Tumour Names and Carcinogenesis Flashcards
what is the SPIKES protocol
protocol for delivering bad news to patients
what are some examples of tumour classifications
benign/malignant, histological origin, primary or secondary
what are some examples of histological classifications of tumours
epithelial, mesenchymal, haematological
what is a papilloma
benign epithelial non glandular surface tumour
what is an adenoma
benign epithelial surface tumour - glandular
what is a carcinoma
malignant epithelial tumour
if it is secretory it is an adenocarcinoma
what do these prefixes mean for tumours leiomyo- rhabdomyo- lipo- angio- osteo- chondro- fibro-
smooth muscle skeletal muscle adipose blood vessel bone cartilage fibrous
preceded with the tissue of origin what does -oma mean in cancers
benign mesenchymal tumour
what do you suffix for a malignant mesenchymal tumour
sarcoma
what are some examples of benign melanocytic lesions
lentigo (brown patches) or melanocytes naevi (moles)
what is a melanoma
malignant melanocytic tumour
what are cancers of these CNS regions called meninges astrocytes oligodendroglial ependymal neurones
meningioma astrocytoma / glioblastoma oligodendroglioma ependymoma medulloblastoma
what are germ cells tumours
arise from cells in the gonads or the midline
what are the common types of germ cell cancers in men and women
ovaries - usually benign (dysgerminoma)
testies - usually malignant (seminoma)
what are the three haematological malignancies
leukaemias (chronic/acute) - from bone marrow derived cells ie lymphocytic/lymphoblastic vs myeloid/myelogenous (other haematological cells)
myeloma (plasma cells)
lymphomas (lymph node cells)
what is a hamartoma
benign, non-neoplastic tissue overgrowth (incidentaloma)
consists of at least 2 mature cell types normally found in the organ site
(disorganised mass)
what is a lung harmatoma
bronchial epithelium and cartilage cancer
what is a choristoma
non-neoplastic tissue, benign with histologically normal cells
normal cells but aggregated in the wrong place such as ocular choristoma
derived from germ cell layers
what do we call cancers made up of multiple cell types an give example
compound name
eg benign - angiolipoma
malignant - carcinosarcoma
give an example of a tumour with a cystic component
cystadenoma
what is the difference between primary and secondary metastatic
primary cancer = at site of origin
secondary = metastatic, still aimed with origin but can be different grades
what are some examples of carcinogens of human cancer
chemicals and mineral - asbestos, heavy metals, nitrosamines
infectious agents, viruses and parasites (HPV, EBV, H pylori)
radiation - UV, radon
Physiological, hormones - oestrogen and androgens
what is a carcinogen
any agent that significantly increases the risk of developing cancer
what does genotoxic mean
chemically modify or damage dna ie initiators of cancer
what is a complete carcinogen
something that can promote and initiate cancer such as UV light
what does initiation of cancer require
chemical modification of DNA
replication of modified DNA and mis-incorporation by DNA polymerase
how do promoters contribute to carcinogenesis
stimulate the two rounds of DNA replication required for mutation and fixation
can stimulate clonal expansion of mutated cells
describe the process of initiation, promotion and progression
genotoxic agents interact directly or indirectly with DNA to alter DNA sequence
non-genotoxic agents (promoting agents) can be cytotoxic which result in cell death and stimulate cell division in surviving cells
continuous action by promoting agents accumulates mutations which progress the cancer from benign to malignant
what is the risk of cancer directly related to
levels of cell division
what are the types of point mutations
missense, non-sesne muttons that make protein products more active or less active
frameshift and loss of function
what are the common genetic abnormalities that can lead to cancer
gene amplification - excess and gain of function
chromosomal translocations
aneuploidy (abnormal number of chromosomes in a cell)
what are the two types of mutational consequences
gain in function - activation of protocol-oncognese
loss in function - inactivation of tumour suppressor genes
what is the most common epigenetic consequence of genetic mutation
methylation of gene promoters ie CpG islands
what are the two types of metabolic inactivation in cancer
direct acting - eg Uv directly interacting with DNA
pro carcinogens - require enzymatic activation before they can react with DNA
how does benzopyrene cause cancer
can be generated through combustion of organic material such as tobacco or meat - it is a procarcinogen which requires TP53 to be activated in the body
how are defects in NER linked to cancer
defects in nucleotide excision repair leads to xeroderma pigmentosum (XP) which is a rare inherited direr characterised by sensitivity to UV leading to high frequency of skin cancers
how does the ATM gene link cancer
defects in ATM lead to ataxia telangiectasia - autosomal recessive disorder, increases incidence of cancers
what happens if there is a defect in the repair genes MSH2 and MLH1
leads to hereditary non-polyposis colorectal cancer (HNPCC)
lifetime increase in the risk of developing colorectal and other cancers
genetic polymorphisms in what types of enzymes can lead to increase in risk of cancers
metabolic activation, detoxifying, DNA repair
what about tobacco smoke increases risk of cancer
33 carcinogens
polycyclic aromatic hydrocarbons eg benzopyrene, acrolein, nitrosamines, radioactive lead and polonium
heavy metals
what is the increase risk of cancer with mixing alcohol and smoking
100x for head and neck cancer
how is alcohol linked to cancer
oral, oesophageal, bowel and liver cancer
converted to acetaldehyde - can cause dna damage
increase levels of oestrogen and testosterone
increase uptake of carcinogenic chemicals
reduces levels of folate
can kill surface epithelium = more proliferation
what is the role of oestrogen in breast cancer
increased exposure to oestrogen can stimulate cell division and induce cell damage
how is breast cancer risk associated with menarche
each year the vey first time you start menstruating the risk of breast cancer decreases by 20%
how do oophorectomy and orchiectomy affect cancer rates
removal of ovaries reduces risk of breast cancer by 90%
removal of testies reduces prostate cancer incidence
how does chronic inflammation affect risk of cancer
DNA damage from release of free radicals by immune cells which is the initiation
growth factor induced cell division to repair tissue damage cause by the inflammation is the promotion
what are the top 6 cause of cancer
diet tobacco infection reprod behaviours occupation alcohol
