Pathophysiology of Cancer and Metastasis – Flashcards
Unlock all answers in this set
Unlock answersquestion
When a single cell acquires the ability to reproduce aggressively and to invade other tissues
answer
When does cancer occur?
question
Cancer cells multiply and colonize areas of the body where it doesn't belong
answer
What is the difference between a normal cell and a cancer cell?
question
An abnormal growth of cells or tissues that can be benign or malignant
answer
Neoplasm (Tumor) is defined as
question
Abnormal growth that is not cancer and does not spread to other areas of the body (can still cause dysfunction/harm)
answer
Benign Tumor
question
Abnormal growth that invades surrounding tissues and spreads to distant areas of the body.
answer
Malignant Tumor
question
grows slowly in capsule non invasive well differentiated low mitotic index doesn't spread
answer
Benign vs. Malignant - BENIGN
question
grows rapidly not encapsulated invasive poorly differentiated high mitotic index can spread
answer
Benign vs Malignant - MALIGNANT
question
Lipoma
answer
benign tumor is fat
question
Glioma
answer
benign tumor is glia (nervous system)
question
leiomyoma
answer
benign timor in smooth muscle
question
chondroma
answer
benign tumor in cartilage
question
neuroma
answer
benign tumor in nerve
question
adenoma
answer
benign tumor in epithelial/glandular tissue
question
carcinomas (Adenocarcinoma- glandular tissue) (Basal cell- most common skin cancer)
answer
malignant epithelial tumors
question
sarcomas (Chondrosarcome- cartilage) (osteosarcoma- Bone)
answer
Malignant connective tissue tumors
question
leukemia
answer
malignant tumor in blood
question
lymphoma
answer
malignant tumor in immune system
question
is a neoplasm that shows cellular changes of cancer but has not broken through the basement membrane or basal lamina (localized, pre-invasive cancer)
answer
Carcinoma in situ (CIS)
question
cells multiply and invade tissues
answer
Invasive neoplasm
question
metastatic carcinoma
answer
An invasive neoplasm is found somewhere else in the body
question
A substance or agent that contributes to the development or increases the incidence of cancer
answer
Carcinogenesis
question
1. Initiation (causes a genetic mutation) 2. Promotion (causes rapid cell growth) 3. Progression (additional mutations that cause the cancer to spread)
answer
The 3 steps that carcinogens cause cancer:
question
carcinogens
answer
Viruses, bacteria, tobacco, alcohol, diets, obesity, lack of physical activity, occupational hazards, radioactive gases, UV radiation, Ionizing radiation, and hormones are examples of
question
cytokine release from inflammatory cells
answer
Chronic inflammation is due to
question
formation of free radicals and gene mutations
answer
Chronic inflammation promotes
question
substances produced by cancer cells
answer
Tumor markers are
question
plasma cell membranes, in the blood, CSF, or urine
answer
Tumor markers are found on
question
1. Screen and identify individuals at high risk for cancer 2. Help identify specific types of tumors 3. Observe clinical course of cancer
answer
Tumor markers are used to
question
1. Immortalization and Transformation (loss of response to normal regulators of cell growth) 2. Progression 3. Metastasis (ability to leave a tumor and invade other cells/tissues at another location in the body)
answer
3 phenotypes (characteristics) of cancer cells that are not associated with normal cells
question
maintenance of telomeres mutations of genes (proto-oncogens and tumor suppressor genes) angiogenesis
answer
Immortalization and Transformation includes:
question
a normal, nonmutant gene that uses protein products to stimulate cellular growth and responds to cell signals
answer
Proto-oncogene
question
a mutated version of the proto-oncogen
answer
Oncogene
question
activate cells into cellular division by mimicking and taking the place of the normal growth factors that would usually be necessary for cell growth
answer
Oncogenes can
question
1 (dominant)
answer
For mutation from proto-oncogene to oncogene you need __ mutation(s) in an allele.
