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Pathology 2210 > Cancer > Flashcards

Flashcards in Cancer Deck (69):
1

Define Cancer:

A class of diseases characterised by uncontrollable cell division and the ability of these cells to be able to invade other tissues by invasion or metastasis

2

Define Invasion:

The direct growth of cancer into an adjacent tissue

3

Define Metastasis:

The migration of cancer cells to distant sites

4

Define Neoplasm:

A new and abnormal tissue growth

5

For Benign Tumours, what is their;

Growth Rate:
Character of Growth:
Tumour Spread:
Cell Differentiation:

Slow
Expansion
Remains localised
Well Differentiated (It's structure mimics normal tissue)

6

For Malignant Tumours, what is their;

Growth Rate:
Character of Growth:
Tumour Spread:
Cell Differentiation:

Fast
Infiltration (Can send processes into other tissues)
Metastasises
Can range from well to poorly differentiation

7

In general prefix + oma means that the tumour is________

Benign

8

What do these prefixes mean?
Adeno-
Angio-
Chondro-
Haemangio-
Lymphangio-
Fibro-

Adeno = Has a glandular structure
Angio = Vessels
Chondro = Cartilage
Haemangio = Blood vessels
Lymphangio = Lymph vessels
Fibro = Fibrous tissue

9

Is a Papilloma/Polyp benign or malignant?

Benign

10

What is a Carcinoma?

A malignant tumour that arises from the epithelial cells

11

What is a Sarcoma?

A malignant tumour that arises from non-epithelial cells

12

What some exceptions to the prefix + oma = benign rule?

Melanoma
Lymphoma

13

Colon/rectal, breats and prostate cancers are believed to be linked with ______________________

Diet and lifestyle choices

14

Liver cancer is associated with ________________

The Hepatitis virus

15

Cervix/Uterine cancer is associated with ____________

Human Papilloma Virus

16

How do we deal with benign tumours?

1. Ignore it if it isn't affecting function (e.g. Lipoma)
2. Remove it if it is large or in the way
3. Remove it if it could cause damage to surrounding tissues/organs (e.g. benign brain tumour)
4. Remove it due to malignant potential (colon polyps)

17

How common are Breast Fibroadenomas

- Very common especially in young women
- May be left or removed (due to pain or other symptoms or patient concern)

18

What is a Breast Fibroadenoma?

Characteristically well-circumscribed benign tumour of the breast fibrous and glandular tissue

19

Breast Fibroadenomas usually present as __________________________ that is _______, ______, _______ and not _______

Single Discrete mass
Smooth, rubbery, mobile and not tender

20

Breast Fibroadenomas respond to __________ and _________ and therefore can change in size over the _____________.

Oestrogen and Progesterone
Ovarian/Menstrual Cycle

21

Breast Fibroadenomas _______ progress to malignancy

Do not

22

How do we diagnose Breast Fibroadenomas?

Ultrasound
Biopsy
Fine Needle Aspiration (FNA)

23

How do we treat Breast Fibroadenomas?

Can be left or removed (due to symptoms {pain} or patients wishes)

24

What is a Meningioma?

A generally benign tumour of the meninges that cover the brain and spinal cord

25

Meningiomas are unlikely to _________. They are removed due to the ____________________________

Metastasise
Damage they cause the brain due to increased pressure

26

Colon Polyps are ________ tumours of the colon and are usually _________

Benign
Asymptomatic

27

Colon polyp incidence _________ with age and is screened for by using a ____________

Increases
Colonoscopy

28

Cancer is a multi-step process that results from the accumulation of ___________ and __________ alterations

Genetic and Epigenetic

29

What genetic factors can affect cancer developent?

Gain/Loss of Chromosomes or Chromosome pieces
Presence of oncogenes

30

What is an oncogene?

A gene whose activation by mutation or inappropriate expression leads to an increased ikelihood of cancer

31

Carcinoma In Situ (CIN) is a pathway leading to ________ cancer development. It is characterised by the ___________________ and __________________

Colorectal cancer
Loss of tumour suppressor genes
Mutation of oncogenes (K-RAS)

32

What is a tumour suppressor gene?

A gene whose partial or complete inactivation either in germ line or somatic cells leads to an increased likelihood of cancer

33

What is a microsatellite?

A region of the DNA where you have multiple repeats
Repeating regions is normally 1-6 nucleotides long

34

______________ enzymes repair microsatellite regions whose structure has been affected during ___________

Mismatch repair enzymes
Cell division

35

If there is a mutation or lack of expression of _____________________ then we get variable alterations in length of the microsatellite regions. This is called _______________

Mismatch repair enzymes
Microsatellite instability

36

A microsatellite located in the coding region that has mutated will alter _____________ and therefore the ___________

Amino acids sequence
Protein structure

37

A microsatellite located in the regulatory region that has mutated will alter ___________

Gene Expression

38

CpG Island Methylator Phenotype (CIMP) is a pathway leading to ________ cancer characterised by the ______________ of CpG islands

Colorectal cancer
Hypermethylation

39

CpG islands are often found in the ________ region of DNA, therefore hypermythlation of these islands ________________________ which can lead to ______

Promoter
Silences important genes
Cancer

40

Cancer Treatment is dependent on:

Cancer type
Cancer stage
Pathological features e.g. size
The patient e.g. age, other illnesses, patient choice

41

What are the 4 types of cancer treatment?

