Test 3 Flashcards
The seven warning signs of cancer
Changes in bowel or bladder habits A sore that does not heal Unusual bleeding or discharge Thickening or lump in the breast or elsewhere Indigestion or difficulty swallowing Obvious change in a wart or mole Nagging cough or hoarseness
Common sites of metastasis for different cancer types
Breast cancer: bone* lung* liver brain
Lung cancer: brain*, bone, liver, lymph nodes, pancreas
Colorectal cancer: liver * lymph nodes, adjacent structures
Prostate cancer: bone(especially spine, legs) pelvic nodes
Melanoma: gi tract, lymph nodes, lung, brain
Primary central brain cancer: central nervous system
Benign
Harmless, does not usually require intervention
Malignant
Indicates cancer, serious and lead to death without intervention.
Abnormal, serve no useful function and harmful to normal body tissues.
Cancer
Over 1.8 million people are newly diagnosed with cancer each year.
Two reason for the increase are the longer life expectancy of people in more affluent countries and increased exposure to substance hat cause cancer. Cancer will occur in about 1 in 3 people
Growth
The growth that is well controlled through cellular regulation, ensuing t hat the right number of cell is always present in any tissue or organ.
Hypertrophy: growth that cause tissue to increase in size by enlarging each cell
Hyperplasia: growth that causes tissue to increase in size by increasing the number of cells
Neoplasia
Any new or continued cell growth not needed for normal development or replacement of dead and damaged tissue
Specific morphology
The feature in which each normal cell type has a distinct and recognizable appearance, size, and shape
Smaller nuclear to cytoplasmic ratio
Means that the nucleus of a normal cell does not take up much space inside the cell
Differentiated function
Means that every normal cell has at least one function it performs to contribute to whole body function
Tight adherence
Occurs because normal cells make proteins that protrude from the members, allowing cells to bind closely and tightly together
Nonmigratory
Tha normal cells do not wander throughout the body except for blood cells
Orderly and well regulated growth or cellular regulation
Very important feature of norma cells
They divide to develop normal tissue and to replace lost or damaged normal tissue
Features of cancer cells
Anaplasia A large nuclear- cytoplasmic ratio Specific function lost Loose adherence Migration (metastasis) No contact inhibition Rapid or continuous cell division Abnormal chromosomes (aneuploidy)
Anaplasia
Is the cancer cells loss of the specific appearance of their parent cells. The more malignant he smaller and rounded the cell gets
A larger nuclear-cytoplasmic ratio
Occurs because the cancer cell nucleus is larger than that of a normal cell and the cancer and the cancer cell is smaller than a normal cell
Specific functions
Are lost partial or completely in cancer cells.
Loose adherence
Is typical for cancer cells because they do not make fibronectin, as a result cancer cells easily break off from the main tumor
Migration
Occurs because cancer cells do not bind tightly together and have many enzymes on their cell surfaces. The ability to spread metastasize is unique to cancer cells and a major cause of death
Contact inhibition
Does no occur in cancer cells because of lost cellular regulation when when all sides of these cells are in continuos contact with the surfaces of other cells
Rapid or continuous cell division
Occurs in many types of cancer cells because they re-enter the cell cycle for mitosis almost continuously because cellular regulation is lost
Cancer cells do not respond to apoptotic signal and have an unlimited life span
Abnormal chromosomes (aneuploidy)
Are common in cancer cells as they become more malignant
Cancer development
Carcinogenesis and oncogenesis are other names for cancer development. He process of changing a norma cell into a cancer cell is called a malignant transformation, occurring through loss of cellular regulation leading to the steps of initiation, promotion, progression and metastasis.
Carcinogens
Substances that change the activity of a cells genes so treat the cell becomes a cancer cell. May be chemical, physical agents or viruses.
Initiation first step of carsinogenesis
Is a change in gene expression caused by anything that can penetrate a cell, get into the nucleus and mutate the DNA leading to loss of cellular regulation
Promotion step 2 in carcinogenesis
The enhanced growth of an initiated cell by substances known as promoters.
Progression step 3 in carcinogenesis
Is the continued change of a cancer, making it more malignant over time. The tumor must firs develop its own blood supply.
Metastasis step 4 in carcinogenesis
Occurs when cancer cells move from the primary location by breaking off fro the original group and establishing remote colonies.
Steps 1 of metastasis malignant transformation
Malignant transformation, some normal cuboidal cells have undergone malignant transformation and have divided enough times to form a timorous area within the cuboidal epithelium
Step 2 in metastasis Tumor vasculation
cancer cell secrete vascular endothelial growth factor stimulation to bud and for new channels that grow in the tumor.
Step 3 metastasis blood vessel penetration
penetration cancer cells have broken off from the main tumor, enzymes on the surface of the tumor cells make holes in the blood vessels allowing cancer cells to enter blood vessels and travel around the body
Step 4 in metastasis arrest and invasion
cancer cells clump up in blood vessel calls and invade new tissue areas. If the new tissue areas have the right conditions to support continued growth of cancer cells new tumors will form at this site.
Cancer classification
Grading of the tumor classifies cellular aspects of the cancer
Ploidy classifies tumor chromosomes as normal or abnormal
Staging classifies clinical aspects of the cancer, determines the exact location of the cancer and its degree of metastasis at diagnosis
Euploidy the normal diploid number
Aneuploidy some cancer cells gain or lose whole chromosomes and may have structural abnormalities of the remaining chromosomes
Grading of malignant tumors
Gx- grade can not be determined
G1- tumor cells are well differentiated and closely resemble he normal cells from which they arose. This grade is considered a low grade of malignant change. These tumors are malignant but are relatively slow growing.
