Module 2: Neoplasia

What are the 3 possible goals of cancer treatment?

(1) Curative (2) Control (3) Palliative

What the 6 molecular and cellular mechanisms that are known to facilitate the development of cancer?

(1) Defects in DNA repair mechanisms (2) Defects in growth factor signaling pathways (3) Evasion of apoptosis (4) Avoidance of cellular senescence (5) Development of sustained angiogenesis (6) Metastasis and invasion

What are the 7 risk factors that can lead to the development of cancer?

(1) Heredity (2) Obesity (3) Hormonal factors (4) Immunologic mechanisms (5) Chemicals (6) Radiation (7) Cancer-causing viruses

What are the 4 oncogenic viruses that can induce cancer?

(1) Human Papilloma Virus (HPV (2) Epstein-Barr Virus (EBV) (3) Human Herpes Virus-8 (HHV-8) (4) Hepatitis B Virus (HBV)

List the 5 possible treatments for cancer:

(1) Surgery (2) Radiation Therapy (3) Chemotherapy (4) Hormonal Therapy (5) Biotherapy

What are the 2 broad etiologic causes of cancer?

(1) The genetic and molecular mechanisms that transform normal cells into cancer cells. (2) The external factors such as age, heredity, and environmental agents.

What are the 3 main groups of cells that proliferate?

(1) Well-differentiated neurons and cells of skeletal and cardiac muscles that rarely divide and reproduce. (2) Progenitor or parent cells that continue to divide and reproduce, such as blood, skin, and liver cells. (3) Undifferentiated stem cells that can enter the cell cycle and produce large numbers of progenitor cells if needed.

What is a polyp?

A Polyp is a growth that projects from a mucosal surface, such as the intestines. A polyp can be benign or malignant.

Define neoplasm

A neoplasm is the "new growth" that arises during neoplasia.

What is angiogenesis?

Angiogenesis is the development of new blood vessels within a tumor

Give an example of a hereditary cancer:

BRCA1,2 causes breast and ovarian cancer; retinoblastoma; familial adenomatous polyposis causes colon cancer.

List some common symptoms people with cancer have:

Bleeding, pleural/peritoneal fluid, anorexia, weight loss, wasting of body fat and muscle tissue, weakness, fatigue, sleep disturbances, anemia.

What organs do hormones and the development of cancer target?

Breast, ovary, endometrium, and prostate

What are paraneoplastic syndromes? Give an example.

Cancer can also produce symptoms in sites not directly affected by the disease. These manifestations are termed paraneoplastic syndromes. Examples are syndrome of inappropriate ADH secretion, Cushing syndrome due to ectopic ACTH production, and hypercalcemia.

Explain what carcinoma in situ is?

Carcinoma in situ is a localized pre-invasion lesion. These can typically be surgically removed or treated, and recurrence is less likely.

List some side effects of chemotherapy drugs.

Chemotherapy drugs cause a reduction in all three blood cell types, which can lead to neutropenia, anemia, and thrombocytopenia. Anorexia, nausea, and vomiting are common side effects.

Define differentiation

Differentiation is the process by which cells become more specialized with each mitotic division.

Why is anemia common in people with cancer?

Effects of the cancer treatments, blood loss, hemolysis, or impaired red blood cell production are all factors that can contribute to anemia in cancer patients.

Define grading and staging and be familiar with table 2.5.

Grading is based on the cellular characteristics of the tumor and the degree of abnormalities present. Tumor grading involves the microscopic examination of cancer cells to determine their level of differentiation. Staging is the assessment of the clinical spread of the disease.

When is surgery appropriate in the treatment of cancer?

It can be beneficial for diagnosing, staging, and palliation. As well as to remove some solid tumors or treat oncologic emergencies.

Define neoplasia

Neoplasia, meaning "new growth", is the process of altered cell differentiation and growth, indicative of cancer.

What body parts do we screen through observation? Palpation? Laboratory tests and procedures?

Observation: Skin, mouth, and external genitalia Palpation: Breasts, thyroid, rectum/anus, prostate, and lymph nodes Laboratory tests: Pap smear, colonoscopy and mammography

What are the 3 genetic events that lead to oncogene formation and activation?

Point mutation, chromosomal translocation, and gene amplification

What are progenitor cells?

Progenitor or parent cells are not fully differentiated to the same extent as mature specialized cells and yet are differentiated enough to give rise to daughter cells of the same lineage.

Define proliferation

Proliferation is an adaptive process for new cell growth to replace old cells or when additional cells are needed.

What are the 2 cancer associated genes?

Protooncogenes and tumor suppressor genes

How does radiation kill cancer cells?

Radiation uses high-energy particles or waves to destroy or damage cancer cells. The use of radiation leads to the creation of free radicals, which damages cell structures. It can interrupt the cell cycle process, kill cells, or damage DNA in cells.

What is seeding?

Seeding of cancer cells describes the process of how shed tumor cells enter circulation and move into similar or different body cavities.

List some lifestyle factors that contribute to the development of cancer?

Smoking, alcohol, chewing tobacco, high fat/low fiber diet, high intake smoked meats, sun exposure, obesity

What are the two broad categories of malignant neoplasms?

Solid tumors Hematologic cancers

What are the benefits of the stem cell?

Stem cells, unlike progenitor cells, remain undifferentiated and dormant until they are needed. When needed, they begin to divide, producing not only other stem cells, but also cells capable of carrying out the functions of the needed differentiated cell. When a stem cell divides, one daughter cell retains the stem cell characteristics, while the other daughter cell becomes a progenitor cell and continues to divide until it reaches a state of terminal differentiation.

Explain metastasis and how it occurs:

The multi-step process of metastasis occurs as follows: a cancer cell must break loose from the primary tumor, invade the surrounding extracellular matrix, gain access to a blood vessel, survive its passage in the bloodstream, emerge at a favorable location, invade the surrounding tissue, begin to grow, and establish a blood supply.

What is important about the sentinel node?

The sentinel node is the first lymph node to which the primary tumor drains. The extent of disease may be determined through lymphatic mapping and sentinel lymph node biopsy.

What is the most important procedure in diagnosing the correct cancer and histology?

Tissue biopsy

What is the purpose of grading and staging a tumor?

To determine how severe the cancer has progressed and to understand its spread. That way we can better know how it needs to be treated and also to determine the patients prognosis.

What are tumor markers helpful for?

Tumor markers are used for establishing prognosis, monitoring treatment, and detecting recurrent disease.