Ch 8

Proto-oncogenes

• Normal "growth genes" in the human chromosomes that promote some aspects of cell growth, differentiation, or mitotic activity • Becomes an oncogene if mutation occurs or genes are translocated to another chromosome

Teratoma

• Tumor arising from *cells that can differentiate* into many different types of tissues: bone, muscle, glands, epithelium, brain tissue, hair • Frequently occurs in *reproductive tract*, but may develop in other areas

Polyps or papilloma

benign tumor on stalk arising from an epithelial surface

*Angi*oma: (angie has growths on her blood vessel)

Benign tumor of blood vessels

Keratoses

Benign tumor of keratinocytes

*Chondr*oma:

Benign tumor of the cartilage

*Aden*oma: (Aden's gland skin has a growth)

Benign tumor on glandular epithelium

Viruses - HPV patients are predisposed to cervical cancer Gene and chromosome abnormalities Failure of immune defenses Heredity

5 etiologic factors involved with causing neoplastic disease

Surgery Radiotherapy Hormones Anticancer drugs Adjuvant chemotherapy Immunotherapy

6 most common treatments for tumors

Nevus (Mole)

A benign pigmented skin lesion of melanocytes (melanin-forming cells)

Melanoma

A malignant tumor of melanocytes (melanin-forming cells)

Leukemia

A neoplasm of hematopoietic (blood forming) tissue

Blastoma

A primitive or young tumor

Oncogene

Abnormally functioning gene that stimulates cell growth excessively, leading to unrestricted cell proliferation

Polyp, papilloma

Any benign tumor projecting from surface epithelium

- *Granulo*cytic - *Lympho*cytic - *Mono*cytic

Any type of hematopoietic (blood forming) cells can give rise to a leukemia, but the 3 most common types are:

heart disease

Cancer in the second most common cause of death in the US, right after ________

"insults"

Cancers usually arise from multiple genetic _____ to the genome rather than single gene mutations

regional lymph nodes or distant sites

Chances for cancer survival are significantly reduced when it metastasizes to ______ or _______

Rapidly diving cells found in Mouth, skin, hair, bone marrow, digestive tract, kidneys, bladder, lungs, nervous system, reproductive system

Chemotherapy eliminates cancer cells and rapidly dividing cells found in ____________

- Lymphoid tumors - Skin tumors arising from pigment-producing cells within epidermis - Certain tumors of mixed cellular components - Certain types of tumors composed of primitive cells seen in children

Exceptions encountered in naming of

Basal and squamous cell carcinoma

Malignant tumors of keratinocytes

- *Anemia*: inadequate red cell production - *Thrombocytopenia*: causes bleeding - *Infections* from inadequate number of normal white cells

Leukemic cells crowd out normal cells causing:

Carcinoma

Malignant tumor arising from surface, glandular, or parenchymal epithelium

Necrosis

Malignant tumor may outgrow its blood supply; The part of the tumor with the poorest blood supply undergoes __________

Sarcoma

Malignant tumor of any primary tissue *other than* surface, glandular, and parenchymal epithelium

Lung cancer in males Breast cancer in females

Most common cancers in each sex

- *Proto-oncogenes* - *Tumor-suppressor genes* - *DNA repair genes*

Mutations in these 3 genes are associated with tumor formation.

Proto-oncogenes Tumor-suppresor genes DNA repair genes

Mutations in these three genes are linked with tumor formation

Primitive Cell Tumors!

Named after site of origin with suffix "-blastoma" added - Example: tissue of origin (retina) + blastoma = retinoblastoma

Leukemia

Neoplasm of blood cells

Leukemia:

Neoplasm of blood cells - Usually *do not form solid tumors* - Instead, proliferates diffusely within bone marrow, overgrows and crowds out normal blood-forming cells - Neoplastic cells "spill over" into the bloodstream and large number of abnormal cells circulate in the peripheral blood

Precancerous Conditions

Nonmalignant conditions with a tendency to become malignant

Acute leukemia

Rapidly progressive leukemia, more difficult to control. *Immature cells*

Chronic leukemia

This type of leukemia proceeds at a relatively slow pace and often can be controlled. *mature cells*

65 % 5 year survival rate 50% 10 year survival rate

The 5 year and 10 year survival rate of breast cancer

BRCA 1 and BRCA2

The breast cancer susceptibility genes

Leukemia cells

The cells of this tumor diffusely infiltrate the bone marrow and lymphoid tissues, spill over into the bloodstream, and infiltrate throughout various organs of the body

