Exam 2 Cancer Pathology & Treatment

What is cancer?

A group of diseases characterized by uncontrolled proliferation and spread of abnormal cells.

How do normal cells differ from cancer cells?

Normal cells divide and differentiate in a controlled way; cancer cells have abnormal division and differentiation.

What is differentiation?

The process by which cells undergo structural changes to form different tissues.

What does “undifferentiated” mean in cancer?

Cancer cells do not resemble their parent tissue; undifferentiated cells are associated with faster spread and poorer prognosis.

What is cellular dysplasia?

Variation from normal cellular structure; it can be benign, malignant, or pre-malignant.

What is metaplasia?

Early dysplasia; abnormal but potentially reversible.

What is hyperplasia?

An increased number of cells; it can be normal or abnormal.

What is a tumor?

An abnormal growth of new tissue that serves no useful purpose and may harm the host.

How are tumors classified by behavior?

As benign or malignant; they may also be primary or secondary.

How are cancers commonly named?

By the tissue from which they arise.

What suffix is commonly associated with benign tumors?

-oma.

What suffixes are commonly associated with malignant tumors?

-sarcoma and -carcinoma.

What are the exceptions to typical cancer naming?

Lymphoma is malignant lymphatic cancer; leukemia is cancer of bone marrow and blood.

What are the two broad categories of cancer etiology?

Endogenous genetic causes and exogenous environmental causes.

What are examples of exogenous cancer causes?

Environmental exposures, including toxins and viruses.

What happens when normal cell-cycle checks detect irreparable damage?

Apoptosis is triggered, causing cell death.

What are oncogenes?

Mutated genes that regulate the cell cycle and promote increased cell replication.

What are tumor suppressor genes?

Genes that normally regulate cell growth but become inactivated or deleted in cancer.

What is metastasis?

Cancer cells break away from the primary tumor, travel through blood or lymph, and form tumors in new tissues.

How can malignant tumors spread besides metastasis?

Through direct expansion into adjacent structures.

Where does metastasis occur more frequently?

In highly vascularized tissues.

What can primary tumor growth cause?

Organ dysfunction and bleeding; tumors may also develop angiogenesis.

What is angiogenesis?

The development of new blood vessels associated with tumor growth.

What are common symptoms of pulmonary cancer involvement?

• Dry persistent cough

• dyspnea

• hemoptysis.

What are common symptoms of hepatic cancer involvement?

Upper-quadrant pain, malaise/fatigue, anorexia, weight loss, and low-grade fever.

What are the major consequences of bone cancer involvement?

Pain and pathologic fractures; bone lesions may be osteolytic or osteoblastic.

Which part of the skeleton is most commonly involved with bone metastases?

The axial skeleton.

What can brain cancer involvement cause?

Personality/judgment changes, cognitive impairments, and sensory or motor impairments.

Which cancer system involvement is described as most common?

Lymphatic system involvement.

What are the principal medical modalities for treating cancer?

• Surgery

• chemotherapy

• radiation therapy

• stem cell transplants.

What are the two purposes of cancer surgery?

Curative or palliative treatment.

What are palliative purposes of cancer surgery?

Alleviate pressure, correct obstruction, and reduce pain.

Why is lymph node status important in cancer?

It provides information about cancer involvement and spread.

Why is chemotherapy useful for widespread cancer?

It can treat disseminated disease throughout the body

What is the “killing” paradigm of chemotherapy?

Chemotherapy uses dosing designed around the maximum tolerable dose to kill cancer cells.

Why does chemotherapy cause many side effects?

It affects rapidly dividing cells, including normal cells.

What are major chemotherapy side effects?

• Nausea

• anemia

• thrombocytopenia

• hair loss

• weakness

• fatigue

• neuropathy.

What does immunotherapy do?

Activates the body's defense system against tumor cells.

What are common immunotherapy side effects?

• Fatigue

• body aches

• fever

• chills.

How does radiation therapy destroy tumors?

Ionizing energy is focused on a specific tumor location.

Why is radiation therapy often fractionated?

Normal cells recover more quickly than malignant cells between doses.

What are major radiation side effects?

• Fatigue (short or long-term)

• radiation burns

• fibrosis.

How does cellular differentiation relate to cancer prognosis?

Undifferentiated malignant cells are associated with faster spread and poorer prognosis.

What characteristic distinguishes malignant from benign tumors regarding prognosis?

Malignant tumors can spread to other tissues through metastasis or direct expansion.

Why can metastasis worsen prognosis?

Cancer has spread beyond the primary site and can involve distant organs and tissues.