Ch. 40 - Cancer

Pathophysiology Exam 2

What is cancer?

A group of diseases characterized by uncontrolled growth and division of abnormal cells that can invade surrounding tissues and spread to distant sites

What is a neoplasm?

An abnormal mass of tissue resulting from uncontrolled cell growth

What is the difference between a benign and malignant tumor?

Benign tumors remain localized and do not invade or metastasize, while malignant tumors invade nearby tissues and can metastasize to distant organs

What does metastasis mean?

The spread of cancer cells from primary tumor to distant parts of the body through the blood or lymphatic system

Why is metastasis clinically significant?

Metastatic cancer is generally more difficult to treat and is responsible for most cancer-related deaths

What is differentiation in relation to tumors?

The degree to which cancer cells resemble normal cells. Well-differentiated tumors resemble normal tissue more closely, while poorly differentiated tumors tend to be more aggressive

What is anaplasia?

Loss of normal cell differentiation, resulting in immature, abnormal-looking cells that often grow aggressively

What is dysplasia?

Abnormal cell growth or development that may progress to cancer if left untreated

What is hyperplasia?

An increase in the number of normal cells in a tissue due to increased cell division

What is hypertrophy?

An increase in cell size rather than cell number

How are cancers generally named?

According to the tissue or cell type from which they originate

What is a carcinoma?

A malignant tumor that arises from epithelial cells. It is the most common type of cancer

What is a sarcoma?

A malignant tumor arising from connective tissues such as bone, muscle, cartilage, or fat

What is leukemia?

A cancer of blood-forming tissues, especially the bone marrow, resulting in abnormal white blood cell production

What is lymphoma?

A cancer of lymphocytes originating in the lymphatic system

What is multiple myeloma?

A malignancy of plasma cells in the bone marrow

What is a primary tumor?

The original site where the cancer begins

What is a secondary tumor?

A metastatic tumor that has spread from the primary site

What is angiogenesis?

The formation of new blood vessels that supply oxygen and nutrients to a growing tumor

Why is angiogenesis important for tumor growth?

Tumors require a blood supply to continue growing and to facilitate metastasis

What is tumor grading?

A system that describes how abnormal cancer cells look under the microscope and how aggressively they are likely to behave

What is tumor staging?

A system that describes the extent of cancer spread within the body

Which system is commonly used to stage solid tumors?

The TNM system

What does “T” represent in the TNM staging system?

The size and extent of the primary tumor

What does “N” represent in the TNM staging system?

Regional lymph node involvement

What does “M” represent in the TNM staging system?

Presence or absence of distant metastasis

Which stage generally represents localized cancer?

Stage I

Which stage generally indicates distant metastasis?

Stage IV

Why is cancer staging important?

It helps determine prognosis, guides treatment decisions, and allows comparison of outcomes between patients

Which generally has a better prognosis: an early-stage or late-stage cancer?

Early-stage cancer

What are the major treatment options for cancer?

Surgery, radiation therapy, chemotherapy, immunotherapy, targeted therapy, hormone therapy, stem cell transplantation, and palliative care

What is the goal of surgery in cancer treatment?

To remove the tumor and, when possible, achieve complete removal of cancerous tissue

How does radiation therapy treat cancer?

It damages the DNA of cancer cells, preventing them from dividing and leading to cell death

How does chemotherapy work?

It destroys rapidly dividing cells, including cancer cells, but can also affect normal rapidly dividing cells

Why does chemotherapy commonly cause hair loss and mouth sores?

Hair follicles and the cells lining the mouth divide rapidly, making them susceptible to chemotherapy

Why are chemotherapy patients at increased risk for infection?

Chemotherapy suppresses bone marrow function, reducing white blood cell production (especially neutrophils)

What is neutropenia?

An abnormally low number of neutrophils, increasing the risk of serious bacterial and fungal infections

Why can chemotherapy cause anemia and thrombocytopenia?

Bone marrow suppression decreases production of red blood cels and platelets

What is immunotherapy?

Treatment that uses or enhances the body’s immune system to recognize and destroy cancer cells

What is targeted therapy?

