NURS 337: Exam #1 - Cancer Biology

Diseases in which abnormal cells divide without control and can invade other tissues?

Cancer

Derived from the Greek word for crab, karkinoma

Cancer

Cellular growth that no longer responds to normal genetic controls?

Cancer

Cell continues to reproduce, without the need for them to reproduce?

Cancer

Deprives other cells of nutrition?

Cancer

Neoplasms may consist of atypical or immature cells?

Cancer

What are the growth dysregulation (Cancer)?

- Genetic disorder

- Heritable

DNA mutuation?

Genetic disorder

Heritable?

Darwinian selection

Hodgkin's lymphoma?

Malignant

Wilm's tumor?

Malignant

Ewing sarcoma?

Malignant

What are the Misomer?

- Melanoma

- Hepatoma = hepatocellular carcinoma

-oma?

Benign

-carcinoma?

Malignant

-sarcoma?

Malignant

What is the description of cell in benign tumors?

- Similar to normal cells

- Differentiated

- Mitosis fairly normal

What is the growth of benign tumors?

- Relatively slow

- Expanding mass

- Frequently encapsulated

What is the spread of benign tumors?

Remains localized?

What are the systemic effects of benign tumors?

Rare

How life-threatening are benign tumors?

Only in certain locations (like the brain)

What are the cells in Malignant tumors?

- Varied in size and shape with large nuclei

- Many undifferentiated

- Mitosis increased and atypical

What is the growth of Malignant tumors?

- Rapid growth

- Cells not adhesive infiltrate tissue

- No capsule

What is the spread of Malignant Tumors?

Invades nearby tissues or metastasizes to distant sites through blood and lymph vessels

What are the systemic effects of malignant tumors?

often present

Are malignant tumors life-threatening?

Yes, by tissue destruction and spread of tumors

Loss of mature or specialized features (structural differentiation) of a cell or tissue?

Anaplasia

What are the characteristics of anaplasia?

- Revert to its immature form

- Pleomorphism

- Abnormal nuclear morphology

- Abnormal mitoses

- Loss of polarity

- Loss of function

Early stage cancers?

Carcinoma in situ

Preinvasive epithelial tumors of glandular or squamous cell origin?

Carcinoma in situ

Have not broken through basement membrane or invaded the surrounding stroma?

Carcinoma in situ

What are the outcomes of carcinoma in situ?

- Remain stable

- Progress to invasive and metastatic cancers

- Regress and disappear

Activation of proto-oncogenes, resulting in hyperactivity of growth-related gene products called oncogenes

Genetic/Molecular Mechanisms of Cancer

Mutation of genes, resulting in the loss or inactivity of gene products that would normally inhibit growth (called tumor-suppressor genes)

Genetic/Molecular Mechanisms of Cancer

Mutation of genes, resulting in an overexpression of products that prevent normal cell death or apoptosis, this allowing continued growth of tumors?

Genetic/Molecular Mechanisms of Cancer

What are the signaling genes of Genetic/Molecular Mechanisms of cancer?

- Signaling genes

- Oncogenes (oncoproteins)

- DNA repair genes

- Apoptosis genes (BAX/Bcl-2)

- Tumor suppressor genes

Proto-oncogenes (Ras, Myc)?

Normal cellular proliferation

Oncogenes (oncoproteins) = mutuated proto-oncogenes?

Uncontrolled cell growth

Inhibit cell proliferation

Tumor suppressor genes

Regulate cell cycle?

Tumor suppressor genes

Stop cell division?

Tumor suppressor genes

Prevent mutations?

Tumor suppressor genes

What are the types of genetic/molecular mechanisms of cancer?

- Governors

- Guardians

Mutuation -> removing the "brake" on cell division -> uncontrolled growth?

Governors

Retinoblastoma gene (Rb)

Governors

Detect genomic changes & choreograph "damage" control -> cessation

Guardians

Mutation -> loses the ability to "damage" control -> uncontrolled growth?

Guardians

What are examples of guardians?

