Onc Lec 1: Intro

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55 Terms

1
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What is cancer?

disease of unregulated cell growth, division, and differentiation

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What does angiogenesis mean?

formation of new blood supply

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What are some mechanisms that cancer is spread?

rapid growth, dec cellular adhesion, inc motility, angiogenesis

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What does carcinoma affect?

epithelial tissue

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What does adenocarcinoma affect?

glandular epithelial tissue

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what does sarcoma affect?

connective tissue

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What does glioma affect?

CNS glial cells

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What does neuroblastoma affect?

neurons (and Brenna’s brother apparently)

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what does lymphoma affect?

lymphocytes

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What is knudson hypothesis?

cancer is the result of accumulated mutations to a cell’s DNA (takes multiple “hits” to DNA for malignancy to develop, not just one)

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What is carcinogenesis?

development of cancer depends on accumulation of genetic modifications (activation of proto-oncogenes or inhibition of tumor suppressor genes)

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What are proto-oncogenes?

genes that stimulate cell proliferation

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What are tumor suppressor genes?

genes that keep proliferation in tact

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What is the most common cancer in men?

prostate

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What is the most common cancer in women?

breast

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What are the 2nd and 3rd most common cancers in both sexes?

lung and colorectal

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How did the incidence disparity b/t males and female change from the early 90s?

it significantly narrowed

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What combined strategy contributed to the decrease in death rate and increased 5 year survival rate?

prevention (reduction in smoking), early detection, improved treatment

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There have been notable improvements in survival for most cancer types due to ____

earlier detection and/or advances in tx

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What is the 2nd most common cause of death in the US? (heart disease is 1st)

cancer

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What is the leading cause of death for both sexes?

lung cancer

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What is the second cause of death in women?

breast cancer

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What is the 2nd cause of death in men?

prostate cancer

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What is the 3rd cause of death in both sexes?

colon and rectal cancer

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What is the most common, preventable cause of cancer?

tobacco

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carcinogen pathophysiology

exposure to carcinogens —> covalent bonds form b/t carcinogens and DNA —> accumulation of permanent mutations in critical genes

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What type of radiation has deep penetrating power and breaks DNA?

ionizing radiation

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What type of radiation has little penetrating power and damages pyrimidines, interfering w/ replication?

nonionizing radiation

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What is ionizing radiation used for?

used to sterilize drugs, vaccines, and some f foods including fruits. spinach, lettuce, and meat

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What is nonionizing radiation used for?

used to sterilize air, water, and solid surfaces

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What are examples of ionizing radiation?

gamma rays, xrays, cathode rays

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What are examples of non ionizing radiation?

UV rays

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What happens when tumor suppressor genes are deleted or mutated?

growth proceeds unchecked

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What activates oncogenes resulting uncontrolled cellular proliferation?

a mutational change in the gene

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what are homologs of normal cellular genes that participate in cell growth pathways and cell cycle regulation?

oncogenes (humans normally carry some, but they are usually kept in check)

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What are examples of viral oncogenes?

EBV- burkitt and hodgkin lymphoma

HPV- cervical, head, and neck cancers

Hep B- hepatocellular carcinoma

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How do viral oncogenes cause cancer?

some viruses carry an oncogene and incorporate it into human DNA when the virus infects the cell and sometimes turns on a human oncogene

(all oncogenic viruses have ability to stimulate unlimited cell growth)

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What are the most important ways for nonsmokers to reduce cancer risk?

maintain healthy weight, regular physical activity, and healthy diet

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How many drinks of alcohol per day would substantially increase risk for cancer?

2

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What is the most commonly used system for staging at the initial diagnosis?

T- tumor location, size, level of invasion

N- presence or absence of nodal metastases

M- presence or absence of metastases

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What determines the treatment and outcomes of cancer?

staging

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What is clinical staging?

based on physical examination, imaging tests, and biopsies of affected areas

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What is pathologic staging?

can only be determined from individual pt’s who have had surgery to remove a tumor or explore the results of both clinical staging with surgical results

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What is the staging system for Hodgkins and non-hodgkins lymphoma?

Ann Arbor

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What is the staging system for multiple myeloma?

international staging system (ISS)

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What staging is used for prostate cancer?

Gleason score grades aggressiveness of cancer cells (2-10)

add scores from 2 areas w/ the most cancer cells

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What are many solid tumors graded on?

proliferative indices

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what is molecular testing useful for?

determining both prognosis and treatment

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What are paraneoplastic effects of a tumor?

remote effects that are not related to the direct invasion, obstruction or metastasis

sx usually due to aberrant hormonal or metabolic effects

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How are paraneoplastic syndromes divided?

by the system they affect (endocrine, hematologic, neurologic, neuromuscular, mucocutaneous)

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What are paraneoplastic endocrine syndromes?

the tumor tissue itself secretes the hormone that produces the syndrome (ectopic hormone production)

believed to result from activation of oncogenes in the tumor that are usually suppressed in normal tissue

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What are ectopic hormones?

pro-hormones of higher molecular weight than those secreted by normal, differentiated endocrine cell

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What are paraneoplastic neurologic syndromes?

immunologic response is directed against shared antigens that are ectopically expressed by the tumor, but otherwise predominantly expressed by the nervous system

antibodies detected in serum and CSF fluid in most pts

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Why are paraneoplastic syndromes clinically important?

may provide early clues to the presence of some cancers or the metabolic or toxic effects of the syndrome may create a more urgent situation than the cancer itself (once the tumor resolves, the syndrome resolves as well)

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What is Sweet’s Syndrome associated with?

leukemia