Carcinogens

Question 1

Aflatoxins

Answer 1

Derived from Aspergillus which can grow in stored rice and grains. Causes hepatocellular carcinoma. Accounts for high rate of this cancer in parts of Africa

Question 2

Alkylating agents

Answer 2

Used for chemotherapy. Leukemia and lymphoma seen as side effect of these agents 5-10 years down line

Question 3

Alcohol

Answer 3

Associated with:

• squamous cell carcinoma of oropharynx and upper esophagus
• hepatocellular carcinoma due to cirrhosis
• pancreatic carcinoma due to chronic pancreatitis

Question 4

Arsenic

Answer 4

Present in cigarette smoke. Causes SCC of skin, lung cancer, angiosarcoma of liver

Question 5

Polycyclic hydrocarbons

Answer 5

Most important carcinogen in cigarette smoke. Associated with:

• oropharyngeal and esophageal carcinoma
• lung cancer
• urothelial carcinoma of kidney and bladder
• pancreatic carcinoma

Question 6

Nitrosamines

Answer 6

Found in smoked foods. Cause intestinal type of stomach carcinoma. Account for high rates of stomach cancer seen in Japan

Question 7

Naphthylamine

Answer 7

Component of cigarette smoke. Causes urotehlial carcinoma of bladder.

Question 8

Vinyl chloride

Answer 8

Used to make PVC pipes (occupational exposure). Causes angiosarcoma of liver.

Question 9

EBV

Answer 9

Associated with:

• nasopharyngeal carcinoma, classically in Chinese male or African. Presents as neck mass due to early lymph node spread
• Burkitt lymphoma
• CNS lymphoma in AIDS patient

Question 10

HHV-8

Answer 10

Kaposi sarcoma (tumor of endothelial cells). Seen in:

• older eastern european males, in which case it is excised
• AIDS patients, in which case HARRT is initiated
• transplant patients, in which case immunosuppression is lowered

Question 11

Ionizing radiation

Answer 11

Exposure occurs in nuclear reactor accidents, radiotherapy. Causes AML, CML, papillary carcinoma of thyroid due to hydroxyl free radical generation