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Patho > Week 2: Cancer > Flashcards

Week 2: Cancer Flashcards

1
Q

General trend between cancer incidence and age

A

Cancer requires a series of mutations in somatic cells, so increased likelihood of developing cancer with age

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2
Q

Extrinsic stimuli for cancer

A

Environmental/acquired stimuli eg. smoking

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3
Q

Intrinsic stimuli for cancer

A

Genetic design of the cell eg. BRCA gene

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4
Q

Characteristics of benign tumors (2)

A
  1. well differentiated

2. localized and demarcated

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5
Q

Characteristics of malignant tumors (4)

A
  1. less differentiated
  2. grow rapidly
  3. can invade neighboring tissues
  4. can spread to other body sites
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6
Q

Define neoplasia

A

uncontrolled, abnormal growth of cells or tissues in the body

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7
Q

What is the difference between cancer & neoplasia?

A

cancer is a malignant form of neoplasia

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8
Q

Define differentiation

A

degree of specialization within a cell

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9
Q

Differentiation in a normal cell

A

all cells become more differentiated as they mature

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10
Q

Relationship between cancer & differentiation

A

less differentiated, often express molecules that are normally only expressed in immature or less differentiated cells

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11
Q

Define Carcinoembryonic antigen

A

Tumor cell marker of colorectal carcinomas, usually only expressed before birth

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12
Q

Define proliferation

A

a cell’s ability to divide and make copies of itself

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13
Q

Proliferative capacity

A

a limited number of cell divisions before that cell will die

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14
Q

Relationship between cancer & proliferation

A

Cancer cells become immortalized and can divide without undergoing cell death, often divide more rapidly

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15
Q

The more _____ the greater the capacity to _______and the more _______ the cancer

A
  1. undifferentiated
  2. proliferate
  3. malignant
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16
Q

3 major tasks of cell cycle

A
  1. DNA replication or synthesis
  2. Mitosis (nucleus divides)
  3. Cytokinesis (cell divides)
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17
Q

Which phase in the cell cycle is important for regulation of cell division?

A

G (gap) phases

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18
Q

What is the relationship between the cell cycle and cancer?

A

Cell cycle is altered in many cancer cells

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19
Q

What is different about the cell cycle of a cancer cell? (2)

A
  • Disruption of normal cell division

- Cancer cells are autonomous or independent of normal growth controls

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20
Q

What does the term “autonomous” mean with respect to cancer?

A

Cancer cells are independent of normal growth controls so they can divide indefinitely and proliferate continually

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21
Q

What is the major function of telomerase?

A

places telomeres at the end of chromosomes

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22
Q

Why does telomere loss occur and what is the result?

A

Why: telomeres are built into the ends of chromosomes to prevent the loss of genetic info as polymerase cannot copy the information at the end
Result: as cells divide, telomeres are lost, trigger apoptosis

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23
Q

What is the relationship between cancer & telomeres?

A

Cancer cells overcome the association between telomere loss and death by activating telomerase to add new telomeres to the end of chromosomes

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24
Q

What is the role of p53 in the cell cycle?

A

slows the cell cycle to allow for repair of mutations before cell division, has anticancer functions centered around DNA repair

25
Q

Anticancer functions of p53 (3)

A
  1. Activates DNA repair proteins when DNA has sustained damage
  2. Arrests the cell cycle to allow DNA repair proteins time to fix mutations
  3. Initiates apoptosis if DNA damage cannot be reversed
26
Q

How does alteration of this normal role for p53 relate to cancer?

A

results in altered growth signals, cell cycle is not regulated

27
Q

What is the role of pRB in the cell cycle?

A

governs the restriction point in G1; if cells pass this point, they are committed to the cell cycle

28
Q

How does alteration of this normal role for pRB relate to cancer?

A

results in increased cell proliferation

29
Q

Explain what is meant by the statement: “cancer is genetic, but not necessarily inherited”

A

Genetic changes or mutations are required for cancer to arrive, but we don’t necessarily inherit these changes from our parents

30
Q

Define the term genetic and inherited in relation to cancer

A 
genetic = mutation is involved
inherited = mutation is inherited from parent
31
Q

Most changes that lead to mutation are ______ not ______.

A
  1. acquired

2. inherited

32
Q

General steps of the multi-step basis of cancer (3)

A
  1. Initiation: DNA mutation, irreversible
  2. Promotion: stimulation of cell proliferation, reversible in early stages
  3. Progression: obtaining malignant phenotype, invasiveness and metastasis, autonomous growth, genomic instability
33
Q

Example of the multi-step concept and cancer - familial adenomatous polyposis (FAP) (6 steps)
What types of genes are mutated in this kind of cancer?