- P53, APC

- BRCA-1 (chromosome 17)

- BRCA-2 (chromosome 13)

What are the two types of replicative immortality?

- Telomeres

- Telomerase

Protective chromosomes from folding and fusing (protective cap)

Telomeres

Decrease DNA mutation

Telomeres

Prevent immortality

Telomeres

Smaller with each cell division

Telomeres

Restore and maintain telomeres?

Telomerase

Unlimited division and proliferation?

Telomerase

90% of cancer cells?

Telomerase

Growth of new blood vessels?

Angiogenesis

Essential in tissue undergoing repair

Angiogenesis

Essential to the growth and spread of cancer

Angiogenesis

Cancerous tumors

Angiogenesis

Maintain secretion of angiogenic factors

Angiogenesis

Vascular endothelial growth factor (VEGF)

Angiogenesis

Suppress angiogenesis inhibitors

Angiogenesis

Reprogramming Energy Metabolism?

Warburg effect

Use of glycolysis under normal oxygen conditions (aerobic glycolysis)

Warburg effect

Allows products of glycolysis to be used for rapid cell growth

Warburg effect

Allows lactate and its metabolites to be used for the more efficient rapid cell growth

Warburg effect

Tumor-promoting inflammation?

Chronic inflammation

an important factor in the development of cancer

Chronic inflammation

What are examples of Tumor promoting inflammation?

- Hep B and C viruses

- Epstein-Barr Virsues (EBV)

- HIV/AIDS

- Human Papillomavirus (HPV)

- Human T-cell leukemia

- Reflux disease

- Helicobacter pylori

Primary hepatocellular carcinoma?

Hep B and C viruses

Burkitt's lymphoma?

Epstein-Barr Virus (EBV)

Kaposi sarcoma herpesvirus (KSHV)

HIV/AIDS

Cervical Cancer

Human papillomavirus (HPV)

Lymphoma virus (HTLV)

Human T-cell leukemia

Adenocarcinoma of the lower esophagus?

Reflux disease

Gastric carcinoma?

Helicobacter pylori

Direct invasion of contiguous organs

Local spread

Is a prerequisite for metastasis and the first step in the metastatic process.

Spread

Invasion then requires that cancer attach to specific receptors and survive in the specific environment.

Spread

Spread from the site of origin to a distant site?

Metastasis

What is the route of metastases?

- Blood (hematogenous)

- Lymphatics

What are the selectivity sites of the spread of cancer?

- Breast cancer-> bones

- Lymphomas -> spleen

Spread?

Dormancy

Small metastasis can occur cant be noticed but can spread?

Micro metastasis

What are the systemic manifestation of cancer?

- Pain

- Obstruction

- Tissue necrosis and ulceration

- Weight loss and cachexia

- Anemia

- Severe fatigue

- Effusions

- Infections

- Bleeding

What are the diagnostic tools for cancer?

- Routine screening

- Self-examination (monthly self breast examination)

- Blood tests

- Tumor markers

- X-rays, CT scan, MRI, ultrasound

- Cytology

- Biopsy: immunohistochemistry

- Screen and identify

- Diagnosed

- Observe trends

Essential for early detection and following treatment?

Routine screening

Identifies genetic mutations that are independent of hereditary but only occur with the disease itself?

Genomic Tumor Assessment

Substances produced by benign or malignant cells.

Tumor markers

Found on or in a tumor cell, in the blood, in the spinal fluid, or in urine.

Tumor markers

Secrete a protein known as alpha-fetoprotein (AFP) into the blood

liver cancer

Secrete prostate-specific antigen (PSA) into the blood

prostate cancer

Staging of cancer?

Based on the presence of metastasis

No metastasis/confine to origin

Stage I

Local invasion

Stage II

Spread to regional structures

Stage III

Distant metastasis

Stage IV

World Health Organization's TNM system?

- T for tumor spread

- N for node involvement

- M for the presence of metastasis

Primary tumor - the size of tumor and its local extent

Tumor (T)