NURS 337: Exam 1 Study Guide Final (Cancer Biology & Epidemiology)

What is Cancer?

Disease in which abnormal cells divide without control and can invade other tissue

What is Neoplasia?

uncontrolled, abnormal growth of cells or tissues in the body

What are the two causes of Cancer?

- Genetic disorder : DNA mutation

- Heritable : Darwinian selection

What does Malignant mean?

Cancerous

What does Benign mean?

non cancerous

What does "-oma" usually mean?

Benign

What is Carcinoma?

malignant in epithelial tissue

What is Sarcoma?

malignant in mesenchymal tissue

Is Hodgkin's lymphoma malignant or benign?

malignant

Is Wilms tumor malignant or benign?

malignant

Is Ewing sarcoma malignant or benign?

malignant

Is melanoma malignant or benign?

malignant

Is hepatocellular carcinoma malignant or benign?

malignant

Benign Tumor vs Malignant Tumor: Cell differentiation

Benign: differentiated; looks similar to normal cells

Malignant: Undifferentiated/Anaplastic; abnormal cells

Benign Tumor vs Malignant Tumor: Capsule

Benign: encapsulated; contained, well-defined border

Malignant: no capsule; invades surrounding tissues

Benign Tumor vs Malignant Tumor: Mitosis

Benign: normal or low mitotic activity

Malignant: increased and atypical mitosis

Benign Tumor vs Malignant Tumor: Growth Rate

Benign: slow growing

Malignant: rapid, atypical mitosis

Benign Tumor vs Malignant Tumor: Spread

Benign: remains localized

Malignant: metastasizes; spreads to distant sites

Benign Tumor vs Malignant Tumor: Threat level

Benign: not life threatening

Malignant: life threatening

What is Anaplasia?

Loss of mature or specialized features of a cell or tissue; CANCEROUS

What is Carcinoma in SITU?

early stage cancer ; preinvasive epithelial tumors

What grade is Carcinoma in SITU?

high grade dysplasia

What are Proto-oncogenes?

normal cell proliferation proteins

What are Oncogenes?

mutated proto-oncogene / cancerous

What is the function of Tumor Suppressor Genes?

- Inhibit proliferation

- Stop cell division

- Prevent mutation

What is the role of Governors? What are examples?

stop the growth

- P53

- Rb gene

What is the role of Guardians? What are examples?

damage the growth

- BRCA-1

- BRCA-2

What are Telomeres?

normally present; does not allow cell to be immortal and get smaller with every cell division

What is Telomerase?

NOT normally present; restore and maintain telomeres; unlimited division; 90% of cancer

What is Angiogenesis?

growth of new blood vessel

What is VEGF?

cancerous tumors secrete to gain nutrients from blood vessels

What is Warburg Effect?

cancerous cells using aerobic glycolysis

What is Reverse Warburg Effect?

other cells using aerobic glycolysis to allow cancerous cells to have lactate and metabolites for cell growth

What is an important factor in the development of cancer?

chronic inflammation

What can Hepatitis B & C viruses lead to?

Primary hepatocellular carcinoma

What can Epstein-Barr virus (RBV) lead to?

Burkitt's lymphoma

What can HIV/AIDS lead to?

kaposi sarcoma herpesvirus (KSHV)

What can Human papillomavirus (HPV) lead to?

Cervical cancer

What can Reflux disease lead to?

adenocarcinoma of the lower esophagus

What can Helicobacter pylori lead to?

gastric carcinoma

What is a prerequisite to metastasis?

Local spread

What is Metastasis?

spread from the site of origin to a distant site

What are the two routes of Metastasis?

- Blood: blood vessels

- Lymphatics: lymphatic vessels

What are Manifestations of Cancer?

- Cachexia / wasting away

- Pain

- Obstruction

- Tissue necrosis

- Anemia

- Severe fatigue

- Effusion

- Infection

- Bleeding

What are the Diagnostic tests of Cancer?

- Routine screening

- Blood test

- Tumor markers

- Biopsy

- Cytology

What do AFP and PSA tumor marker tests reveal?

- AFP → liver cancer

- PSA → prostate cancer

What is TNM?

Universal language to classify tumors

What does T in TNM stand for?

Tumor Spread

What are the different classifications of Tumor Spread?

- T0: Organ free of tumor

- T1: Lesion less than 2 cm

- T2: Lesion 2-5 cm

- T3: Lesion more than 5 cm

What does N in TNM stand for?

Nodes Involvement

What are the different classifications of Node Involvement?

- N0: No node involvement

- N1-3: Involvement of regional nodes and extent of spread

What does M in TNM stand for?

Metastasis Presence

What are the different classifications of Metastasis Presence?

- M0: No metastasis

- M1: Metastasis present

What does Staging Classify?

where has the cancer spread

What are the different levels of Staging?

- Stage i: Confine to origin

- Stage ii: Local invasion

- Stage iii: Spread to regional structures (Lymph Nodes)

- Stage iv: Distant metastasis

What are the different levels of Grading?

- Grade 1: Well differentiated

- Grade 2: Moderately differentiated

- Grade 3: Poorly differentiated

- Grade 4: Anaplastic

What does Grading classify?

how bad do the cells look on a histopathological level

What does "In SITU" mean?

abnormal cells present

What does localized mean?

where it started

What does regional mean?

spread to nearby tissue and lymph nodes

What does Distant mean?

metastasis; spread to distant parts of the body

What does Unknown mean?

not enough information to know

What are the different types of Cancer Therapy?

- Surgery

- Chemotherapy

- Radiation Therapy

- Hormone therapy

- Targeted therapy

- Immunotherapy

- Stem cell transplant

How does Chemotherapy work?

uses drugs to kill cancer cells

How does Radiation Therapy work?

to kill cancer cells or shrink tumor size

How does Hormone therapy work?

slow or stop cell growth

How does Targeted therapy work?

target mechanisms leading to cancer

How does Immunotherapy work?

boost the immune system to fight cancer

How does Stem cell transplant work?

restore destroyed stem cell

How much does cancer contribute to all deaths? Rank for leading causes of death?

25%; 2nd leading cause of deaths in The US

How many of Cancer related deaths may be preventable?

40%

What is Prevalence?

Percentage affect with a disease at a given time

What is Incidence?

number of new cases in a specific time period

What is Morbidity?

having signs or a symptoms of a disease

What is Mortality?

number of deaths due to a disease

What is Sensitivity?

correctly identified those with a disease

What is Specificity?

identify those without a disease

What is the leading cancers diagnosed in males?

- prostate

- Lung

- Colorectal

What is the leading cancers causing death in males?

- Lungs

- Prostate

- Colorectal

What is the leading cancers diagnosed in females?

- Breast

- Lung

- Colorectal

What is the leading cancers causing death in females?

- Breast

- Lung

- Colorectal

How can lifestyle factors cause cancer?

What you are exposed to in life can cause many different types of cancers

How does fat in the body affect cancer?

Cancer induces lipolysis; growth of fat

- Fat supports the growth of cancer and metastasis

Stagings of colon cancer

Duke’s A 5 yr survival > 90%

Duke’s B 5 yr survival 55% to 85%

Duke’s C 5 yr survival 20% to 55%

Duke’s D 5 yr survival < 5%