question
are genes whose protein products can directly or indirectly prevent cell division or lead to apoptosis
answer
Tumor suppressor genes
question
defective proteins that do not suppress cell growth, which allows mutated cells to proliferate
answer
loss of function in tumor suppressor genes cause
question
2 (recessive)
answer
Tumor suppressor genes need __ mutation(s) on both alleles for a mutation to occur
question
new capillaries (internal vasculature) by tumor (results in a continuos blood floor to the tumor)
answer
Angiogenesis is the creation of
question
a lack of oxygen
answer
Angiogenesis is activated by
question
a hormone/growth factor called Vascular endothelial growth factor (VEGF)
answer
Angiogenesis is influenced by
question
Invasiveness (ability to penetrate basal membranes, only Malignant tumors can do this) Angiogenesis (offers malignant cells direct access to blood and lymph systems)
answer
Tumor progression includes
question
invade and colonize territories normally inhabited by other cells
answer
Invasion means that cells
question
1. Decreased cell to cell adhesion (normal cells do not divide and proliferate unless they are anchored) 2. Anchorage independence (without anchorage, the transformed cell can multiply and migrate) 3. Mechanical pressure on tissue (on basement membrane of tissues) 4. Release of lytic enzymes- secreted by tumors (breaks down normal tissue making expansion easier into blood and lymph systems)
answer
The 4 steps to invasion
question
spread of malignant cancer from a primary site of origin to a distant site (life threatening characteristic of cancer)
answer
Metastasis is the
question
direct or continuous extension penetration and transportation in the lymphatics, blood vessels, or body cavities entry and growth in secondary sites
answer
Metastasis includes
question
gain immortality by activating oncogenes and inactivating tumor suppressor genes have ability to continually grow undergo angiogenesis break adhesions with neighboring cells dissolve the extracellular matrix by mechanical pressure and lytic enzymes migrate and invade surrounding tissue travel via circulatory system invade survive proliferate in new sites
answer
Summary of Metastatic cells
question
well differentiated
answer
Grade I of Malignant Neoplasms
question
moderately differentiated
answer
Grade II of malignant neoplasms
question
poorly differentiated
answer
grade III of malignant neoplasms
question
nearly anaplastic
answer
grade IV of malignant neoplasms
question
in situ, non-invasive
answer
Tis stage of malignant neoplasms
question
small minimally invasive within primary organ site
answer
T1 stage of malignant neoplasms
question
larger more invasive within the primary organ site
answer
T2 stage of malignant neoplasms
question
larger and/or invasive beyond margins of primary organ site
answer
T3 stage of malignant neoplasms
question
very large and/or invasive spread to adjacent organs
answer
T4 stage of malignant neoplasms
question
no lymph node involvement
answer
N0 stage of malignant neoplasms
question
regional lymph node involvement
answer
N1 stage of malignant neoplasms
question
extensive regional lymph node involvement
answer
N2 stage of malignant neoplasms
question
more distant lymph node involvement
answer
N3 stage of malignant neoplasms
question
No distant metastases
answer
M0 stage of malignant neoplasms
question
distant metastases present
answer
M1 stage of malignant neoplasms
question
Weight loss (earliest sign) Pain (later sign) Fatigue Anemia Leukopenia (decreased WBC count) Thrombocytopenia (decreased platelets) Infection Cachexia (muscle wasting)
answer
Clinical manifestations of cancer
question
1. Lung and bronchus 2. Breast 3. Colon and rectum
answer
Leading sites of cancer death in women
question
1. Lung and bronchus 2. Prostate 3. Colon and rectum
answer
Leading sites of cancer death in men
question
age greater than 40 personal or family history increases risk 2-3x previous biopsies that showed dysplasia or atypical hyperplasia radiation exposure increased age of 1st pregnancy, or never pregnant laste menopause (long term use of estrogen or hormone replacement increases risk) obesity after menopause recent use of hormones women who consume 1 or more alcohol beverages/day BRCA1 and 2 gene mutation
answer
Breast cancer risk factors
question
Tumor suppressor gene mutations that increase risk of breast cancer
answer
BRCA 1, BRCA 2, and P53
question
Oncogenes that allow for amplification of growth factor genes, promoting growth of cancer cells. The "HER" family activates proliferation and metabolic pathways that promote growth
answer
HER1, HER2, and HER3
question
