Oncogenesis, Cancer-Relation Manifestations, and treatment

Cancer

a disorder of cell differentiation and growth

Proliferation

rapid growth to form new cells

Benign

Well differentiated

Malignant

less differentiated (cancer)

Naming Benign Tumors

tissue name + “oma”

Naming Malignant tumors

Epithelial tissues: tissue name + carcinoma

Glandular tissue: tissue name + adencarcinoma

Mesenchymal tissue: tissue name + sarcoma

Benign tumors description

• act and look like normal tissue

• grow slowly

• surrounded by fibrous capsule

• do no metastisize

• Can cause damage from compression

Malignant Neoplasm Description

• do not look or act like normal cells

• grow rapidly

• lack capsules

• infiltrate and metastasize

• can compress or destroy surrounding tissue

Normal Cell cycle

the # of cells produced = the # of cells that die

Cancer Cell Cycle

Growth fraction increases and doubling time decreases

growth fraction

dividing:resting cells

doubling time

the amount of time it takes for cells to double in mass

Growth Factors

tells cells when to divide

Mechanical invasiveness

the ability to invade surrounding tissue

Release of Lytic Enzymes

releases enzymes that destroy cells and weaken areas to occupy space

Diminished cell adhesion

allows the ability for cells to shed off of tumors and spread to distant parts of the body

Increased Cell motility

the cells have heightened ability to move

Metastasis

the ability of cells in a primary tumor to escape, travel in blood or lymph, exit, and create a second tumor.

Angiogenesis

cells create their own blood vessels by leeching off other tissues

Oncogenesis

the process through which healthy cells become cancer cells

proto-oncogenes

a group of genes that code cell division for normal cells can can become cancerous when mutated

anti-oncogenes

suppressor genes that help control cell growth

Tumor Supressor Gene

inhibit cell division

oncogenes

mutated proto-oncogenes that have potential to cause cancer

Local Effects of tumor growth

compression and effusions

Systemic Effects of tumor growth

• anemia

• anorexia and cachexia

• fatigue and sleep disturbance

• ectopic hormones or factors secreted

Paraneoplastic syndrome

a body site that is in impacted by the tumor that doesn’t necessarily express manifestation directly associated with it

Diagnostics for Cancer

• screening

• tumor markers

• cytologic studies (pap smear)

• tissue biopsy

• immunohistochemistry (estrogen receptor)

• Microarray technology (gene chips)

• Staging and grading

Grading

microscopic examination of differentiation and number of mitosis (I-IV)

Grade 0

some identification or lack of differentiation in sample

Grade I

very localized area of growth

Grade II

early locally advanced

Grade III

Late locally advanced

Grade IV

No longer local, metastasized

Staging

Clinical, radiographic, surgical examination of extent and spread, treatment, prognosis

TNM

Tumor, Node, Metastasis

T1-4

tumor size

N0-3

lymph node involvement

M0-1

matastasis

Cancer Treatments

• Primary Prevention

• Secondary Prevention- early diagnosis

• Tertiary Prevention- surgery, chemo, radiation

• Biological Response Modifiers (BRM)- cytokines and vaccines

• Gene Therapy- precision medicine