G2- tumor cells are modestly differentiated, they still retain some of the characteristics of normal cells but also have more malignant characteristics than do G1 tumor cells
G3- tumor cells are poorly differentiated by the tissue of origin can usually be established. The cells have a few normal cell characteristics.
G4- tumor cells are poorly differentiated and retain no normal cell characteristics. Determination of the tissue of origin is difficult and perhaps impossible.
Staging (T)
Primary Tumor (T) Tx- primary tumor cannot be assessed T0- no evidence of primary tumor Tis- carcinoma in situ T1,T2,T3,T4- Increasing size and or local extent of the primary tumor
Staging (N)
Regional lymph Nodes (N)
Nx- regional lymph nodes cannot be assessed
No- no regional lymph node metastasis
N1,N2,N3- increasing involvement off regional nodes
Staging (M)
Distant metastasis (M)
Mx- presence of distant metastasis cannot be assessed
Mo- no distant metastasis
M1- distant metastasis
Doubling time
Tumor growth is assessed in terms of doubling time (the amount of time it takes for a tumor to double in size)
Mitotic index
The percentage of actively dividing cells within a tumor
Oncogenes
Are not abnormal genes but are part of every cells normal makeup. Become a problem only if they are over expressed as a result of exposure o carcinogenic agents or evens with loss of cellular regulation
External factors
Including environment exposure are responsible for about 80% of cancer in north America
Chemical carcinogenesis
Can occur from exposure to many known chemical, drugs, and other products used in everyday life
Physical carcinogenesis
From physical agents or events also causes cancer by DNA damage. Two physical agents that are known to cause cancer are radiation and chronic irritation- burn scars or skin injury
Viral carcinogenesis
Occurs when viruses infect body cells and break DNA strands. Viruses that cause cancer oncoviruses
Dietary factors
Dietary factors include low fiber intake and a high intake of red meat or animal fat.preservatives preparation methods and additives(days, flavoring, sweeteners) may have cancer promoting effects
Personal factors
Immune function, age, and genetic risk also affect.immune function protects the body from foreign invaders and non-self cells
Cancer incidence increases among immunosuppressed people.
Advancing age is the single most important risk factor for cancer, as a person ages, immune protection decreases and external exposure to carcinogens accumulate
Primary prevention
Is the use of strategies to prevent the actual occurrence of cancer.
Avoidance of known or potential carcinogens is an effective prevention strategy when a cause of cancer is known and avoidance is easily accomplished
Sun screen, don’t smoke, pipe, diet low in fiber with colon, breast, and ovarian, multiple sexual partners or protection. HPV gardasil and cervarix
Secondary prevention
Regular screening.
Yearly mammography for women older than 40 years
Yearly clinical breast examination for women older than 40 years
Every 3 years for women 20-39
Colonoscopy at age 50 years and tha every 10 years
Yearly fecal occult blood for all ages
Digital rectal examination for men older than 50
BRCA1 gene increase the risk for both breast and ovarian
BRCA2 gene ris for breast and mutations in the APC, MLH1, mlh2 in crease for colon
Cancer associated with tobacco
Lung. Uterine Oral Kidney Pharynx. Bladder Larynx. Liver Esophagus. Stomach Pancreas. Myeloid leukemia
Viral origin
Epstein-barr virus- Burkett she lymphoma, bell lymphoma, nasopharyngeal carcinoma
Hepatitis b virus-primary liver carcinoma
Hep c virus- primary liver carcinoma, possibly b-cell lymphomas
Hpv- cervical carcinoma, vulvar carcinoma, penile carcinoma and other anogenital carcinomas
Human lymphotrophic virus 1- adult t cell leukemia
Human lymphotrophic virus 2-hairy cell leukemia
Leading sites of new cancer
New cases Male. Female Prostate. Breast Lung. Lung Colon. Colon Urinary. Uterine
Estimated death
Male Female Lung. Lung Prostate. Breast Colon. Colon Pancreas. Pancreas
General
Cancer can develop in any organ or tissue and destroys normal tissue, which decreases function of that tissue or organ.
Advance cancer can
Reduce immunity and blood producing functions
Altered gi structure and function
Motor and sensory deficient
Decreased respiratory function
Reduced immunity and blood producing functions
Impaired immune and blood producing function occur most often in patient with leukemia and lymphoma but can also occur with any cancer that invades the bone marrow.
Can cause anemia by decreasing the number of RBC’s and causes thrombocytopenia by decreasing the number of platelets
Altered gi structure and function
Abdominal tumors may obstruct or compress structures anywhere in the GI tract, reducing the ability to absorb nutrients and eliminate wastes.
Anorexia, cachexia, diet in high protein and carbs
Motor and sensory
When cancer invade bone or the brain or compress nerves.
Causes pain, fractures, spinal cord compression and hypercalcemia
Reduce gas exchange
Cancer can disrupt oxygenation in several way and often results in death. Tumors in the airway cause obstruction
Cancer management
The purpose of cancer management is to prolong survival time and improve quality of life.
Surgery
The earliest known treatment for cancer and continues to be a cornerstone of therapy.