Cancer

Question 1

Neoplasia

Answer 1

New growth - may be benign or malignant

Question 2

Regulated growth & cellular differention

Answer 2

What distinguishes benign from malignant

Question 3

Benign Tumor

Answer 3

Well differentiated, localized, and demarcated

Question 4

Malignant Tumor

Answer 4

Less well differentiated, grow rapidly, invade neighboring tissues, spread to other body sites

Question 5

Proliferation

Answer 5

the ability of a cell to divide and requires growth signal (eg growth factors)

Question 6

Immortalized

Answer 6

Cancer cells ignore normal growth restraints and have a high proliferative capacity

Question 7

Differentiation

Answer 7

The degree of specialization of a given cell. Become more specialized as they mature.

Question 8

Terminally differentiated

Answer 8

Cells that no longer divide

Question 9

Cancer cells

Answer 9

Less well differentiated or less mature than normal cells

Question 10

Carcinoembryonic Antigen (CEA)

Answer 10

molecules normally only expressed in immature or less differentiated cells - normally produced before birth only

Question 11

Inverse relationship

Answer 11

Between differentiation and the ability of a cell to proliferate

Question 12

Cell Cycle

Answer 12

cell growth and division; many cancer cells show changes in the cell cycle and are autonomous (independent of normal growth controls)

Question 13

3 causes of growth & maturity abnormalities

Answer 13

1) the ability to produce telomerase
2) Changes in pRB that governs the cell cycle rate
3) Changes in p53 that slows the cell cycle to allow for repair of DNA mutations before cell division

Question 14

Events of the cell cycle

Answer 14

Mitosis, followed by cytokinesis, and interphase

Question 15

Telomeres

Answer 15

Repeated sequences not used to make cell proteins

Question 16

Immortalized

Answer 16

Cancer cells can replace telomeres by activating telomerase, thus can divide indefinitely

Question 17

pRB

Answer 17

• Acts as a break to the cell as this protein governs cell cycle commitment
• Activity is governed by phosphorylation and disruption leads to increased cell proliferation, seen in cancer

Question 18

p53

Answer 18

A cell protein that has a number of anti-cancer functions centered around DNA repair including:

• activation of DNA repair proteins
• Arrest of the cell cycle to allow DNA repair proteins to fix mutations
• Initiation of apoptosis if DNA damage cannot be reversed

Question 19

Most cancers

Answer 19

Acquired, not inherited

Question 20

Conversion of a normal cell into a cancer cell

Answer 20

Requires multiple mutations. Mutations may be point mutations or chromosomal rearrangements

Question 21

Conversion of a normal cell into a cancer cell

Answer 21

Requires multiple mutations. Mutations may be point mutations or chromosomal rearrangements

Question 22

Tumor Suppression genes

Answer 22

Normally restrain cell growth = “loss of function” eg, pRB, p53, APC, DCC
Mutate BOTH copies

Question 23

Oncogenes

Answer 23

Normally promote growth as protooncogenes within cells. eg growth factors, receptors
Mutate ONE copy
Virus

Question 24

DNA repair genes

Answer 24

Normally correct damage or mutations in the cellular DNA. Failure to fix these mutations increases the likelihood that cancer will arise

Question 25

Carcinogenesis

Answer 25

The process of tumor formation and a series of mutations is required for cancer

Question 26

Clonal Tumor Cells

Answer 26

Derived from a single progenitor cell and tumor cell markers identify cancer and reflect this clonality

Question 27

Retionoblastoma

Answer 27

A rare childhood cancer of the eye that involves mutation in both alleles of the tumor suppressor gene (pRB)

Question 28

Loss of pRB function

Answer 28

Unregulated growth or cancer

Question 29

Hereditary Nonpolyposis Colon Cancer (HNPCC)

Answer 29

Colon cancer due to mutations in DNA repair genes -The decrease in DNA repair leads to an increase in genome instability called mutator phenotype - increases the likelihood that an individual will develop cancer

Question 30

Familial Adenomatous Polyposis (FAP)

Answer 30

Type of colon cancer | -Changes in both oncogenes and tumor suppressor genes are typically required to develop

Question 31

Transformation

Answer 31

Multiple mutations are required for cancer to occur and often result in changes to growth and adherence that contribute to invasion, angiogenesis, and metastasis

Question 32

Altered biochemical properties

Answer 32

Promote growth - secretes growth factors/hormones and promote spread -Secretes protease

Question 33

Chromosomal Changes

Answer 33

- Aneuploid - loss of diploid state - Translocations and other rearrangements - Metastasis

Question 34

Aberrant Adherence Properties

Answer 34

-Loss of contact inhibition -Anchorage independence Cancer cells invade and spread

Question 35

Initiation-Promotion theory

Answer 35

- Initiation (DNA mutation, irreversible) must occur first - Promotion (stimulate cell proliferation, reversible in early stages) must follow initiation for tumors to form - Progression obtains malignant phenotype including invasiveness, metastasis, autonomous growth and genomic instability

Question 36

To be Malignant

Answer 36

- Invasion of neighboring tissues - Angiogenesis - formation of new blood vessels - Metastasis - spread to new sites

Question 37

Clinical Manifestations of cancer

Answer 37

Distinct diseases with similar underlying cellular changes and common manifestations: - Pain - Cachexia - severe form of malnutrition, associated with anorexia, tumor necrosis factor (TNF) - Declining hematopoiesis - Anemia often observed, tumors in bone or bone marrow suppression can contribute

Question 38

Cancer screening & diagnosis

Answer 38

Cancer cells express TUMOR MARKERS and include: -Prostate-specific antigen (PSA) -CA-125 -Carcinoembroyonic antigen (CEA) Markers are not diagnostic but changes in levels are often consistent with changes in tumor growth or responsiveness to treatment

Question 39

Approaches to cancer treatment

Answer 39

- Surgery - Chemo - Radiation

Question 40

TNM

Answer 40

Staging Tumor - how many Nodes - nodes involved Metastasis - has it spread

Question 41

Papanicolaou Test (PAP)

Answer 41

A cytologic method used to detect cancer cells

Question 42

Cell differentiation

Answer 42

Process whereby proliferating cells are transformed into different and more specialized cell types

Question 43

DNA synthesis

Answer 43

Takes place in the S phase of the cell cycle

Question 44

Invasion

Answer 44

The direct extension and penetration by cancer cells to neighboring tissues

Question 45

Hematogenic spread

Answer 45

Metastasis that occurs by way of the blood vessels