Chapter 10: biology of cancer Flashcards
(125 cards)
1
Q
_____ tumor: grow slowly with a well defined capsule
A
Benign
2
Q
_____ tumor: grow rapidly and not encapsulated
A
Malignant
3
Q
____ tumor: well differentiated and low mitotic index
A
Benign
4
Q
____ tumor: poorly differentiated and high mitotic index
A
Malignant
5
Q
Do benign tumors metastasize?
A
No. Malignant do.
6
Q
Lipoma, Leiomyoma, and Meningioma are examples of which type of tumor?
A
Benign
7
Q
Can benign tumors progress to cancer?
A
Yes
8
Q
Which -oma cancers are malignant? (usually only benign tumors end in -oma)
A
Carcinoma, adenocarcinoma, sarcoma, and lymphoma
9
Q
Carcinoma arises from
A
Epithelial tissue
10
Q
Adenocarcinoma cancer arises from
A
ductal or glandular tissue
11
Q
Sarcoma arises from
A
Mesenchymal tissue
12
Q
Lymphoma arises from
A
Lymphatic tissue
13
Q
Sarcoma. B or M?
A
Malignant
14
Q
Carcinoma, B or M?
A
Malignant
15
Q
Carcinoma in situ (CIS)
A
Pre-invasive epithelial malignant tumors of glandular or epithelial origin that have not broken through basement membrane or invaded the surrounding stoma
16
Q
When is an epithelial malignant tumor considered in situ?
A
When the tumor has not broken through the basement membrane or invaded the surrounding stroma
17
Q
What are possible outcomes of CIS?
A
- Remain stable
- Regress and disappear
- Become cancer
18
Q
is CIS often treated?
A
Yes
19
Q
What are the two foundational concepts for understanding biology of cancer cells?
A
- Cancer is a very complex genetic disease
2. Tumors exist in a complex microenvironment that contains both benign and cancerous cells.
20
Q
The microenvironment affects tumors in what three ways?
A
- Tumor initiation
- Tumor promotion
- Tumor progression
21
Q
Are multiple mutations required before oncogenes are activated?
A
Yes
22
Q
Name three multiple mutations that are required before onco-genes are activated
A
- Small-scale DNA changes
- Large changes in chromosomes
- Epigenetic changes
23
Q
After enough mutations, a normal cell transforms into a cancer cell. T or F
A
True
24
Q
____ _____ means cancer cells accumulate faster than noncancer cells
A
Clonal proliferation
25
The cell acquires characteristics that allow it to have what over its neighbors?
Selective advantage
26
Increased growth rate or _____ apoptosis increases chances of survival for cancer cell
decreased
27
Hallmark of cancer: ________ immune destruction
avoiding
28
Hallmark of cancer: ______ growth suppressors
evading
29
Hallmark of cancer: ______ replicative immortality
Enabling
30
Hallmark of cancer: Inflammation that...
promotes tumors
31
Hallmark of cancer: Activating invasion and ______
metastasis
32
Hallmark of cancer: ________ ______ (mutator phenotype)
Genomic instability
33
Hallmark of cancer: inducing ______
angiogenesis
34
Hallmark of cancer: _____ cell death
resisting
35
Hallmark of cancer: ______ cellular genetics
de-regulating
36
Hallmark of cancer: ______ proliferative signaling
sustaining
37
What is tumor initiation when considering the complex microenvironment?
Produces an initial abnormal cancer cell
38
What is tumor promotion when considering the complex microenvironment that contains both benign and cancerous cells?
Cancer cells multiply and expand
39
What is tumor progression when considering the complex microenvironment that contains both benign and cancerous cells?
Tumor is spreading to local, regional, and distant sites (mets)
40
Cancer is predominantly a disease of ____ ____ ___ during aging
disease of cumulative genetic changes during aging
41
Which mutation refers to silencing or expression of genes?
Epigenetic changes
42
Cellular genes may become cancerous oncogenes as a result of _____ _____
epigenetic changes
43
Explain how inflammatory and immune cells help tumor growth
1. non-malignant cells nearby release pro-inflammatory mediators.
2. the i and i cells infiltrate and form the stroma (microenvironment) which helps the cancer suppress the immune system and evade
44
Stomal cells evolve to phenotypes that promote CA progression and ______
metastasis
45
Can cancer cells proliferate without growth factors?
Yes
46
______ ______: can grow without adhering to normal extracellular matrix (ECM)
Anchorage independence
47
What's important to remember about anchorage independence?
Cancer cells can be grown outside the body/independence for the need of anchorage
48
_____ also known as cancer cells
oncogenes
49
_____: mutant proto-oncogenes or over-expressed p-o's; always proliferating/uncontrolled cell death
Oncogenes
50
What genes encode proteins that, in their normal state, negatively regulate proliferation; independent of normal growth factors
Tumor-suppressor genes
51
Example of point mutations
in lung cancer, RAS gene converts from regulated to unregulated
52
_______: burkitt lymphomas. Chronic myeloid leukemia: results in an abnormal chromosome called the Philadelphia chromosome. Resulting in the uncontrolled growth of the myeloid
Translocations
53
What results in the inactivation of tumor-suppressor genes?
Mutations
54
Is Retinoblastoma gene a tumor supressor gene?
yes
55
Mutated RB leads to what?
Leads to persistent cell growth
56
What is the "guardian of the genome"?
Tumor protein p53
57
What does TP53 do?