4%

The survival rate for pancreatic cancer

95%

The survival rate for thyroid cancer

4% to 95%

The survival rates in cancer range from ___% to ___%

- *Cell type* • Granulocytic, lymphocytic, monocytic - *Maturity of leukemic cells* • *Acute* if immature cells • *Chronic* if mature cells

The two basis for classification of Leukemia

Benign Tumors

These tumors are named by adding suffix -oma to the name of the cells of origin

CEA (carcinoembrionic antigen):

This cancer antigen (marker) is present in amounts related to the size of tumor and its possible spread - Produced by most malignant tumors of the GI tract, pancreas, breast

Alpha fetoprotein

This cancer derived substance is normally produced by *fetal tissues in the placenta* but not adult cells elevated in primary *carcinoma of the liver*

Human chorionic gonadotropin

This cancer derived substance is normally produced by *placenta* elevated in *testicular carcinoma*

Squamous cell carcinoma

This malignant skin tumor is: - Composed of abnormal infiltrating squamous cells - *More aggressive* tumor that sometimes metastasizes

Basal cell carcinoma

This malignant skin tumor is: - Composed of clusters of infiltrating cells that resemble the normal basal cells of the epidermis - slowly growing, can be locally destructive but *rarely metastasizes*

Multiple Myeloma

This neoplasm derives *from plasma* cells within the bone marrow and *does NOT spread unlike leukemia*

Hemangio-

This prefix means *blood* Vessels

Chondro-

This prefix means cartilage

Fibro-

This prefix means fibrous tissue

Adeno-

This prefix means gland

Cancer:

This term describes: - Unrestrained growth and spread - Cells do not respond to control mechanisms that normally regulate cell growth and differentiation - Serves no useful purpose - Terms neoplasm and tumor may be used interchangeably

Neoplasm

This term means "new growth"

Primitive Cell Tumors

This tumor arises from persistent groups of *primitive* cells and may arise in *children* - Brain - Retina - Adrenal gland - Kidney - Liver - Genital tract

Malignant Tumors

This tumor: • Starts from a single cell that has sustained damage to its genome, causing it to proliferate abnormally • Clone of identical cells is formed; if unchecked, eventually develops into a distinct tumor • Exhibit behavior different from that of normal cells • Do not respond to normal growth regulatory signals • Proliferate unnecessarily • May secrete growth factors to stimulate their own growth, allowing tumors to flourish at the expense of surrounding normal cells • Secrete enzymes that break down normal cell and tissue barriers, allowing them to - Infiltrate into adjacent tissues - Invade lymphatic channels and blood vessels - Spread throughout the body • Tumor cells do not normally "wear out" as normal cells, but become "immortal" and can proliferate indefinitely

Non infiltrating (in Situ) Carcinoma

This type of cancer: • Arises from the surface epithelium • Remains localized within the epithelium for many years most common in *cervix, breast*, urinary tract, colon, skin

DNA Repair Genes

This type of gene regulates processes that monitor and repair any errors in DNA duplication during cell division; DNA damage from radiation, chemicals, or other environmental agents

Tumor Suppressor Genes

This type of gene: • Normally suppresses cell proliferation • It can lose function by mutation which may lead to unrestrained cell growth • *Exists in pairs* at corresponding gene loci on homologous chromosomes • *Both suppressor genes* must cease to function before cell malfunctions

Sarcoma:

Tumor arising from connective tissues such as fat, bone, cartilage, muscle - Less common, but *spreads more rapidly* -* Metastasizes* into bloodstream

MALIGNANT

Tumor with: - Growth rate: rapid - Growth character: infiltration - Spread by metastasis by bloodstream or lymphatic channels - Cell differentiation: poorly differentiated cells

BENIGN

Tumor with: - Slow growth rate - Expansion rather than infiltration -Does not invade surrounding tissue - Tumor remains localized - Well-differentiated cells

cells and tissues of origin

Tumors are named and classified according to their

*Actinic Keratoses* (small, crusty patches on sun-exposed skin) *Leukoplakia* (thick white patches in mucous membranes of mouth from tobacco smoke)

Two types of precancerous conditions

Aleukemic leukemia

Type of *leukemia* in which *white cells are confined to the bone marrow* such that their number in the peripheral blood is normal or decreased

1 in 4

___ in ____ people will develop cancer

Mutation:

any change in the normal arrangement of DNA nucleotides on the DNA chain

Cancer

any type of malignant growth

Anemia Hair loss mouth problems Constipation Infection Nausea/vomiting Depression Anorexia Sexual probs Diarrhea Fatigue

common side effects of chemotherapy

Acid-phosphatase

normally produced by *prostate* epithelial cells may be elevated in *prostate cancer*

Tumor associated antigen tests

some cancers secrete substances that can be detected in the blood by these lab tests