or more phases
chemotherapy side effects
- Alopecia (damage to follicle cells)
- Impaired bone marrow production of blood cells (myelosuppression)
- Infertility
describe Hormonal drugs
Tumours that can be stimulated by hormones
- Breast, Prostate, Ovaries
Impact on hormone production = cancer cell death
Can be achieved by:
Blocking hormone production
Fooling signal pathway
Blocking hormone receptors
Describe Immunotherapy drugs
Biological treatment to manipulate immune system
Immune system works more effectively
- Tag and destroy
Different types
- Adoptive cell transfer (T cell)
- Cytokines (cell Protiens)
- Vaccines
- Monoclonal antibodies
Used in combination with cytotoxic treatments
grading of tumour
- Grade I—Cells differ slightly from normal cells (mild dysplasia) and are well differentiated (low grade).
- Grade II—Cells are more abnormal (moderate dysplasia) and moderately differentiated (intermediate grade).
- Grade III—Cells are very abnormal (severe dysplasia) and poorly differentiated (high grade).
- Grade IV—Cells are immature and primitive (anaplasia) and undifferentiated; cell of origin is difficult to determine (high grade).
- Grade X—Grade cannot be assessed.
