Pulmonary Neoplasms-Barsky Flashcards
What is the most common cancer found in the lungs?
metastasis from breast, colorectal and endometrial carcinomas; and soft tissue and bone sarcomas and skin melanomas
The (blank) can also be a site of metastasis to the lungs, especially from breast cancer and ovarian cancer (transcoelomic spread)
pleura
Why is it important to distinguish a metastasis from a primary lung cancer?
Staging
-if primary Stage 1-4 but confined to lung then stage 1-2
-if metastasis stage 4
Prognosis and therapy
How do you distinguish between metastasis and primary lung cancer?
- Microscopic appearance
- Multiple v solitary lesion (not always discriminatory)
- Presence of precursor lesions (mets do not have precursor lesions)
- Organ specific immunocytochemistry
- Molecular profiling
What cancer is most common in men? What cancer kills the most men?
Prostate
LUNG CANCER
BUT its been decreasing since 1990
Having the disease is almost predicition of dying from it
What is the most common cancer in women? What cancer kills the most women? Has it changed as of late?
Breast
lung cancer
Slight decrease but not by much
What are the causes (etiologies) of human cancer?
What are the 2 most dramatic causes of lung cancer?
- ENVIRONMENTAL CARCINOGENS
- UV RADIATION
- OTHER IONIZING RADIATION
- VIRUSES
- LIFESTYLE, DIET, IMMUNE STATUS
- HEREDITARY FACTORS OR GENES
- UNKNOWN
Environmental carcinogens and ionizing radiation!
If you alter smoking you can alter what?
the incidence and mortality of lung cancer
How do chemical carcinogens lead to lung cancer?
Acts by forming DNA adducts which give rise to mutations; if mutations occur in hot spots, spots which change gene expression or protein, mutations can be carcinogenic; if mutations occur in introns or junk DNA or in the non-coding strand they can be harmless
If you quit smoking, do you reduce the likelihood of getting cancer?
if you smoke and quit you have declining risk of lung cancer but have an increased risk of disease as compared to a non smokers because you don’t lose all your DNA adducts
T or F
If you quit at a younger age you will have a greater benefit from smoking cessation
T
How does ionizing radiation (i.e radon) cause cancer?
- forms DNA adducts
- causes single and double strand breaks
Next to smoking which is clearly the leading cause of lung cancer, the next leading cause of lung cancer is (blank). How do you reduce these levels?
If you get away from radon, can you reduce your risk of cancer?
RADON. air ventilation (check houses for this)
no because once you have a strand break you cannot repair this
What are the 5 basic categories of oncogens?
- Growth factors
- growth factor receptors
- signal transducing proteins
- nuclear transcription factors
- cyclins and cyclin dependent kinases
What are the four types of protooncogene functions?
Growth inhibitory factors
Molecules that regulate cell adhesion
Molecules that regulate signal transduction
Molecules which regulate nuclear transcription and cell cycle
What is the most important oncogene that causes lung cancer? How can we counteract this?
HER-1 (EGFR)
-block the tyrosine kinase domain in HER1
In malignancies, overexpression or dysregulation of EGFR may increase the signaling response and result in….?
- increased invasion and metastasis
- increased survival
- increase angiogenesis
- increased proliferation
- decreased apoptosis
(blank) is one of the most commonly mutated genes seen in virtually all types of human canceres.
TP53
What does TP53 do? If DNA cannot be repaired, apoptosis genes such as (blank) are induced.
Is it predictive for lung cancer?
Senses DNA damage arresting cell in GI and induces DNA repair
BAX
-no
TP53 increases (blank) preventing phosphorylation of RB It also induces (blank) which aids in DNA repair.
CDKI p21 (CDKN1A) GAD45
What type of tumor is this:
apex of the lung; invades sympathetic ganglion chain (unilateral sympathetic blockade to the face); rare. Anatomical description is important in terms of presentation.
pancoast tumor
What type of lung tumor is this:
easiest to diagnose by bronchoscopy
Central
What type of lung tumor is this:
diagnose via needle aspiration. Most common.
Peripheral lung tumor
What is the clinical presentation of central lung cancer?
cough, chest pain, hemoptysis, sputum
