Pathpharm cancer lecture wk 2 Flashcards
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Define Cancer:
tissue overgrowth which is independent of the laws governing the remainder of the body. Serves no purpose to the body.
What is the original definition for tumor?
A mass greater than 2cm
Define neoplasm:
new growth
T or F: All neoplams are cancer.
F. Neoplasm just refers to new growth. Does not specify if it is malignant or benign
T or F: Cells that are atropic or hypertrophic can be considered normal
TRUE-depends on life stage
T or F: Metaplasia is normal.
F. Metaplasia is always caused by “rebellious” cells
When cells are dysplayed, but have not penetrated the basement membrane of the organ they are described as a:
in situ neoplasm
When growth penetrates through the basement membrane of an organ and can spread throughout the body it is described as an:
invasive neoplasm
A tumor that is well-defined, has a low mitotic index, and does not metastatize is most likely:
benign
A tumor that is poorly defined, poorly differentiated, has a high mitotic index and has metastasis is most likely:
malignant
Define anaplasia:
When a cell no longer resmbles the original cell. Ex: original cell was cuboidal, new cell looks columnar
Altered contact inhibition refers to:
the cells within a tumor’s ablility to continue growing and multiplying despite normal growth parameters
Define autonomy:
cell’s ability to disconnect from the normal laws of cell growth
How does a malignant tumor change the transport of sugar and amino acids?
Instead of nutrients going to appropriate cells they go straight to the tumor
T or F: A benign tumor is never life threatening
F. Depending on location benign tumors can be life threatening
List the 6 hallmarks of cancer:
- self-sufficiency in growth signals 2. insensitivity to antigrowth signals 3. Evading apoptosis 4. Limitless replicative potential 5. Sustained angiogenesis 6. Tissue invasion and metastasis
Define angiogenesis:
the vascularization of neoplastic cells (tumor can develop circulation and grow quickly)
Why are tumor classifications important?
help us know the origin of the cancer, important for diagnosing and treating cancer-site of origin determines appropriate treatment
Cancer found in epithelial cells:
carcinoma
Cancer found in grandular tissue:
adenocarcinoma
Cancer found in connective tissue:
sarcoma
Cancer found in lymph tissue:
lymphoma
Cancer found in blood forming tissue (marrow)
leukemia
Cancer found in the uterus:
fibroma
Cancer found in bones:
osteoma
Cancer found in cartilage:
chondroma
Cancer found in glial cells of the CNS:
gliomas
What is one of the most deadly types of cancer?
gliomas
Carcinogenesis refers to:
the foundations of how a cancer begins
T or F: All cancers have a huge genetic component.
F. Genetics plays a role, but not always.
Define protooncogenes:
normal genes that code for cellular growth
Define oncogenes:
mutant genes
What do oncogenes do in their non-mutant state?
direct protein synthesis and cellular growth
What are tumor suppressor genes?
Cells present in everyone that act to suppress the growth of tumors
What role do DNA repair genes play in carcinogenesis?
DNA repair genes can get mutated and become carcinogenic
List the 3 stages of cancer development:
Initiaion, promotion, progression
What happens during initiation?
DNA is damaged and mutates
What happens during promotion?
Upon exposure to a carcinogenic environment/genetics cancerous cells get enhanced
What happens during progression?
local invasiveness, angiogenesis, metatasis-cancerous growth continues, adjacent organs may be invaded
During initiation, what is happening on a cellular level?
DNA is damaged and cells mutate
What is happening on a cellular level during promotion?
oncogenes are activated by a promoter agent
What is happening on a cellular level during progression?
a malignant tumor is growing and spreading
What are tumor-suppressor genes?
In their normal state negatively regulate proliferation-anti-oncogenes
What happens if tumor-suppressor genes are in an unsteady state?
oncogenes will take over
Viral insertion of HPV, HCV, or EBV can have what effect on a protooncogen gene?
can cause it to mutate
Point mutations, gene amplification, and chromosomal rearrangement are all examples of:
protooncogene mutations
Cancer is predominantly a disease of _____________
aging
How do recurrent infections/inflammation relate to cancer?
Every time cells are killed off and need to re-grow there is a possibility of mutation.
T or F: Cancer can easily develop after 1 cell mutation.
F. multiple mutations aare required before cancer can develop
T or F: When tumor suppression genes are inactivated, oncogenes will be activated.
T. Tumor suppressor genes and oncogenes have an inverse relationship. When one is on the other will be off.
T or F: Once oncogenes are activated the development of cancer can take years.