A

Involves changes in the TS and oncogenes

  1. Deletion of APC TS gene
  2. Deletion of a second APC allele
  3. Mutation of ras oncogene
  4. Loss of both alleles of DCC TS gene
  5. Loss of p53 TS gene
  6. Additional changes lead to invasion and metastasis
34
Q

Define tumor suppressor genes

A

function to inhibit cell growth & division

35
Q

What is required for retinoblastoma to arise?

A

mutation in both alleles of pRB - inherited and/or acquired

36
Q

What type of mutation occurs when TS genes are mutated?

A

loss of function

37
Q

Define oncogenes

A

Form growth factors, enzymes, receptors within the cell that generally promote cell growth
Typically work as protooncogenes (inactive form)

38
Q

How does a protooncogene become an oncogene?

A

activating mutation of one of the two alleles of a proto-oncogene converts it to an oncogene

39
Q

How is the Philadelphia chromosome formed (1) and what disease does it give rise to (2)?

A
  1. Transmutation of chromosome 9 and chromosome 22

2. Chronic myelogenous leukemia

40
Q

What is the role of DNA repair genes?

A

correct damage or mutations in cellular DNA due to DNA replication error or environmental exposure

41
Q

What is the consequence of unrepaired DNA mutation?

A

damage can spread across cells

failure to fix mutation increases likelihood of cancer

42
Q

Give an example of a type of cancer that involves mutations in DNA repair genes.

A

Hereditary nonpolyposis colon cancer (HNPCC) - inherited mutations that impair DNA repair genes

43
Q

What are the altered biochemical properties of a cancer cell? (2)

A
  1. Promote growth by secreting growth factors/hormones

2. Promote spread by secreting proteases

44
Q

What are chromosomal changes that occur in a cancer cell? (3)

A
  1. Aneuploid (loss of diploid state)
  2. Translocations and other rearrangements
  3. Chromosomal instability
45
Q

What are the aberrant adherence properties of a cancer cell? (3)

A
  1. Loss of contact inhibition
  2. Anchorage independence
  3. Promotion of invasion and metastasis
46
Q

Define invasion, angiogenesis, and metastasis

A

Invasion: active process involving transfer of cancer cell across tissue barriers
Angiogenesis: formation of new blood vessels
Metastasis: spread to new sites

47
Q

What occurs during invasion? (3)

A
  1. Adhesion: adherence of cancer cells to basement membrane or extracellular matrix
  2. Proteolysis: breakdown of extracellular barriers
  3. Motility: movement of cancer cell from origin to neighboring sites
48
Q

Three major factors of metastasis (3)

A
  1. Involves entry of tumor cell to blood lymph and distribution to other body sites where secondary tumors establish
  2. Follows general patterns (vascular drainage)
  3. Favors some sites bc they provide a good environment for tumor growth
49
Q

Common clinical manifestations of cancer (3)

A

pain, cachexia, and declining hematopoiesis

50
Q

Define cachexia

A

severe form of malnutrition associated with anorexia and tumor necrosis factor

51
Q

Define declining hematopoiesis

A

declining formation of blood cellular components, often see anemia; tumors in bone or bone marrow can contribute to this issue

52
Q

Define tumor cell markers

A

expressed as a consequence of changes in the cancer cell, can be used to identify cancer and reflect their clonality

53
Q

How are tumor cell markers used for diagnosis and treatment?

A

help determine changes in tumor growth or response to treatment; not usually specific enough to use for diagnosis

54
Q

Examples of tumor cell markers (3)

A 
prostate-specific antigen (PSA) - prostate cancer 
CA-125 - ovarian cancer 
carcinoembryonic antigen (CEA) - colorectal cancers
55
Q

What are common treatments for cancer? (4)

A
  1. Surgery: elimination of local tumor
  2. Chemotherapy: treatment of disseminated tumor cells
  3. Radiation: elimination of local tumor
  4. Personalized medicine: tailor treatment to unique characteristics of each person
56
Q

What is tumor staging used for?

A

Group people according to the extent of the disease – can determine choice of treatment, estimate prognosis, compare results after treatment

57
Q

TNM staging method: T what does it indicate and stages (4)

A 
size and local spread 
Tx: tumor cannot be adequately assessed 
T0: no evidence of primary tumor 
Tis: carcinoma in situ 
T1-4 progressive increase in tumor size or involvement
58
Q

TNM staging method: N what does it indicate and stages (3)

A

involvement of the regional lymph nodes
Nx: cannot be assessed
N0: no evidence of regional node metastasis
N1-3: increasing involvement of regional nodes

59
Q

TNM staging method: M what does it indicate and stages (3)

A

describes the metastatic involvement
Mx: not assessed
M0: no distant metastasis
M1: distant metastasis present, specify sites

Patho (14 decks)

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