Quiz 4 Flashcards by Christina Stafstrom

Abnormal growth resulting from uncontrolled proliferation

Serves no physiologic function

Cancer

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Cancer is also referred to as

Neoplasm (new growth)

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Difference between malignant and benign tumors

Malignant: rapid growth, invasive, poorly differentiated, non encapsulated, high mitotic index, mets
Benign: encapsulated, slow growth, no mets

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Malignant cancer of connective tissue

Sarcomas

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Malignant epithelial tumors

Carcinomas
Adenocarcinomas (ducts and glands)

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Anaplasia

Poorly differentiated

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Pre invasive epithelial malignant tumors
Have not broken through basement membrane or invaded surrounding stroma

Carcinoma in situ

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Prognoses of cancer in situ

Stable for long time
Progress to mets/invasive cancer
Regress or disappear

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These are required before cancer can develop

Multiple mutations

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What is the biology of cancer cells

Clonal proliferation or expansion occurs
D/t mutation: cells acquire characteristics that allow it to have selective advantage over its neighbors (increased growth rate or decreased apoptosis)

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Alteration in DNA sequencing affecting expression or function of a gene

Mutation

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Types of mutations

Point mutations (small scale changes)
Driver mutations (drive progression of cancer)
Passenger mutations (random events)

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Repeated duplication of chromosome
10 or 100s of gene copies made

Gene amplification

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Large change in chromosomal structure
Piece of one chromosome is translated to another chromosome

Chromosome translocation

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Cancer cell progeny can accumulate faster than non mutant neighbors

Clonal proliferation/ Clonal expansion

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Tumor micro environment

Stroma

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Cancer development is similar to

Wound healing

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Process during which normal cell becomes a cancer cell

Malignant transformation

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3 mechanisms of human carcinogenesis

Activation of proto oncogenes causes growth of oncogenes
Mutation of genes (loss or inactivity of tumor suppressing genes)
Mutation of genes results in over-expression of products that prevent apoptosis

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Mutants genes
In non mutant state, direct protein synthesis and cell growth

Oncogenes

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Encode proteins
In normal state, negatively regulate proliferation

Tumor suppressor gene

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Healthy, non mutated genes that code for cellular growth

Proto oncogenes

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How cancer Evades growth suppressors

Secretion of growth factors (autocrine)
Mutation of signal from cell receptor to on position
Mutation in RAs intracellular signaling protein
Inactivation of Rb tumor suppressor
Mutation of tumor suppressor gene

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Responsible for maintenance of genomic integrity
Encode proteins that are involved in repairing damaged DNA
loss of function of caretaker gender leads to increased mutation rates

Care taker genes

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How should the healthcare professional reply when parents question why a computed tomographic (Cl) scan of the head was not ordered for their 5-year-old child after a minor fall?

Research suggests that repeated CT scans can increase the risk of developing brain cancer.

Currently, what percentage of children with cancer can be cured?

85%

What congenital malformation is commonly linked to acute leukemia in children?

Down syndrome

What are the significant risk factors associated with the development of skin cancers? (Select all that apply.)

• Light-colored hair • Pale eyes • Fair skin • Freckles

Which dietary factor is most strongly associated with an increased risk of colorectal cancer?

High intake of red meats and processed meats

Which substance has been shown to increase the risk of cancer when used in combination with tobacco smoking?

Alcohol

What is the major virus involved in the development of cervical cancer?

Human papillomavirus

How do cancer cells use the enzyme telomerase?

To switch on the telomerase to enable cells to divide indefinitely

Which term is used to describe a cell showing a loss of cellular differentiation?

Anaplasia

the presence of an abnormal cell type within a tissue and often is called "precancerous."

Dysplasia

abnormal change in the characteristics of a tissue.

Metaplasia

enlargement of an organ or tissue due to increased production of its cells, also often considered precancerous.

Hyperplasia

Carcinoma refers to abnormal cell proliferation originating from which tissue origin?

Epithelial cells

Children with Down syndrome have a ____________ risk of developing acute lymphoblastic and myelogenous leukemia and a higher risk for developing acute megakaryocytic leukemia.

10 to 20 fold increased

Results from epigenetic silencing Modulation of genes Mutations in caretaker genes that protect genome and DNA repair

Genomic instability

Appears to increase in malignant cells May be caused by malformations in cellular machinery

Chromosome instability

Chromosome instability may result in overexpression of

Oncogenes

Body cells are not immortal, can only divide a limited number of times

Hayflick limit

Protective caps on each chromosome that are held in place by telomerase

Telomeres

Cancer cells can activate __________, leading to continued division

Telomeres

Aka neovasularization

Angiogenesis

Growth of new vessels

Angiogenesis

Advanced cancer cells can secrete angiogenic factors to

Facilitate feeding of the tumor

Cancer cells perform this Allows lactate and its metabolites to be used for more efficient production of lipids and other building blocks needed for rapid cell growth

Glycolysis

Cancer cells generate large amounts of ATP

Reverse Warburg effect

Important factor in development of cancer This predisposes a person to cancer

Chronic inflammation; active inflammation (stimulate wound healing responses that include proliferation and new blood vessel growth)

Examples of inflammatory disorders that increase cancer risk

H pylori (stomach) Hep B and C (liver) UC > 10 years (colon)