Chemotherapy
Radiotherapy
Surgery
Targeted treatments

42

_________ is often the first line of treatment for solid tumours

Surgery

43

In order to prepare the patient for surgery they often have to undergo ______________ to _______ the tumour

Chemotherapy to shrink the tumour

44

After surgery patients may require _______________ to destroy remaining cancer cells

Radiation therapy

45

What must surgeons consider before surgery?

- Accessibility of the tumour
- Tumour size
- Has it metastasised?
- Age and health of patient
- Likelihood of success

46

What is radiation therapy?

The use of high energy radiation to kill tumour cells by damaging their DNA and preventing them from dividing

47

Radiation treatment is usually _________ (dose is divided up into smaller ones) so that __________ have time to _________

Fractionated
Healthy Tissues
Repair

48

What are some common cancers treated with radiation therapy?

Breast
Prostate
Lung
GI
Skin

49

What are the advantages of Radiotherapy?

- Treats cancers in situ without anaesthetic (Surgery) or systemic side effects (Chemo)
- Effectively controls symptoms and improves quality of life
- Effective in managing severe conditions associated with malignancy

50

What are the side effects of Radiotherapy?

- Usually limited to the area treated e.g. hair loss or skin reactions
- Fatigue
- Symptoms associated with damage to certain tissues

51

What is chemotherapy?

The treatment of disease via chemical substances

52

How does chemotherapy work?

- Inhibits normal cell function (metabolism, DNA synthesis, cell division)

53

Chemotherapy affects ________ but affects __________ the most due to their ______________

All cells
Cancer cells
Increased activity

54

What are anti-metabolites?

- Structurally related to naturally occurring substances (Vitamins, AAs, Nucleotides) that interfere with nucleotide production
- Inhibit key enzymes or substitute for normal purine/pyrimidines
- Decrease DNA synthesis and interfere with cell growth

55

Methotrexate is an analogue of ________ that inhibits the enzyme _____________. It inhibits _____________

Folic Acid
Dihydrofolate Reductase (DHFR)
DNA synthesis

56

Methotrexate is toxic to the cells of the __________, ________ and _________ as these cells ___________

Bone Marrow
Oropharynx
GI Tract
Rapidly divide

57

Methotrexate is used to treat _________________ and _____________________

Acute Lymphoblastic Leukaemia
Burkitt's Lymphoma

58

Alkylating Drugs a form of highly reactive electrophillic that _________________. This affects __________ and ___________.

Covalently bind to DNA
Transcription and Replication

59

What are some examples of Alkylating Drugs?

Cyclophophamide and Cisplatin

60

Platinum compounds like _______ cause DNA _________ and _____________. It is ____ specific and therefore ______ be used to treat many cancers.

Cisplatin
Cross-Links
Interstrand adducts
Not-specific
can

61

Inhibitors of chromatin function like _______ and ______ deplete __________ and promote ______________________ and ___________

Paclitaxel and Taxol
Soluble tubulin
Microtubule polymerisation
Apoptosis

62

Inhibitors of Chromatin function are used to treat ___________________ like _________, _____________________ and _________

Aggressively growing tumours
Ovarian Cancer
Advanced breast cancer
Lung cancer

63

Due to the lack of specificity of chemotherapy __________ that are _____________ or _________________ are affected

Normal cells
Rapidly dividing
Have high energy needs

64

What are targeted treatments?

Treatments that affect cancer cells but are less toxic to non malignant cells

65

What are Steroid Receptor Antagonists?

Compounds that are structurally similar to steroids that compete with them at the receptor but don't trigger the receptors

66

Steroid Receptor Antagonists can be used to treat ___________ as these cancer cells __________ oestrogen receptor production and they are _____________________. __________ is most commonly used for this cancer.

Breast Cancer
Up-regulate
Dependent on Oestrogen for growth
Tomoxifen

67

Many reactions in the body are regulated by _______ enzymes. In cancer cells the activity of these enzymes is ________. To prevent this we use __________

Kinase enzymes
Increased
Kinase Inhibitors

68

About 10% of ____________________ carry mutations in the __________________. This causes constant _______________ which causes cancer cell proliferation

Non-Small Cell Lung Cancer (NSCLC)
Epidermal Growth Factor Receptor (EGFR)
Activation of the receptor

69

If the patient has a ______ mutation then they are given a ___________________

EGFR
EGFR tyrosine kinase inhibitor