Intro into cancer chemo

What are the hallmarks of malignant neoplastic tissue?

• un-regulated cell proliferation

• invasiveness

• metastasis to distant sites

  • bone, brain, and the liver

What are some characteristics of the cancer cell?

• increased # of mitotic cells

• cells breaking through tissue barriers

• incomplete differentiation or un-differentiated cells

• large nuclei

What are some biochemical characteristics of the cancer cell?

• altered cell surfaces components

• secretion of lytic enzymes or growth factors

  • blood vessel or tumor growth

• high rates of nucleic acid synthesis (de novo)

  • have to make new DNA every time they divide

• higher concentration of enzymes in these pathways

True or false: cancer cells are human cells

true

What type of “normal cells” are most affected by chemotherapy?

Those undergoing cell division and growth

• bone marrow

• hair follicle

• GI mucosa

What factors affect patient function?

• growth/expansion in confined spaces and kick out normal cells

• high metabolic rates and produce nutritional deficits out of proportion to tissue mass

• decrease host defense

• produce hormone-like substances

• invade through tissues

• metastasis

What factors affect drug responsiveness?

• tumor determinants

• drug scheduling

• circadian timing of chemotherapy

• patient determinants

• site and blood supply of the tumor

True or false: tumors may remain in a zero growth state for years

true

Tumor angiogenesis factors cause what?

growth of capillaries into the tumor

What should always follow surgery or radiation even if the report says the area is clear?

chemotherapy

True or false: surgery and radiation can also induce metastases

true

What classifies total tumor burden?

• large bulky tumors that are not usually curable by chemotherapy

• drug may not be able to penetrate due to poor blood supply

• removal of the bulk of the tumor followed by chemotherapy is necessary

What are tumor determinants?

• growth fraction and doubling time

• total tumor burden

• tumor heterogeneity

• cell cycle

• phase specific or non-specific (of cell cycle)

What are some mechanisms in which drug resistance occurs?

• increases in inactivating enzymes

• decreases or changes in activating enzymes

• P-glycoproteins that pump the drug out the cell