Cancer Ch 12

The survival rate for stage IV Hodgkin disease can be as high as:

70% Survival rates for Hodgkin disease is 99% for stage I and 70% for stage IV.

Which statement is true regarding patients with BMI >35 with cancer No difference has been found in breast cancers of patients with BMIs >35 High insulin levels are protective for breast cancer A higher BMI has a relationship with breast cancer mortality An obese patient will have a clearly delineated progression of breast cancer

A higher BMI has a relationship with breast cancer mortality

The RAS gene converts from a proto-oncogene to an oncogene by: Designating a chromosome that has a piece of one chromosome fused to a piece ofanother chromosome Duplicating a small piece of a chromosome, repeatedly making numerous copies Altering one or more nucleotide base pairs Promoting proliferation of growth signals by impairing tumor-suppressor genes

Altering one or more nucleotide base pairs A point mutation is the alteration of one or a few nucleotide base pairs. This type of mutation can have profound effects on the activity of proteins. A point mutation in the RAS gene converts it from a regulated proto-oncogene to an unregulated oncogene, an accelerator of cellular proliferation.

Which of the statements below supports the hypothesis that intestinal polyps are benign neoplasms and the first stage in the development of colon cancer An accumulation of mutations in specific genes is required for the development of cancer Tumor invasion and metastasis progress more slowly in the gastrointestinal tract Apoptosis is triggered by diverse stimuli, including excessive growth Cancer cells accumulate slower than non-cancer cells

An accumulation of mutations in specific genes is required for the development of cancer Multiple genetic mutations are required for the evolution of full-blown cancer.

Which term is used to describe a muscle cell showing a reduced ability to form new muscle while appearing highly disorganized Dysplasia Hyperplasia Myoplasia Anaplasia

Anaplasia Anaplasia is defined as the loss of cellular differentiation, irregularities of the size and shape of the nucleus, and the loss of normal tissue structure. In clinical specimens, anaplasia is recognized by a loss of organization and a significant increase in nuclear size with evidence of ongoing proliferation.

Which of the following best describes carcinoma in situ Are preinvasive epithelial malignant tumors that have not penetrated the basement membranes Are not easily treated by surgery but may be treated with radiation/chemotherapy Are treated with radiation immediately after diagnosis Are best treated surgically

Are preinvasive epithelial malignant tumors that have not penetrated the basement membranes There is controversy over surgical treatment vs watchful waiting of these preinvasive tumors. Common sites are cervix, oral cavity, esophagus and bronchus

By what process do cancer cells multiply in the absence of external growth signals?

Autocrine stimulation Cancer cells must have mutations that enable them to proliferate in the absence of external growthsignals. To achieve this, some cancers acquire the ability to secrete growth factors that stimulate their own growth, a process known as autocrine stimulation.

What is the cause of oral ulcers and hair loss in chemotherapy patients

Because it targets those cells that reproduce quickly, as in the GI tract and hair follicles

Which of the following is a characteristics of a benign tumors Benign tumors include the suffix -oma. Benign tumors invade local tissues. Benign tumors spread through the lymph nodes. Benign tumors cause systemic symptoms.

Benign tumors include the suffix -oma. Benign tumors (which are not cancers) are usually named using -oma as a suffix with the organ name as the root. For example, a benign tumor of smooth muscle cells is called a leiomyoma.

It has been determined that a tumor is in stage 2. What is the meaning of this finding?

Cancer is locally invasive. Cancer confined to the organ of origin is stage 1 Cancer that is locally invasive is stage 2 Cancer that has spread to regional structures, such as the lymph nodes, is stage 3 Cancer that has spread to distant sites, such as a liver cancer spreading to the lung or a prostate cancer spreading to bone, is stage 4

Which of the following is most accurate regarding cancer staging Localized cancer is considered high stage Benign tumors are stage 4 Stage I has the poorest prognosis Cancers that have spread regionally are stage 3

Cancers that have spread regionally are stage 3

What is the consequence for cells when the functioning TP53 gene is lost as a result of mutation? Cells undergo apoptosis. Cells escape apoptosis. Cells receive less oxygen. Cells adhere more readily.

Cells escape apoptosis. The most common mutations conferring resistance to apoptosis occur in the TP53 gene. The remainingoptions do not accurately describe the effect when the functioning TP53 gene is lost as a result ofmutation.

Carcinoma in situ is characterized by which changes Cells have broken through the local basement membrane Cells have invaded immediate surrounding tissue. Cells remain localized in the glandular or squamous cells. Cellular and tissue alterations indicate dysplasia.