TRUE
If a person is exposed to mutagens and somatic cells mutate, this mutation (will/will not) be passed on to next generations.
will NOT
If a person is exposed to mutagens and germline cells mutate, this mutation (will/will not) be passed on to next generations.
will
How might H. pylori cause cancer?
People who have chronic stomach ulcers (inflammation and constant cellular repair) are at high risk of developing gastrinoma
Chronic inflammation is an important factor in the development of cancer because:
it can promote mutation, and invoke a decreased response to DNA damage
Define proliferation:
The growth or production of cells by mutiplication of parts
Define differentiation:
Describes how much or how little the tumor looks like the normal tissue it came from
What are tumor cell markers?
biological substances that can be detected in blood, spinal fluid, or urine
Give some examples of tumor cell markers:
hormones, enzymes, genes, antigens, antibodies
What are some purposes of tumor cell markers?
Can be used to screen, diagnose, mark tumor progression
T or F: Discovering a tumor cell marker by itself is enough to make a diagnosis of cancer
F. Markers are never used alone or as a diagnostic test.
When making a diagnosis one should first:
Assess what the patient looks like
The most common vehicle used for cancer to travel through the body is the ___________________
lymphatic system
List the 4 most common sites to find cancer:
Brain, bones, liver, lungs
Why are the brain, bones, liver, and lungs prone to developing cancer?
They are all highly vascular organs
A cancer in stage 1 is:
confined to organ or origin
A cancer in stage 2 is:
locally invasive
A cancer in stage 3:
has lymph node invasion
A cancer in stage 4:
has spread to distant sites throughout the body
What are the 4 phases of tumor spread?
transformation, growth, local invasion, distant metastasis
Define metastasis:
primary cancer cells travel and proliferate in other sites
On a biopsy report T refers to a tumor’s:
size (T0=no tumor-T3=skin/chest wall involved by invasion
On a biopsy report N refers to a tumor’s:
node invasion (N0=no axillary nodes involved-N2=mobile anda fixed nodes involved
On a biopsy report M refers to a tumor’s:
degree of metastases (M0=no metastases, M1=demonstratable metastases, M2=suspected metastases)
How is tumor grading different than cancer stages?
Tumor grading is assessing the tumor itself, not the stage of cancer
A tumor in Grade 1 is:
well differentiated and resembles the tissue or origin
A tumor in Grade 2 is:
Moderatly differentiated, with increased size and shape of cells
A tumor in Grade 3 is:
poorly differentiated, malignant, a lot of variation in the size and shape of the tumor
A tumor in Grade 4:
has no resemblance to the original tissue, malignant
Patients with cancer who have undergone chemotherapy may exhibit clinical manifestations such as:
Anemia, thromocytopenia (platelets <5000), pain, and cachexia (severe malnutrition)
What are some warning signs of cancer?
Lump or swelling, a sore that doesn’t heal, recent change in a wart/mole, unusual discharge, changes in bladder/bowel habits, nagging cough/hoarseness, difficulty in swallowing, extreme weight loss
To make a definitive cancer diagnosis a clinician should:
Note persistence of sx’s, identify various cancer markers, identify mass/metastasis, have a morphological confirmation
T or F: Chemotherapy is systemic and will kill good cells as well as cancerous cells
TRUE
Chemotherapy, radiation, surgery, and immunotherapy are all methods of:
managing cancer
Skin dryness and hair loss are common side effects of:
chemotherapy
Chemotherapy’s ability to suppress bone marrow refers to:
suppressing RBC’s and platelets
T or F: childhood cancers are a disease entity.
F, they are described as a spectrum of malignancies
What are the most common childhood cancers?
leukemias, sarcomas, and embryonic tumors
What are embryonic tumors?
originate during uterine life, occurs when embryonic tissue does not fully mature, then later proliferates in this immature form
Childhood tumors are commonly called ____________
blasts
This type fo cancer commonly involves tissue (childhood or adult)
childhood
This type of cancer has few prevention strategies
childhood
This type of cancer has strong environmental and lifestyle influences
adult cancer
This type of cancer commonly involves organs
adult cancer
This type of cancer is 80% preventable
adult cancer
This type of cancer has a >80% cure rate
childhood
This type of cancer has fewer long term consequences
adult cancer
What type of cancer is often detected early with screening?
adult cancer
Prenatal exposure and increased parental age are possible environmental factors for:
childhood cancer
What is the prognosis for childhood cancer?
80% are fully cured