Activates caretaker genes to repair damaged DNA and initiate apoptosis
58
_____ ______ may result from epigenetic silencing, or modulation of gene functioning
genomic instability
59
____ _______ leads to an increase in malignant cells
chromosome instability
60
______ cells are not _____, and can only divide a limited number of times before senescence or apoptosis
Somatic; immortal
61
______ are protective caps on each chromosome that germ and cancer cells target
Telomeres
62
In _____ cells, telomeres are held in place by telomerase which allows for longer cell division
germ
63
90% of what can activate telomerase?
cancer cells (unlimited division and proliferation)
64
______: growth of new vessels
angiogenesis
65
Advanced cancers activate this which leads to secretion of angiogenic factors
HIF-1alpha
66
Name the highlighted angiogenic factor from the powerpoints
Vascular endothelial GF
67
Normal cells generate ATP via oxphos, whereas cancer cells use _____ even under normal oxygen conditions
glycolysis
68
Why do some cancer cells also use oxphos along with CAF to under aerobic glycolysis?
To secrete usable metabolites, which allow cancer cells to replicate quickly
69
Apoptosis is controlled by the balance of pro-apoptotic and anti-poptotic members of what family?
Bcl-2 family
70
What two pathways trigger apoptosis?
1. Intrinsic in response to cellular stress; especially if the DNA is damaged
2. Extrinsic, via activation of death receptor
71
Dysregulation of intrinsic or extrinsic pathways in most cancers provide resistance to ______
apoptotic cell death
72
Is chronic inflammation an important factor in the development of cancer?
yes
73
Example of chronic inflammation and its association of cancer?
Helicobacter pylori: peptic ulcer disease, stomach carcinoma, and mucosa-asociated lymphoid tissue lymphomas
74
Name three viruses associated with cancers
Epstein-Barr virus, Kaposi sarcoma, and HPC (cervical cancer)
75
Cancer cells recruit _____ cells to decrease host immune response
immune
76
Treg cell function is manipulated in tumors and used to produce high levels of which immunosuppressive cytokine?
Interleukin-10
77
Tumors using interleukin 10 suppresses what two things?
Antigen recognition, and the ability of CD8+ T cells to recognize and kill tumor cells
78
Increased treg cells and decreased T cells in the tumor microenvironment also makes the tumor more resistant to what?
Chemo treatment and xrt
79
Once cells become malignant, they enhance _______
inflammation
80
what is TAM?
Tumor associated macrophage
81
_____ cells turn acute inflammatory response on its head from "rejection" to "regeneration" respons
cancer
82
the presence of tumor-associated macrophages frequently...
frequently correlates with a worse prognosis
83
TAM mimic M1 phenotype of _____, a phenotype that induces cellular proliferation
macrophages
84
TAM have a diminished ____ response
cytotoxic
85
TAM block T-cytotoxic cells and NK cell functions, and produce cytokines that are advantageous for....
tumor growth and spread
86
Direct invasion of contiguous organs is known as ____ ____
local spread
87
Metastases to distant organs...cancer is traveling through the _____ and ____
Lymphatics and blood
88
Activation and metastasis requires great _____ and occurs late
efficiency
89
Epithelial mesenchymal transition is the mode that changes fixed cancer cells to
metastatic cancer cells
90
Initially, tumors spread locally through "direct extension" t or f
True
91
After growing, tumors spread by invasion into surrounding tissues through the release of _____ ____
lytic enzymes
92
Concerning metastases, some cancer cells bind to _____
platelets
93
Breast cancer goes into the _____ and lymphomas migrate to the _____
bone; spleen
94
Can metastatic cancer cells enter dormancy?
Yes
95
Early signs of cancer?
Unexplained weight loss. Skin changes, nagging cough, indigestion, and change in bowel habits
96
New growth is called ________ syndromes
Paraneoplastic syndromes
97
Paraneoplastic syndromes are commonly caused by ______ and _____.
Serotonin and bradykinin.
98
Serotonin and bradykinin are released from _______ tumors
carcinoid
99
Hypoxia
No oxygen
100
Hypoxemia (like anemia)
No oxygen in the blood (is a type of hypoxia)
101
Are paraneoplastic syndromes common? Arise late or early?
Not common. arise late.
102
Malignancy has little or no pain during what stage
early
103
What is pain from cancer influenced by?
Fear, anxiety, sleep loss, fatigue, and overall physical deterioration
104
Name the mechanisms of pain from cancer
- pressure
- obstruction
- invasion of sensitive structures
- tissue destruction
- inflammation/infection
105
What is the most frequently reported symptom of cancer?
Fatigue
106
What is syndrome of cachexia?
Most severe form of malnutrition
107
What do you treat anemia with?
Exogenous erythropoietin
108
Mechanism of anemia
Chronic bleeding resulting from iron deficiency
109
Direct tumor invasion to the bone marrow causes ______ and ______
leukopenia and thrombocytopenia
110
Chemotherapy drugs are toxic to the _____ ____
bone marrow
111
Risk of infection increases when the absolute _____ and ______ count falls
neutrophil and lymphocyte
112
How do they test for cancer
Biopsy, aspiration collection, and exfoliative cytology (i.e pap smear)
113
Microscopic analysis for staging cancers is based on presence of _________
metastasis
114
Stage I
no metastasis
115
Stage II
Local invasion
116
Stage III
Spread to regional structures
117
Stave IV
Distant metastasis
118
Tumor cell markers are substances produced by ____ ___
cancer cells
119
Tumor cell markers are found on or in tumor cells, in the ____, ____, or ____
blood, CSF, or urine
120
What are tumor markers used to do?
Screen and identify individuals at high risk for cancer
121
Tumors are classified based on __________ analysis of protein expression for improved treatment
Immunohistochemical
122
_____ chemotherapy is for shrinkage or disapperance of tumors
induction
123
______ chemotherapy : eliminate micrometastasis after surgery
adjuvant
124
______ therapy: given before localized treatment to shrink tumor
Neoadjuvant
125
Cancer tx: gene therapy
Patients own T-cells are genetically modified with a new gene for a protein that directs T-cells to target and kill leukemia cells