Treatment that specifically targets molecules or pathways involved in cancer cell growth while minimizing damage to normal cells

What are monoclonal antibodies?

Laboratory-produced antibodies designed to recognize and bind to specific antigens on cancer cells

How do monoclonal antibodies help treat cancer?

They help the immune system identify and destroy cancer cells or block signals that promote tumor growth

Why are monoclonal antibodies considered targeted therapy?

They are designed to bind specific proteins or receptors found on cancer cells

What is one advantage of monoclonal antibody therapy over traditional chemotherapy?

It is generally more selective for cancer cells, reducing damage to many normal tissues

Can monoclonal antibodies be combined with chemotherapy?

Yes, they are often used in combination to improve treatment effectiveness

What is cancer cachexia?

A complex syndrome characterized by involuntary weight loss, muscle wasting, fatigue, and loss of appetite that is not fully reversed by increasing calorie intake

What causes cancer cachexia?

Tumor-related inflammation and metabolic changes increase energy expenditure and muscle breakdown while reducing appetite

Why is cachexia dangerous?

It causes loss of muscle mass, weakness, and decreased treatment tolerance, impaired quality of life, and poorer outcomes

What are common signs of cachexia?

Weight loss, muscle wasting, fatigue, weakness, and decreased appetite

How is cachexia managed?

Treatment focuses on the underlying cancer, nutritional support, symptom management, physical activity when appropriate, and selected medications in some patients

What is the leading cause of lung cancer?

Cigarette smoking

What other factors increase the risk of lung cancer?

Secondhand smoke, radon exposure, occupational exposures (such as asbestos), air pollution, and family history

What are common signs and symptoms of lung cancer?

Persistant cough, coughing up blood (hemoptysis), chest pain, shortness of breath, hoarseness, recurrent respiratory infections, and unexplained weight loss

Why is lung cancer often diagnosed at a late stage?

Early lung cancer frequently causes few or no symptoms

What imaging study is commonly used to evaluate suspected lung cancer?

A chest CT scan is commonly used, with biopsy required to confirm the diagnosis

What is the most common cancer among women worldwide (excluding some skin cancers)?

Breast cancer

What are common risk factors for breast cancer?

Increasing age, family history, inherited genetic mutations (such as BRCA1 or BRCA2), prolonged estrogen exposure, obesity after menopause, and alcohol use

What are common signs of breast cancer?

A painless breast lump, skin dimpling, nipple retraction, nipple discharge, breast asymmetry, or enlarged axillary lymph nodes

What screening test is commonly used to detect breast cancer?

Mammography

How is breast cancer commonly treated?

Treatment depends on the type and stage and may include surgery, radiation therapy, chemotherapy, hormone therapy, targeted therapy, immunotherapy, or combinations of these

What is the most common non-skin cancer among men in many countries?

Prostate cancer

What are the major risk factors for prostate cancer?

Increasing age, family history, inherited genetic factors, and African ancestry

What are common symptoms of prostate cancer?

Early prostate cancer is often asymptomatic. Later symptoms may include urinary frequency, hesitancy, weak stream, nocturne, erectile dysfunction, or bone pain if metastasis occurs

Where does prostate cancer commonly metastasize?

Bone, especially the spine, pelvis, ribs, and hips

What screening tests may be used for prostate cancer?

Prostate-specific antigen (PSA) blood testing and digital rectal examination (DRE). Screening decisions should be individualized based on age, risk factors, and shared decision-making

What are major risk factors for colorectal cancer?

Increasing age, family history, inflammatory bowel disease, obesity, physical inactivity, smoking, heavy alcohol use, diets high in processes or red meat, and certain inherited syndromes

What are common signs and symptoms of colorectal cancer?

Blood in the stool, changes in bowel habits, abdominal pain, unexplained weight loss, fatigue, and iron deficiency anemia

Why can colorectal cancer cause iron deficiency anemia?

Chronic slow bleeding from the tumor can lead to ongoing blood loss

What is the preferred screening test for colorectal cancer?