cancer can depend on presence, but does not start or cause cancer stimulates proliferation of mutations in mammary cells
answer
Estrogen receptors
question
1. ductal carcinoma (cancer arising from collecting ducts) 2. lobular carcinoma (cancer arising from terminal lobules)
answer
The 2 subtypes of breast cancer
question
the upper outer quadrant of breast (aka tail of spence)
answer
Most common site of breast cancer is
question
ductal infiltrating carcinoma
answer
Most common type of breast cancer is
question
painless lump change in size of breast dimpling discoloration inverted nipple discharge from nipple chest pain ulceration edema that comes with discoloration Peau d' orange
answer
S/Sx of breast cancer
question
PAP smear and is most likely treated if detected early
answer
Cervical cancer is found on a
question
HPV infection (#1 cause) sexual intercourse prior to age 16 multiple sexual partners smoking poor nutrition positive family history DES in utero (DES is synthetic form of estrogen hormone)
answer
Cervical cancer risk factors
question
the most common solid tumor of young men, ages 15-35, occurring with familial predisposition
answer
Testicular cancer is
question
hard, painless nodule Feeling of "heaviness" in lower abdomen Metastases: bone, brain, abdomen, lung
answer
Clinical manifestations of testicular cancer
question
the germ cells that create the spermatozoa
answer
Testicular cancer: most cases arise from
question
False. Why? because benign tumors can be so large they can cause compression or alter body functions
answer
True or False: Benign tumors have no consequences to the human because they do not metastasize
question
Biopsy
answer
How is cancer diagnosed?
question
PSA (prostate specific antigen)
answer
What is an example of a tumor cell marker?
question
Screening individuals for cancer
answer
What are tumor cell markers like PSA used for?
question
NO!
answer
Are tumor cell markers diagnostic for cancer?
question
tail of spence (upper outer quadrant)
answer
The most common site of breast tumors are
question
AGE, hormone use, early onset of menses
answer
What are some risk factors for developing breast cancer?
question
Dimpling of breast, painless lumps, nipple discharge
answer
What are some signs or symptoms of breast cancer?
question
Lung CA (same in women too)
answer
What is the leading cause of cancer related death in men?
question
Angiogenesis
answer
The growth of new blood vessels that occurs in cancer is a process known as
question
False this is typically late stage
answer
True or False: Cancer usually presents in the earlier stages with pain and painful lumps
question
4 Can you name the steps? 1. Decreased cell to cell adhesion 2. Anchorage independence 3. Mechanical Pressure on tissue 4. Release of Lytic enzymes
answer
How many factors are involved in determining the invasiveness of a tumor?
question
Malignant
answer
A neoplasm that has undifferentiated cells, a fast growth rate, is invasive, and is not encapsulated would be defined as:
question
T2: tumor is large with extensive invasion to primary organ N2: Extensive regional lymph node involvement M1: metastasis to distant site is present
answer
John, A 28 y/o male has testicular cancer with staging of T2N2M. What does this mean?
question
Yes becasuse 1. Jeff is within the age range that have the higher rates of testicular cancer (15-35 years old) 2. Testicular CA has a familial predisposition because it typically arises from the germ cells (reproductive cells) that create sperm
answer
Jeff is John's 25 y/o brother. Would you worry about Jeff being at risk for testicular CA?
question
A small tumor with metastasis to a distant organ
answer
Which type of tumor would have the worst prognosis? A. A large invasive tumor without metastasis present B. A moderately large tumor with regional lymph node involvement with no metastasis C. A small tumor with metastasis to a distant organ
question
True This is why elderly are at higher risk of developing cancer because they have had more time to experience these "hits"
answer
True or False: In order for cancer to develop it requires multiple hits/mutations to occur over time
question
C. Telomerase is what causes a mutation in the timor suppressor gene, RAS Telomerase does not cause mutation in tumor suppressor genes. Also, RAS as you remember is not a tumor suppressor gene it is a proto-oncogene
answer
Which of the following is FALSE of the role of telomerase in cancer? A. Telomeres in normal cells get shorter with each cell division until the cell cannot divide anymore B. The telomerase enzyme is what allows cancer cells to continue to divide because they do not shorten C. Telomerase is what causes a mutation in the tumor suppressor gene, RAS D. All are true