Cells remain localized in the glandular or squamous cells. Carcinoma in situ (CIS) refers to preinvasive epithelial malignant tumors of glandular or squamous cell origin. These early stage cancers are localized to the epithelium and have not broken through the local basement membrane or invaded the surrounding tissue. Dysplasia refers to changes in mature cell structure.

Which cancer may be treated with radiation delivered by brachytherapy?

Cervical Radiation sources, such as small 125I-labeled capsules (also called seeds), can also be temporarily placed into body cavities, a delivery method termed brachytherapy. Brachytherapy is useful in the treatment of cervical, prostate, and head and neck cancers. Brachytherapy is not used in the treatment of the other cancers

Burkitt lymphomas designate a chromosome that has a piece of chromosome 8 fused to a piece of chromosome 14. This is an example of which mutation of normal genes to oncogenes? Point mutation Chromosome translocation Gene amplification Chromosome fusion

Chromosome translocation Chromosome translocations, in which a piece of one chromosome is translocated to another chromosome, can activate oncogenes. One of the best examples is the t(8;14) translocation found in many Burkitt lymphomas; t(8;14) designates a chromosome that has a piece of chromosome 8 fused to a piece of chromosome 14.

The leading modifiable environmental or lifestyle factors that cause cancer in the US is

Cigarette smoking Cigarette smoking, which is a known carcinogen, is the leading cause of cancer death in the US, contributing to 5.4 million deaths per year

Which cancers are all associated with chronic inflammation? Brain, muscle, and endocrine Colon, thyroid gland, and urinary bladder Bone, blood cells, and liver Eye, tracheal, and kidney

Colon, thyroid gland, and urinary bladder Some organs appear to be more susceptible to the oncogenic effects of chronic inflammation; forexample, the GI tract, prostate, thyroid gland, pancreas, urinary bladder, pleura, and skin. One large study found a 66% increase in the risk of lung cancer among women with chronic asthma, an inflammatorydisease of the airways. At present, no research supports a link between the remaining options and chronic inflammation.

Which of the following do cancer cells not have Contact inhibition Mechanisms for glycolysis Enhanced glucose consumption Proliferation unless anchored

Contact inhibition

Two "hits" are required to inactivate tumor-suppressor genes because: Each allele must be altered, and each person has two copies, or alleles, of eachgene, one from each parent. The first hit stops tissue growth, and the second hit is needed to cause abnormaltissue growth. Tumor-suppressor genes are larger than proto-oncogenes, requiring two hits toeffect carcinogenesis. The first hit is insufficient to cause enough damage to cause a mutation

Each allele must be altered, and each person has two copies, or alleles, of each gene, one from each parent. A single genetic event can activate an oncogene, acting in a dominant manner in the cell. However, each person has two copies, or alleles, of each gene, one from each parent. Therefore two hits are required to inactivate the two alleles of a tumor-suppressor gene, allowing the process to become active. The remaining options do not describe the reason two hits are required.

Carcinoma refers to abnormal cell proliferation originating from which tissue origin Blood vessels Epithelial cells Connective tissued Glandular tissue

Epithelial cells Only cancers arising from epithelial cells are called carcinomas.

What is the most commonly reported symptom of cancer treatment?

Fatigue Fatigue is the most frequently reported symptom of cancer and cancer treatment.

In childhood neuroblastoma, the N-myc oncogene undergoes which type of mutation of normal gene to oncogene? Point mutation Chromosome fusion Gene amplification Chromosome translocation

Gene amplification Amplifications are the result of the duplication of a small piece of a chromosome over and over again; consequently, instead of the normal two copies of a gene, tens or even hundreds of copies are present (see Chapter 4). The N-myc oncogene is amplified in 25% of childhood neuroblastoma.

Which of the following is the virus linked to the development of cervical cancer

HPV-Human papillomavirus

Which of the following best describes tumor cell markers Hormones, enzymes, antigens, and antibodies that are produced by cancer cells Receptor sites on tumor cells that can be identified and marked Cytokines that are produced against cancer cells Identification marks that are used in administering radiation therapy

Hormones, enzymes, antigens, and antibodies that are produced by cancer cells Tumor (biologic) markers are substances produced by both benign and malignant cells that are found either in or on the tumor cells or in the blood, spinal fluid, or urine. Tumor markers may includehormones, enzymes, genes, antigens, and antibodies. The other options do not accurately describe examples of tumor markers and their function.

The most significant cause of complications and death in cancer patients is

Infection

What is the skin-related health risk induced by some types of chemotherapy? Infection Ultraviolet damage Pain Erythema

Infection Decreased renewal rates of the epidermal layers in the skin may lead to skin breakdown and dryness, altering the normal barrier protection against infection. Radiation therapy may cause skin erythema(redness). Pain and ultraviolet damage is not related to chemotherapies.

