unit 4 Cancer Chptr 23

Question 0

Apoptosis

Answer 0

Programmed cell death
This ensure that organs have cells at their functional peak.
Every time mitosis happens the DNA strand gets a little shorter till it’s gone and then a signal triggers apoptosis (death)

Question 1

Contact inhibition

Answer 1

Only when a cell is in contact with all sides, does it stop dividing (mitosis)

Question 2

Normal chromosomes aka–>

Answer 2

Euploidy

23 pairs

Question 3

Benign cells

Answer 3

Normal cells growing at the wrong place or at the wrong time

Ex) moles, fibroid tutors, skin tags, endometriosis, nasal polyps

Question 4

Features of a benign tumor (7)

Answer 4

1) Specific morphology–look like their parent cell
2) Small nuclear-to-cytoplasmic ratio
3) Specific differentiated function- no matter where it is it acts like all the other ex) endometrium grows in a abnormal place estrogen release still makes it shed not matter where it’s at

4) tight adherence
5) no migration
6) orderly growth-May not be in correct place but it is at correct rate and continue beyond normal space
7) normal chromosomes (23pairs)

Question 5

Features of a cancer (malignant) cell (8)

Answer 5

1) anaplasia– as they become malignant they loose they normal shape– they become smaller and rounded, this can make diagnosis of “types” of cancers hard because many look alike
2) a large nuclear to cytoplasmic ratio
3) specific functions are lost
4) loose adherence- because they do not make fibronectin, as a result they can easily break off from main tumor
5) migration- cancer cells do not bind tightly together and have a lot of enzymes on their surface sand this makes it easy for them to slip through blood vessel walls and between tissues (metastasize)
6) contact inhibition– does NOT occur, even when all side are in contact they still divide
7) rapid or continuous cell division–re-enter mitosis almost continuously. And some have as short generation time (2-3 hours). But most have that of their parent cell. Theses cells also do no respond to apoptosis signals. Most have a lot of enzymes (telomerase) which maintain telemedicine DNA. Do not respond to apoptosis signal and have unlimited life span (IMMORTAL)
8) abnormal chromosomes aka (Aneuploidy)- common the more malignant they become, chromosomes are lost, gained, broken; as a result some have more than 23 or less broken or rearranged

Question 6

Benign tumors grow by expansion

Malignant tumors grow by invasion

Answer 6

X

Question 7

Carcinogenesis and oncogenesis are? AKA

Answer 7

Other names for cancer for cancer development

Question 8

Malignant transformation occurs through 4 steps

Answer 8

1) Initiation- is the 1st step in carcinogens. Normal cells can become cancer cells if their genes promoting cell division “oncogenes”, are turned on excessively (over expressed) is an irreversible event that can lead to cancer development.
* *a cancer cell is not a threat unless it can divide, if it can’t it cannot form a tumor. Pg399

2) Promotion- promote or enhance the growth of an initiated cancer cell— many normal hormones like estrogen, insulin and body proteins can act as promoters and make altered cells divide more frequently. (Latency period) is time between cell’ initiation and development of of an overt tumor
3) Progression– starts to get its own blood supply (1cm tumor has at least 1 billion cells)
4) Metastasis- ex) when breast cancer spreads to lungs or bone it is still breast cancer not lung or bone cancer
(Blood born metastasis) tumor released into the blood is the most common cause of cancer spread
Another way spread–> Lymphatic

Question 9

Primary and secondary prevention

Answer 9

Primary prevention- avoiding exposure to cancer causing agents

Secondary– screening for early detection

Question 10

Carcinogens

Answer 10

Substances that change the activity of a cells genes so that the cell becomes a cancer cell– May be chemical physical agents or viruses.
There are more than 50 substances known to cause but over 200 suspected

Question 11

Solid tumor

Hematologist tumors. Arise from what

Answer 11

Solid from specific tissues ( breast cancer and lung cancer)

Hematologic cancer arises from blood cell forming tissue ( leukemia and lymphomas)

Question 12

Ploidy

Answer 12

Classifies tumor chromosomes as normal or abnormal.

Question 13

Staging

Answer 13

Classifies clinical aspects of the cancer

The higher the rating the less they resemble their parent cell.
Gx–cannot be determined
G1–tumor cell closely (well defined) resemble parent cell
Low grade of malignant
Are malignant but are relatively slow growing
G2–moderately defined ( differentiated) they still retain some characteristics of normal cells but Laos have more malignant char. than G1

G3–poorly differentiated, but the tissue of origin can usually be established. Have few normal cell char.
G4–poorly diff. and retain NO normal cell char.
determination of origin is difficult

Question 14

Euploidy

Answer 14

Normal diploid number. 46 chromosomes (23 pairs)

Question 15

Aneuploidy

Answer 15

Some cancer cells gain or lose whole chromosomes and may have structural abnormalities of the remaining chromosomes.