Key cell that promotes tumor survival Develops capacity to block cytotoxic T cell and NK cell functions Secretes angiogenesis factors

Tumor associated macrophage (TAM)

Active immunotherapy

Immunization with tumor antigens to elicit or enhance immune response against particular cancer

Passive immunotherapy

Injecting the patient diagnosed with cancer with antibodies or lymphocytes directed against tumor associated antigens

HPV (human papillovirus)

Cervical cancer

Hep B and C

Liver

H pylori

Stomach

EBV

Nasopharynx, stomach, Hodgkin and no Hodgkin lymphoma

Herpes 8

Kaposi syndrome

HPV 16 & 18 cause majority of what cancers

Cervical and anal 1/2 of vaginal, vulvar, and penile cancers

Spread of cancer cells from site of original tumor to distant tissues and organs through the body

Metastasis

Local spread First step in metastisis Spreads to regional lymph nodes

Invasion

Cancer cells secrete this Disgusts extra cellular matrix and basement membranes Creates pathways for cells to move

Protease

Many epithelial like characteristics are lost Resistance to apoptosis

EMT (epithelial mesenclymal transition)

System complexes triggered by cancer but are not caused by direct local effects of tumor Can be life threatening

Paraneoplastic syndromes

Most severe form of malnutrition Leads to progressive wasting

Cachexia

staging of cancer

Stage 1: confined to organ or origin Stage 2: locally invasive Stage 3: advanced to regional structures Stage 4: spread to distant sites

Staging with WHO

Tumor: number equals size and local extent Nodes: increased number is more lymph nodes involved Metastasis: extent of mets

Substances produced by benign or malignant cells found on/in tumor cells, blood, spinal fluid, or urine

Tumor markers

Secrete AFP

Liver and germ cell tumors

Secrete PSA

Prostate tumors

If tumor marker has biologic activity

S/s expressed Paraneoplastic syndrome occurs

Definitive treatment of cancer

Surgery

Mutations of APC gene have 100% lifetime risk of

Colon cancer (colectomy performed preventatively

Kills cancer while minimizing damage to normal structures

Radiation

Ionizing radiation or brachytherapy

Ionizing: damage to molecular level DNA Brachy: seeds implanted

Eradicates enough tumor cells to enable body’s natural defenses and eradicate remaining cells

Chemo

Shrinkage or disappearance of tumors

Induction chemo

Administered after surgical excision with goal of eliminating micromets.

Adjuvant chemo

Administered before localized treatment (surgical or radiation)

Neoadjuvant chemo

Cancer rates higher for what gender

Men

Cancer rates have ______ for ages 0-19

Increased

Most predominant cancer

Liver

Degree to which development is contingent on its environment

Developmental plasticity

Environmental lifestyle factors for cancer

Tobacco, diet, obesity, alcohol, physical activity, air pollution, ionizing radiation, UC, electromagnetic, infection, sexual behaviors, chemicals and occupational hazards

Cigarette smoke is

Carcinogenic

Tobacco use liked to what type of cancer

Lung, mouth, lips, nasal/sinus, larynx, pharynx, esophagus, pancreas, kidneys, uterus, colon, cervix

Primary dietary potential donors of DNA myelination

Folate, choline, B vitamins

Improves DNA repair and decreases cancer risk

Consuming kiwi, cooked carrots, supplemental coenzymes Q10

Toxic,mutant, carcinogenic chemicals in food

Xenobiotic chemicals

Enzyme housekeepers that metabolize environmental carcinogens and reactive oxygen species

Glutathione s transferases (GSTs)

Diets high in red and processed meats

Increased colorectal cancer

Obesity associated with what cancers

Endometrial, colorectal, kidney, esophageal, breast and pancreatic

How does obesity increase ca risk

Increase insulin resistance and promotes insulin like growth factor Adipose secrete adipokines Causes poor outcomes for cancers

Alcohol related to what cancers

Oral, pharynx, larynx, esophageal, liver, colorectal, breast

How can physical activity decrease ca risk

Decreases insulin and insulin like growth factor Decrease obesity Decrease inflammatory markers Improve immune function Decrease circulating sex/metabolic hormones

Improved physical activity decreases risk of what cancers

Endometrial, colon and breast

is indoor or outdoor pollution worse

Indoor

What cancers is ionizing radiation related to

Thyroid, breast, lung, stomach, colon, esophageal, urinary

UV cancer related to what cancers

Basal cell carcinoma, squamous cell carcinoma, melanoma

Most common diagnosis of malignancy in US

Skin cancer

Is electromagnetic radiation carcinogenic

Conflicting research exists

Most common childhood cancers

Central nervous tumors and leukemias

Most common adolescent cancers

Lymphomas (Hodgkin and non)

These originate while in utero

Embryonic tumors

Commonly named with suffix blast

Embryonal tumors

Most childhood cancers originate from

Mesodermal germ layer

When are most childhood cancers diagnosed

During peak times of physical growth

Childhood cancers are

Fast growing and gave mets before diagnosis is made

Boys or girls not affected by cancer

Boys

Familial cancer risk for children

Wills tumor, retinoblastoma, WAGR syndrome

Childhood exposure to what increases ca risk

Drugs, viruses, ionizing radiation

Quiz 4 Flashcards

(112 cards)