Many cancers create a mutation of RAS. RAS is a(an): Tumor-suppressor gene Growth-promoting gene Intracellular-signaling protein that regulates cell growth Cell surface receptor that allows signaling to the nucleus concerning cell growth

Intracellular-signaling protein that regulates cell growth Up to one-third of all cancers have an activating mutation in the gene for an intracellular signaling protein called RAS. This mutant RAS stimulates cell growth even when growth factors are missing.

Which terms represent the correct nomenclature for benign and malignant tumors of adipose tissue, respectively? Liposarcoma, lipoma Lipoma, liposarcoma Adisarcoma, adipoma Adipoma, adisarcoma

Lipoma, liposarcoma In general, cancers are named according to the cell type from which they originate (e.g., lip for cancers that originate in adipose or fat tissue), whereas benign tumors use the suffix -oma. Cancers arising from connective tissue usually have the suffix sarcoma.

What is the role of caretaker genes?

Maintenance of genomic integrity

What is the cause of anemia in a patient diagnosed with pancreatic cancer?

Malabsorption of iron Iron is malabsorbed in individuals with gastric, pancreatic, or upper intestinal cancer. Commonlyassociated with malignancy, mechanisms of anemia include chronic bleeding (resulting in irondeficiency), severe malnutrition, cytotoxic chemotherapy, and malignancy in blood-forming organs. The pancreas is not involved in the formation of blood components. Chronic bleeding and iron deficiency can accompany colorectal or genitourinary malignancies.

Which of the following best describes "apoptosis"

Normal mechanism for cells to self-destruct when growth is excessive Normal cells have a mechanism that causes them to self-destruct when growth is excessive and cell cycle checkpoints have been ignored. Diverse stimuli, including normal development and excessive growth, trigger this self-destruct mechanism, called apoptosis. The remaining options do not describe apoptosis.

A large percentage of cancers of the upper respiratory passages, lung, bladder and peritoneum are attributed to

Occupational factors

From the list below, which cancer originates from connective tissue Osteogenic sarcoma Basal cell carcinoma Multiple myeloma Adenocarcinoma

Osteogenic sarcoma Cancers arising from connective tissue usually have the suffix -sarcoma.

Which statement is true regarding pain and cancer? Pain is primarily a result of pressure caused by the tumor. Pain indicates the metastasis of a cancer. Pain is usually the initial symptom of cancer. Pain is generally associated with late-stage cancer.

Pain is generally associated with late-stage cancer. Pain is generally associated with the late stages of cancer. Pressure, obstruction, invasion of a structure sensitive to pain, stretching, tissue destruction, and inflammation can cause pain. Pain is not the initial symptom of cancer nor does it indication that the cancer has metastasized.

In a normal, nonmutant state, an oncogene is referred to as a:

Proto-oncogene

Chronic inflammation causes cancer by Increasing vasodilation and permeability that alter cellular response to DNA damage Liberating lysosomal enzymes when cells are damaged that initiates mutations Releasing compounds such as reactive oxygen species that promote mutations Increasing the abundance of leukotrienes that are associated with some cancers

Releasing compounds such as reactive oxygen species that promote mutations. Inflammatory cells release compounds, such as reactive oxygen species (ROS) and other reactive molecules, that can promote mutations and block the cellular response to DNA damage. At present, no research supports the other options as factors related to inflammation causing cancer.

The function of the tumor cell marker is to Provide a definitive diagnosis of cancer Treat certain types of cancer. Predict where cancers will develop. Screen individuals at high risk for cancer.

Screen individuals at high risk for cancer. Screening and identifying individuals at high risk for cancer are ways tumor markers can be used. These markers are not used to definitively diagnose or treat cancer and are not useful in predicting specific sites of cancer development.

Which of the following best describes "autocrine stimulation" of cancer cells Secrete growth factors that stimulate their own growth. Stimulate angiogenesis to create their own blood supply. Encourage secretions that turn off normal growth inhibitors. Divert nutrients away from normal tissue for their own use.

Secrete growth factors that stimulate their own growth. Cancer cells must have mutations that enable them to proliferate in the absence of external growthsignals. To achieve this, some cancers acquire the ability to secrete growth factors that stimulate their own growth, a process known as autocrine stimulation.

Ultraviolet radiation causes which of the following Squamous and basal cell carcinomas Malignant melanoma Carcinoma in situ Leukemia

Squamous and basal cell carcinomas

Which gastrointestinal tract condition can be an outcome of both chemotherapy and radiation therapy? Increased cell turnover Constipation Stomatitis Bloody stool

Stomatitis Chemotherapy and radiation therapy may cause a decreased cell turnover, thereby leading to oral ulcers (stomatitis), malabsorption, and diarrhea. None of the other options accurately describe related conditions resulting from chemotherapy and/or radiation therapies.