Question 16

Further Staging

Answer 16

Determines the exact location cancer and it’s degree of metastasis.

               Primary Tumor (T)
Tx-- Primary tumor cannot be assessed
To--No evidence of Primary tumor 
Tis--carcinoma in situ
T1, T2, T3, T4,-- Increasing size and/ or local extent of the primary

          Regional Lymph Nodes (N) Nx-- Regional lymph nodes cannot be assessed  No-- No regional lymph node metastasis N1, N2, N3-- Increasing involvement of regional lymph nodes

           Distance Metastasis (M)  Mx-- Presence of distance metastasis cannot be assessed Mo-- No distance metastasis M1-- Distance metastasis

Question 17

Staging is not useful for what cancers.

Answer 17

Leukemia and lymphomas

Question 18

Doubling time

Mitotic index

Answer 18

Tumor growth is assessed in terms of doubling time, the time it takes to dbl in size
And mitotic index the % of actively dividing cells within a tumor

The smallest detectable tumor is 1 cm and has a billion cells, it dbls about 30 times to get to this size

A tumor with a mitotic index of less than 10% is a slow-growing tumor.
A tumor with a index of 85% is a fast growing

Question 19

3 factors that influence cancer development

Answer 19

1) exposure to carcinogens
2) genetic predisposition
3) immune function

Question 20

Oncogene

Answer 20

Are a normal part of every cells normal makeup. ( they r turned on under controlled conditions when cells need to divide for normal growth or to replace dead cells) They become a problem only if they are overexpressed as a result of exposure to carcinogenic agents or events

Question 21

Cancer etiology and genetic risks(6)

Answer 21

1) Oncogene activation
2) Chemical carcinogenesis
3) physical carcinogenesis
4) viral carcinogenesis
5) Dietary factors
6) Personal factors
Immune function
Age
Genetic risks

Question 22

Chemical agents

Answer 22

Smoking and alcohol but many more

Question 23

Physical agents

Answer 23

Radiation (ionizing and ultraviolet (uv) and chronic irritation

Question 24

Virus carcinogenesis

Answer 24

When viruses infect cells and damage DNA
Ex) oncovirus

Hepatitis
HPV
Epstein-Barr

Question 25

Dietary factors

Answer 25

Low fiber intake
High red meat intake
High animal fat intake
Preservatives 
Contaminants
Preparation methods
Additives

Question 26

Personal factors

Answer 26

Immune function– natural killers and T-cells
Age–>single most important risk factor
Genetic risk

Question 27

7 warning signs

CAUTION

Answer 27

Changes in bowel or bladder habits
A sore that does not heal
Unusual bleeding or discharge
Thickening or lump in breast or elsewhere
Indigestion or difficulty swallowing
Obvious change in wart or mole
Nagging cough or hoarseness

Question 28

Primary prevention

Answer 28

• Avoidance of known or potential carcinogens
• Modify associated factors ( stop drinking, smoking)
• Removal of “at risk” tissue
• Chemoprevention ex) Celebrex and aspirin to reduce risk of colon cancer—- Use of Vit D and tamoxifen to reduce risk of breast cancer– Use of lycopene to reduce risk of prostate cancer
• Vaccinations- is a new one–> Gardasil– HPV

Question 29

Secondary prevention

Answer 29

Regular "screening" for cancer does not reduce cancer incidence but can greatly reduce cancer deaths
Ex) mammogram 
      Yrly breast exam 
      Colonoscopy
      Yrly fecal occult blood
       Yrly prostate PSA
      Ex....d

Question 30

Clinical staging

Answer 30

Evaluates the clinical signs for tumors and possible spread

Question 31

Surgical staging

Answer 31

Tumor size, number of sites, and spread by inspection at surgery

Question 32

Pathological staging

Answer 32

The most definitive type, determine tumor size number, sites, and spread by pathologic examination of tissues obtained at surgery

Question 33

Number one causes of cancer and deaths for male and female

Answer 33

New cases Deaths
Male Female Male Female
Prostate. Breast. Lung/ bronch. Lung/ bronch

Question 34

Hypertrophy

Answer 34

Growth that causes tissues to increase in size by enlarging each cell

Question 35

Hyperplasia

Answer 35

Growth that causes tissues to increase in size by increasing the # of cells

Question 36

continued cell growth NOT needed for repair or normal development.

ALWAYS abnormal even if it doesn’t causes any harm

Answer 36

Neoplasia

Question 37

Cyclins are activated what happens

Answer 37

Allows cells to leave the Go and enter the cycle

Question 38

Cachexia

Answer 38

Wasting syndrome

Question 39

Hypernatremia

Answer 39

Electrolyte disorder

Question 40

Emetogenic

Answer 40

Vomiting