Week 10 Oncology

Primary tumors arise from cells ____ in given structure

a) local

b) another part of body

a

Secondary tumors arise from cells that have metastasized from ______

a) local

b) another part of body

b

Benin tumors are associated as being

a) non-invasive

b) fast growing

c) overgrowth of normal tissue

d) non-capsulated

e) potential to distend/compress/obstruct

f) invasive/metastatic

g) poorly differentiated

h) a, c, e

i) b, d, f, g

h

Malignant tumors are associated as being

a) non-invasive

b) fast growing

c) overgrowth of normal tissue

d) non-capsulated

e) potential to distend/compress/obstruct

f) invasive/metastatic

g) poorly differentiated

h) a, c, e

i) b, d, f, g

i

Metastasis

movement of cells from one part of the body to another

Why is there an emphasis on wanting to knock out angiogenesis during cancer treatment?

to limit blood flow to that area

Somatic mutation theory states that tumors originate in a ___ cell(s)

a) single

b) multiple

a

When is a tumor acquired for the somatic mutation theory?

due to a genetic/chromosome change

Protooncogenes

non-mutated form of oncogene

Oncogenes

cancer-causing gene that is activated due to carcinogens or viruses

Anti-oncogenes

tumor suppressor genes

Immunosurveillance

continuous searching and destroying of tumors

What is an IMPORTANT risk factor to cancer?

immunosuppression/immunodeficiency

What is the difference between tumor-specific antigens and tumor-associated antigens?

tumor-specific = loaded onto MHC's for immune activation

tumor-associated = expressed by tumor and normal cells

What are some examples of tumor evasion strategies?

overwhelmed by rapid proliferation

down regulation of MHCI

mutation/modulation of antigens --> decreased loading onto MHC I

induce immune suppression (cytokines)

Chimeric antigen receptor t-cell therapy take _____ from patient's blood, modify them in the lab, and then put back into patient's body to fight against tumors.

a) t-cells

b) b-cells

a

Targeted therapy involves inhibiting the ________ enzyme which will then fight against _____ cancers.

a) bruton's tyrosine kinase, t-cell

b) lipase, b-cell cancers

c) bruton's tyrosine kinase, b-cell

c

Naming scheme: label which classification goes with each each

Epithelial tissue =

connective tissue and muscle =

nerve tissue (spinal cord, brain, nerves) =

lymphoid tissue =

hematopoietic =

carcinoma

sarcomas

named after the cell type

lymphomas

leukemias, multiple myeloma

What three things go into the staging of cancer?

rate of growth, extent, prognosis

The clinical stages of cancer are denoted by a "c" and are based on what?

a) exam

b) palpation

c) tissue study

a

The pathologic stage of cancer is denoted by a "p" and is based on what?

a) exam

b) palpation

c) tissue study

c

Regarding TMN staging, the T refers to the

a) size of the primary tumor

b) regional lymph nodes involved

c) no metastases, metastases present

a

Regarding TMN staging, the N refers to

a) size of the primary tumor

b) regional lymph nodes involved

c) no metastases, metastases present

b

Regarding TMN staging, the M refers to

a) size of the primary tumor

b) regional lymph nodes involved

c) no metastases, metastases present

c

The Ann Arbor Staging for Lymphoma uses the letters A, B, E, X. What does the E stand for?

extra-nodal (not in lymph node or has spread from lymph node to adjacent tissue)

Is a lower score or a higher score potentially a better outcome regarding tumor grading systems?

lower scores

What are the most common newly diagnosed cancers?

breast, prostate, lung, colorectal cancer

What is the most prevalent cancer in the world?

lung

3 of 5 diagnosed with be cured and/or survive greater than or equal to ____ years after treatment

a) 4

b) 5

c) 6

b

Cancer related deaths are second to what disease?

a) heart disease

b) liver disease

c) kidney disease

d) none of the above

a

What male race and ethnicity has the highest rate of cancer?

black

What female race/ethnicity has the highest cancer incidence?

American Indiana/Alaska Native

True or false: as we age, our probability of developing invasive cancer decreases

false - increases

When a cancer is local, what does that mean?

a) spread to regional lymph nodes or beyond the primary site

b) spread to remote lymph nodes and other organs

c) defined to primary site

c

When a cancer is regional, what does that mean?

a) spread to regional lymph nodes or beyond the primary site

b) spread to remote lymph nodes and other organs

c) defined to primary site

a

What a cancer is distant, what does that mean?

a) spread to regional lymph nodes or beyond the primary site

b) spread to remote lymph nodes and other organs

c) defined to primary site

b

True or false: trends in five-year survival rates by race have continued to decrease over time

true

What are two types of cancers that we should be aware of as professionals?

bone tumors and soft tissue sarcomas

What are endogenous risk factors to cancer?

genetics, hormones, immunosuppression/immunodeficiency, age

What are exogenous risk factors to cancer?

lifestyle, viral exposure, chemicals, radiation exposure

What is an important modifiable risk factor to cancer?

physical inactivity

What are some systemic signs of cancer?

unexplained weight loss, changes in bowel or bladder habits, nagging cough or hoarseness, fatigue, malaise, weakness, fever

When referring to night pain, what does that mean?

pain worse at night or at rest; non mechanical pain

Paraneoplastic syndrome

signs and symptoms distant from primary tumor and metastases; acquisition of new cellular functions

What is an example of a paraneoplastic syndrome?

cushing syndrome

What are the clinical manifestations of lung cancer? (KNOW THIS!)

exertional dyspnea; persistent, dry, non-productive cough

What are the clinical manifestations of colon cancer? (KNOW THIS!)

change in bowel function, blood in stool, shape

Osteosarcoma

unexplained pain in long bones of teenagers

What are the five most common sites of "seeding"?

lung, liver, bone, lymph nodes, brain

Bone metastases affects the ____ skeleton

a) appendicular

b) axial

b

What are manifestations of metastases that affect the spinal cord?

compress on spinal cord and nerve roots, which then causes gradual distal weakness/sensory disturbances; bowel/bladder changes

What are aggravating factors to cancer metastases to the spinal cord?

weight bearing, increased intra-abdominal pressure

True or false: physical activity/exercise has protective effect against cancer

true

When should we consider cancer if MSK pain presents with:

insidious onset, previous history of cancer, > 50 years old, true night pain, constitutional symptoms, unintended weight loss, non-mechanical pain