What aberrant change causes the abnormal growth in retinoblastoma? Proto-oncogenes are changed to oncogenes. The tumor-suppressor gene is turned off. Genetic amplification causes the growth Chromosomes 9 and 21 are fused.

The tumor-suppressor gene is turned off. One of the first discovered tumor-suppressor genes, the retinoblastoma (Rb) gene, normally strongly inhibits the cell division cycle. When it is inactivated, the cell division cycle can proceed unchecked. The Rb gene is mutated in childhood retinoblastoma. The remaining options do not describe the abnormal growth in retinoblastoma.

Which statement is true regarding pleomorphic cells? Pleomorphic cells are similar in size. They share a common shape. They are a result of anaplasia. Pleomorphic cells differentiate uniformly.

They are a result of anaplasia In contrast to normal cells, which are uniform in size and shape, anaplastic cells are of variable size and shape and abnormally differentiate, making them pleomorphic.

Which of the following is true about malignant tumors They can spread far from the point of origin They are well differentiated It is unable to infiltrate local tissues It tends to encapsulate

They can spread far from the point of origin

What is the role of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) in cell metastasis?

To develop new blood vessels to feed cancer cells By recruiting new vascular endothelial cells and initiating the proliferation of existing blood vessel cells, the angiogenic factors, such as VEGF and growth factor bFGF, allow small cancers to become large cancers.

How do cancer cells use the enzyme telomerase

To switch on the telomerase to enable cells to divide indefinitely Cancer cells, when they reach a critical age, somehow activate telomerase to restore and maintain their telomeres and thereby make it possible for cells to divide over and over again.

Inherited mutations that predispose to cancer are almost invariably what kind of gene? Proto-oncogenes Oncogenes Tumor-suppressor genes Growth-promoting genes

Tumor-suppressor genes Inherited mutations that predispose to cancer are almost invariably in tumor-suppressor genes.

Which of the following best describes oncogene capability Undergo mutation that directs the synthesis of proteins to accelerate the rate of tissue proliferation Direct synthesis of proteins to regulate growth and to provide necessary replacement of tissue Encode proteins that negatively regulate the synthesis of proteins to slow or halt the replacement of tissue Undergo mutation that directs malignant tissue toward blood vessels and lymph nodes for metastasis

Undergo mutation that directs the synthesis of proteins to accelerate the rate of tissue proliferation Oncogenes are mutant genes that, before mutation, direct synthesis of proteins that positively regulate (accelerate) proliferation.

What is the most common route for distant metastasis? (select all that apply) seeding. blood. lymphatic vessels. invasion. proliferation.

blood. lymphatic vessels. To transition from local to distant metastasis, the cancer cells must also be able to invade local blood and lymphatic vessels.

The most common site of metastasis for a patient diagnosed with prostate cancer is which location?

bones. The bone, especially the lumbar spine area, is the most common metastasis site for prostate cancer.

Which statements concerning aging and the occurrence of cancer are true? (select all that apply). decline in immunologic functions. predisposition to nutritional inadequacies. unwillingness to access health care services. reluctance to engage in cancer screenings. effects of immobility on the immune system.

decline in immunologic functions. predisposition to nutritional inadequacies. effects of immobility on the immune system. Many common malignancies occurs mostly in older age as a result of immunologic functions declining with age. Older persons are predisposed to nutritional deficiencies, and malnutrition impairs immunocompetence. Far-advanced cancer often results in immobility and general debility that worsens with age.

Normally, which cells are considered immortal (never die)? (select all that apply). germ. stem. blood. epithelial. muscle.

germ stem Usually, germ cells (those that generate sperm and eggs) and stem cells are the only cells in the body that are immortal.

What are the most common causes of nosocomial infections among patients with cancer? (select all that apply). indwelling medical devices. suppressed immune system. visitor-introduced microorganisms. poor appetite. inadequate wound care.

indwelling medical devices. visitor-introduced microorganisms. inadequate wound care. Hospital-acquired (nosocomial) infections increase because of indwelling medical devices, inadequate wound care, and the introduction of microorganisms from visitors and other individuals.

What cellular characteristics are affected by anaplasia? (select all that apply) size ability to differentiate. life expectancy. tissue structure. shape.

size. ability to differentiate. tissue structure. shape Anaplasia is defined as the loss of cellular differentiation, irregularities of the size and shape of the nucleus, and loss of normal tissue structure.

Which statement concerning benign tumors is true? The resulting pain is severe. Benign tumors are not encapsulated. Benign tumors are fast growing. The cells are well-differentiated.

the cells are well-differentiated A benign tumor is well-differentiated with its tissue appearing similar to the tissue from which it arose.