WEEK ONE - NEOPLASMS + CANCER (Aine)

Question 1

Benign tumour characteristics

Answer 1

Looks similar to the surrounding tissue.
Grows by expansion
Recurrence minimal, prognosis good
Bad: location can affect body

Question 2

Malignant tumour characteristics

Answer 2

Cells look very different
Grow by infiltration, invasion, and metastasis (blood + lymph)
Affects whole body: loss of appetite, cachexia, anemia, N/V, etc etc
Prognosis poor if untreated, recurrence common.

Question 3

Proto-oncogene

Answer 3

normal genes; turned off

Question 4

oncogenes

Answer 4

turned on proto-oncogene; mutate and proliferate cancer

Question 5

what turns on a proto-oncogene?

Answer 5

1) Viruses (e.g. HIV and Kaposi’s sarcoma)
2) DNA damage to tumor suppressant sections of genes

Question 6

Tumor suppressant genes to know

Answer 6

Rb gene: “master brake”
P53 gene
BRCA1 and BRCA2

Question 7

Three stages of carcinogenesis

Answer 7

1) initiation
2) promotion
3) progression

Question 8

Initiation

Answer 8

tumor formation
oncogenes turned on OR carcinogens

Question 9

Promotion

Answer 9

“feeds” cancer – risk factors (smoking, air pollution, sexual activity)

Question 10

Progression

Answer 10

point at which cancer becomes malignant. not all cancers get to this point.

Question 11

3 patterns of cancer spread

Answer 11

1) direct local spread
2) seeding
3) metastatic growth

Question 12

Direct local spread

Answer 12

Invasion of surrounding tissue

Question 13

Seeding

Answer 13

Cell goes through a cavity
During surgery for tumor removal, a few cells are dropped elsewhere

Question 14

Metastatic growth

Answer 14

w/ escape enzymes, cancer spreads through blood or lymph.
Most common sites of m. growth are Liver and Lungs
other sites: bone, brain, adrenal glands

Question 15

General physiological response to cancer

Answer 15

bleeding/hemorrhage
anemia
cachexia, loss of appetite, weakness, wasting of tissue

Question 16

tumor markers

Answer 16

enzymes found in secretions that may tell us where the tumor could be

Question 17

angiogenesis

Answer 17

formation of new blood vessels. tumors need blood to grow and thus induce angiogenesis in the body

Question 18

cancer warning signs

Answer 18

changing bowel/bladder habits, open and unhealing sore, unusual bleeding/discharge, lump/mass, indigestion and difficulty swallowing, obvious change in wart/mole, nagging cough/hoarseness

Question 19

cancer warning signs in children

Answer 19

Unexplained weight loss, headaches w vomiting in the morning, swelling/pain in bones/joints, lump/mass, whitish-looking pupil, recurring fevers, excessive bleeding or bruising, paleness and tiredness

Question 20

three levels of prevention

Answer 20

Primary (life habits), Secondary (screening), and Tertiary (treating)

Question 21

Why do we perform screening tests?

Answer 21

early detection = higher survival

Question 22

examples of screening tests

Answer 22

Annual physical exams
PAP smear (cervical tissue)
Breast Self Exam or yearly mammogram
Testicular Self Exam
Prostrate Screening and Digital Rectal Exam

Question 23

treatment options are based on…

Answer 23

based on realistic and achievable goals for each specific type of cancer. Range includes cure, control, and palliation.

This includes surgeries, chemotherapy, and radiation.

Question 24

surgical options for cancer

Answer 24

Prophylaxis: removal of something to prevent cancer from developing.
Primary (curative): remove primary site & lymph nodes when tumor is small & well differentiated.
Palliative: removal of tumor pressing on nerve
Reconstructive: breast, head, neck
Debulking: removal of the bulk of the tumor; should be performed before the start of chemotherapy whenever possible
Resection of Metastases: used only in selected cases when a cure can be obtained or a reasonable prolongation of survival is possible. Primary cancer must be under control

Question 25

Chemotherapy is primarily for…

Answer 25

primarily for systemic disease.

Question 25

Often how many drugs are given?

Answer 25

Antineoplastic drugs are often given in combination to target different parts of the cell cycle

Question 26

Side effects of antineoplastic drugs

Answer 26

Anorexia, loss of taste/aversion to food, erythema, painful ulcerationof mucous membranes
Nausea/vomiting
Cachexia (debilitation)
Hair loss → alopecia (not permanent)
Stomatitis/mucositis (inflammation – pain, bleeding, sore throat, open sores; d/t direct irritating effects of the drugs that impact normal as well as cancer cells)
Bone Marrow Depression - Neutropenia (loss of WBC; more susceptible to infections), Anemia, Thrombocytopenia

Question 27

Radiation Therapy

Answer 27

high-energy ionizing beams interrupt cell growth. The goal is to deliver a precise dose of ionizing radiation for maximum tumor cell kill without affecting healthy tissue.

Question 28

radiosensitive tumours

Answer 28

Only effective on tumors directly within the path of radiation
Radiosensitive tumors include: bone marrow, lymphomas, epithelial, (also prostate, testicular, cervical)

Question 29

S/E of radiation

Answer 29

headaches, hair loss, nausea/vomiting, fatigue, hearing loss, memory and speech issues, skin and scalp changes.

Question 30

Lethal Dose (radiation)

Answer 30

eradicate 95% of the tumor yet preserve normal tissue

Question 31

Why fractionated doses (radiation)?

Answer 31

delivered over several weeks to allow healthy tissue to repair and to achieve greater cell kill by exposing more cells to the radiation as they begin active cell division
fractionated doses increase radiosensitivity of tumour