Cancer Bio (Dan Lecture 1)

Question 1

What is a neoplasm?

Answer 1

A growth of new cells

Question 2

What is a tumour?

Answer 2

A neoplasm forming a distinct lump

Question 3

What are the 2 types of neoplasm?

Answer 3

Benign and malignant

Question 4

Describe the tissue distribution of benign and malignant neoplasms

Answer 4

Benign neoplasms are localised

Malignant neoplasms have invaded surrounding tissues and may have spread to other organs or tissues by metastasis

Question 5

What are the 6 acquired capabilities of cancer?

Answer 5

1) Evading growth suppresors
2) Activating invasion and metastasis
3) Enabling replicative immortality
4) Inducing angiogenesis (synthesis of new blood vessels)
5) Resisting apoptosis
6) Sustaining proliferative signalling

Question 6

How many people will be diagnosed with cancer in their lifetime?

Answer 6

1 in 2 people born after 1960

Question 7

How many new cases of cancer were there in the UK in 2014?

Answer 7

Approx 360,000

Question 8

What percentage of cancer cases in the UK are linked to lifestyle?

Answer 8

42%

Question 9

What are the 3 most common male cancers? (2014)

Answer 9

1) Prostate
2) Lung
3) Bowel

Question 10

What are the 3 most common female cancers? (2014)

Answer 10

1) Breast
2) Lung
3) Bowel

Question 11

How many people die each year from cancer?

Answer 11

160,000 (2014)

Question 12

Deaths from lung, bowel, breast and prostate cancer account for what % of total cancer deaths each year?

Answer 12

Almost half (47%)

Question 13

Which 3 cancers have the highest mortality in males? (2014)

Answer 13

1) Lung (23%)
2) Prostate (13%)
3) Bowel (10%)

Question 14

Which 3 cancers have the highest mortality in females? (2014)

Answer 14

1) Lung (21%)
2) Breast (15%)
3) Bowel (10%)

Question 15

How does cancer incidence correlate with age?

Answer 15

Approx 75% of cases diagnosed in people 60 and over

More than 1/3 of cases in people 75 and over

Children (0-14years), teenagers and young adults (15-24) make up less than 1% of all cases

Question 16

Which cancers have the highest and lowest 5 year % survival?

Answer 16

High:
Tesitclular (98%)
Malignant melanoma (90%)

Low:
Lung (10%)
Pancreas (3%)

Question 17

What are the 3 main current cancer treatments?

Answer 17

1) Surgery
2) Radiotherapy
3) Chemotherapy

Question 18

What are the advantages and disadvantages of both radio and chemotherapy?

Answer 18

Radio:

• Effective for localised disease
• Relatively expensive (1 machine costs approx 1 million pounds)

Chemo:

• Relatively ineffective for most cancers
• However, can be used to treat metastatic disease
• Cost can be low or high depending on drug use and amount of side effects

Question 19

What are the main causes of cancer?

Answer 19

• Smoking
• Diet (?)
• Viruses (e.g. HPV)
• Environmental factors/pollutants
• Hormones
• Ionizing radiation
• UV radiation
• Genetic predispositon

Question 20

Increasing the number of cigarettes consumed increases the risk of what cancer?

Answer 20

Lung

Question 21

What percentage of cancer deaths are due to smoking?

Answer 21

30%

Question 22

What can be done to reduce the risk of cancer?

Answer 22

• Stop smoking
• Eat less fat and more fruit and veg
• Avoid excessive exposure to sun
• Drink less or no alcohol
• Have lots of children but be monogamous
• Avoid exposure to carcinogens (chimneysweep)

Question 23

What are the characteristics of benign tumours?

Answer 23

• Grow slowly

- Remains localised

Question 24

How are benign tumours normally treated?

Answer 24

Simple surgical excision

Question 25

What are the characteristics of malignant tumours?

Answer 25

- Grow rapidly - Invade and destroy adjacent tissues - Potential to metastasise (spread to distant parts of the body by the blood, lymphatic system or across serous membrane)

Question 26

What is histological classification of neoplasia used to determine?

Answer 26

The tissue or organ of origin of the neoplasm | - Neoplasms resemble their tissue or organ of origin

Question 27

What are the major tissue types of the body?

Answer 27

- Epithelium (skin, lining of GI and urinary tract, and solid abdomial organs e.g. liver, kidney, pancreas) - Connective tissue (muscle, fat, bone, cartilage, nerves, blood vessels) - Lymphoid and blood forming tissues (lymph noses, spleen, bone marrow, thymus) - CNS - Germ cells (testis and ovaries)

Question 28

What are malignant epithelial tumours called?

Answer 28

Carcinomas

Question 29

What are malignant connective tissue tumours called?

Answer 29

Sarcomas

Question 30

What is hyperplasia?

Answer 30

- A 'pre-malignant' disease - Increase in the number of cells in an organ or tissue in response to a stimulus - Regresses when stimulus is removed

Question 31

What is dysplasia?

Answer 31

- 'Pre-malignant' disease | - Change in cells (usually epithelium) characterised by disorderly growth and morphologic changes in cell nuclei

Question 32

What are the 2 types of epithelial tissue in the female breast?

Answer 32

1) the lobules | 2) the ducts

Question 33

What do the lobules and the ducts do?

Answer 33

- In non pregnant women the lobules are in resting phase - Pregnant women lobules are expanded and secrete milk - Ducts convey milk to the nipple

Question 34

What are the 2 types of connective tissue in the female breast?

Answer 34

1) Loose fibrous connective tissue present in lobules | 2) Denser fibrous connective tissue present in extralobular sites to provide structural support

Question 35

The majority of breast cancers are of what origin?

Answer 35

Epithelial (carcinoma)

Question 36

What are the 2 types of breast carcinomas?

Answer 36

Ductal or Lobular

Question 37

What are the 5 stages of Ductal Carcinoma formation?

Answer 37

1) Normal duct 2) Intraductal hyperplasia 3) Intraductal hyperplasia with atypia 4) Ductal carcinoma in situ 5) Invasive ductal cancer Invasive disease is when cells break through basement membrane and invade the fat and connective tissue

Question 38

What does TNM stand for in the TNM system of cancer staging

Answer 38

``` T = tumour N = node M = metastasis ```

Question 39

What are the T stages of the TNM system in staging breast cancer?

Answer 39

Tis - carcinoma in situ T1 - Tumour size less than 2cm in diameter T2 - Tumour size between 2-5cm T3 - Tumour above 5cm in diameter T4 - tumour of any size involving chest wall or skin

Question 40

What are the N stages of the TNM system in staging breast cancer?

Answer 40

N0 - No axillary node involvment N1 - Metastases to axillary nodes that are freely mobile N2 - Metastases to fixed axillary nodes N3 - Metastases to intermal mammary nodes

Question 41

What are the M stages of the TNM system in staging breast cancer?

Answer 41

M0 - No metastases outside of local nodes | M1 - Metastases present

Question 42

How would a 6.2cm breast carcimona with fixed axillary node involvement and no metastases be staged?

Answer 42

T3 N2 M0 carcinoma