Colonoscopy is considered the gold standard because it can both detect and remove precancerous polyps. Other approved screening options are also available

Why are colon polyps often removed?

Some polyps can develop into colorectal cancer over time

What is the primary cause of cervical cancer?

Persistant infection with high-risk types of human papilloma virus (HPV)

Which virus is strongly associated with cervical cancer?

Human papilloma virus (HPV)

How can cervical cancer often be prevented?

HPV vaccination, routine cervical cancer screening, and treatment of precancerous cervical changes

What screening test is commonly used to detect cervical cancer?

The Pap test (Pap smear), often combined with HPV testing depending on age and screening guidelines

What are common symptoms of cervical cancer?

Abnormal vaginal bleeding, bleeding after intercourse, pelvic pain, and abnormal vaginal discharge

What are major risk factors for liver cancer?

Chronic hepatitis B, chronic hepatitis C, cirrhosis, excessive alcohol use, nonalcoholic steatohepatitis (NASH), and exposure to aflatoxins

What are common symptoms of liver cancer?

Right upper quadrant pain, abnormal swelling, jaundice, weight loss, fatigue, and loss of appetite

Why does lover cancer sometimes cause jaundice?

Tumor involvement can impair bile flow or damage liver tissue, leading to bilirubin accumulation

How’s liver cancer commonly diagnosed?

Imaging studies (such as ultrasound, CT, or MRI), blood tests such as alphafetoprotein (AFP) in some cases, and biopsy when needed

Why are patients with cirrhosis at increased risk for liver cancer?

Chronic inflammation and repeated liver cell injury increase the likelihood of malignant transformation

What are common symptoms of primary bone cancer?

Persistent bone pain, swelling, tenderness, decreased function, and sometimes pathological fractures

What is a pathologic fracture?

A fracture that occurs in bone weakened by disease, such as cancer

Why does bone cancer cause pain?

Tumor growth damages bone tissue and irritates surrounding nerves and structures

How is bone cancer commonly diagnosed?

Imagine studies followed by. biopsy to confirm the diagnosis

How is bone cancer commonly treated?

Surgery, chemotherapy, radiation therapy, or a combination, depending on the type and stage

A smoker develops a chronic cough, hemoptysis, and weight loss. Which cancer is most likely?

Lung cancer

A patient has a positive fecal blood test and iron deficiency anemia. Which cancer should be suspected?

Colorectal cancer

A patient has a persistent abnormal vaginal bleeding and is positive for high-risk HPV. Which cancer should be suspected?

Cervical cancer

A patient with cirrhosis develops jaundice, weight loss, nd a liver mass. Which cancer is most likely?

Liver cancer

A man with prostate cancer develops severe lower back pain. What complication should be suspected?

Bone metastasis

What is an oncologic emergency?

A life-threatening complication of cancer or its treatment that requires immediate recognition and management

What is tumor lysis syndrome (TLS)?

A metabolic emergency that occurs when large numbers of cancer cells break down rapidly, releasing intracellular contents into the bloodstream

What laboratory abnormalities are commonly seen in tumor lysis syndrome?

Hyperkalemia, hyperphosphatemia, hypocalcemia, and hyperuricemia, which can lead to acute kidney injury and cardiac arrhythmias

Which patients are at greatest risk for tumor lysis syndrome?

Patients with rapidly growing cancers (especially leukemias and lymphomas) after starting chemotherapy

How is tumor lysis syndrome treated or prevented?

Aggressive IV hydration, close monitoring, and medications to lower uric acid (such as allopurinol or rasburicase then appropriate)

Why is a biopsy considered the gold standard for diagnosing cancer?

It provides tissue for microscopic examination to confirm the presence and type of cancer

Why are imaging studies important in cancer care?

They help detect tumors, evaluate the extent of disease, monitor treatment response, and identify recurrence

What is the purpose of chemotherapy?

To destroy rapidly dividing cancer cells or prevent them from multiplying

What is the purpose of radiation therapy?

To damage cancer cell DNA, leading to loss of reproductive ability and cell death

What is the purpose of immunotherapy?

To enhance or restore the immune system’s ability to recognize and destroy cancer cells