Tumor Markers

Question 1

What is oncology?

Answer 1

Oncology is the study of tumors

Question 2

What is a tumor?

Answer 2

Also called neoplasm, it is a mass of tissue that is formed by an accumulation of clonal cells with abnormal growth control, that is, clonal expansion.

Question 3

What are the two states of a tumor?

Answer 3

Benign (non-cancerous) or malignant (cancerous, invasive)

Question 4

Can both tumor states cause disease?

Answer 4

Yes

Question 5

What are tumor markers?

Answer 5

These are substances synthesized and released by tumor cells or that are produced in response to the presence of cancerous cells.

Question 6

Where can tumor markers be present?

Answer 6

In blood, body fluids, on cell surface or inside cells

Question 7

What is malignancy?

Answer 7

Malignancy is a cellular disease that changes the normal influences that control cell growth, differentiation, and proliferation

Question 8

What do malignant cells do?

Answer 8

They divide without control and can invade or spread to nearby tissues, or distal systems for further colonization.

Question 9

Through what body system does these malignant cells go and what is this called?

Answer 9

Through the bloodstream and lymphatic system. Metastasis

Question 10

What is it called when a tumor is not malignant, do not invade nearby tissue and are still under some control?

Answer 10

Benign tumors

Question 11

Is cancer malignant or benign?

Answer 11

Malignant. It included all malignant/invasive cells including the ones solid or hematologic in nature like lymphomas and leukamias

Question 12

What causes malignant cells?

Answer 12

Genetic or environment or both

Question 13

List the four stages of cancer

Answer 13

Induction phase
In situ phase
Invasive phase
Dissemination phase

Question 14

Discuss the induction phase of cancer

Answer 14

This is the long lasting phase in which cells are exposed to some mutagen or teratogen that affects cellular genes, that is their mutation, deletion, gene rearrangement. Abnormal cell function and division begins but is not predominant

Question 15

Discuss the in situ phase

Answer 15

Transformed cells develop into cancerous cells but the cells remain localized. Tumor begins to grow

Question 16

Discuss the invasive phase

Answer 16

Abnormally proliferating cells multiply and invade the lymphatic or vascular system

Question 17

At what stage are most cancers detected?

Answer 17

Invasive stage

Question 18

Discuss the dissemination phase

Answer 18

Cancerous cells are found in distant sites. It is difficult sometimes I’m this stage to determine the origin or the cells. Often untreatable

Question 19

How are tumor markers used for screening?

Answer 19

High sensitivity, moderate specificity.
Screening tool means if the test is positive, it is a red flag for further analysis. Does not always mean the pt has a tumor. When negative, there is high confidence pt doesn’t have tumor. Eg Pap smear

Question 20

How are tumor markers used for diagnosis?

Answer 20

Used in symptomatic patients.
High specificity, moderate sensitivity
Some TM are highly correlated with the existence of certain kinds of tumor. Very few markers can be used for tumor or cancer diagnosis however

Question 21

How are tumor markers used for monitoring?

Answer 21

Level of tumor markers can be correlated with tumor load. If tumor load is decreased after chemo, it shows as a decrease in tumor marker too. In such cases, tumor markers can be used as a monitor of tumor progression and response to therapy.

Question 22

How are tumor markers used as detectors?

Answer 22

Used to find disease recurrence if it manifests