LMP301 Lecture 14: Cancer Flashcards
(91 cards)
1
Q
Most common cancer for men
A
prostate
2
Q
most common cancer for women
A
breast
3
Q
every year, there are the most deaths from __ cancer
A
lung
4
Q
What is the leading cause of death in Canada right now?
A
cancer
5
Q
define: neoplasia
A
"cancer" new growth (called "neoplasm")
6
Q
define: tumour
A
Swelling; neoplasm
7
Q
define: oncology
A
study of tumours / neoplasms
8
Q
define: cancer
A
common term for all malignant tumours
9
Q
Cancer is a ___ process
A
multistep
10
Q
What happens to cancer cells?
A
- loses stability for differentiated state
- go back to “stem cell” stage
- divide uncontrollably
11
Q
What is it called when cancer invades other parts of the body?
A
Metastasis
12
Q
clonal theory of tumorigenesis
A
Cancer cells clone themselves repeatedly to form a neoplasm
13
Q
Etiology of cancer (3 steps)
A
- initial DNA damage
- chromosome breakdown & rearrangement
- selection of successfully growing mutant cells
14
Q
Example of things that can lead to initial DNA damage
A
- carcinogens
- radiation
- chemicals
- viruses
- unknown
15
Q
What happens during chromosome breakdown & rearrangement?
A
loss of growth control leading to a loss of chromosome stability
16
Q
What happens during selection of successfully growing mutant cells?
A
- new patterns of gene expression (expression of oncogenes, inhibit tumour suppressors)
- tumour production
17
Q
What is seen with cancer cell diversity? (5)
A
- the same tumour can have different gene expression
- things produced by each tumour cell can be different (used as markers)
- clinical symptoms can change over time
- new symptoms appear when cancer spreads
- difficult to predict response to treatment due to high diversity
18
Q
Stages of cancer (4)
A
- Induction phase
- In situ phase
- Invation phase
- Dissemination (metastasis)
19
Q
How long can induction phase last?
A
up to 30 years
20
Q
What is the ideal stage to detect cancer?
A
induction phase
21
Q
Local effects of cancer will lead to…
A
- obstruction of blood vessels & ducts
2. destruction of tissue
22
Q
Consequences of cancer (2)
A
- systemic effects
2. cachexia
23
Q
What are the systemic effects of cancer? Which one is more commonly seen?
A
- ectopic secretion of hormones
- SIADH (more common)
24
Q
Example of ectopic secretion of hormones?
A
Lung cancer: small cell carcinomas product ACTH (more cortisol)
25
Result of SIADH?
- water retention
| - hyponatremia
26
define: cachexia
weakness and wasting of the body due to severe chronic illness
27
Symptoms of cachexia (7)
- anorexia
- lethargy
- weight loss
- muscle weakness
- anemia
- pyrexia
28
define: pyrexia
fever that can't be explained by any cause
29
What happens if someone is experiencing cachexia?
- no appetite -> inadequate food intake
- impaired digestion & absorption
- tumour using up all nutrients
- increased metabolic rate to support tumour growth
30
What biochemical parameters change in those with cancer?
- liver aminotransferases (ALT, AST)
- adrenal abnormalities (cortisol)
- elevated urate, lactate dehydrogenase, calcium
- proteinuria, renal failure
31
Maker for liver damage due to cancer
ALT
| AST
32
maker for adrenal gland damage due to cancer
cortisol
33
maker for kidney damage due to cancer
proteinuria
34
treatment for cancer
- chemotherapy
| - radiation
35
Consequences of chemotherapy
- cytotoxicity
- tumour lysis syndrome
- hyperuricemia
- hypomagnesemia
36
Consequences of radiation
- hypopituitarism
| - gonadal failure
37
tumour lysis syndrome (TLS)
group of metabolic complications that can occur after treatment of cancer
38
hyperuricemia
level of uric acid in the blood that is abnormally high
39
hypopituitarism
diminished hormone secretion by the pituitary gland
40
Process of lab testing / responsibilities for cancer
1. detection / screening
2. confirmation (biopsy)
3. classification (biopsy)
4. monitoring
41
What is used to screen for breast cancer?
mammography
42
What is used to screen for colon & rectum cancer?
fecal occult blood-sigmoidoscopy
43
What is used to screen for lung cancer
x-ray
| cytology of the sputum
44
What is used to screen for cervix cancer
Papanicolaou test (pap test)
45
classification of cancer determines the ___ and ___ of the tumour
staging & grading
46
define: tumour marker
a substance which is released by the tumour or the host in response to the tumour
their presence / increased expression can be used to determined presence of a tumour
47
characteristics of an ideal tumour marker (5)
- easy to measure (see in plasma)
- abundant in body fluids
- specific for certain type of cancer
- sensitive for small tumours
- diseased state will increase the marker
48
Tumour markers are classified into...
- proteins
- enzymes
- hormones
- oncofetal antigens
- carbohydrates
- hormone receptors
- genetic markers
49
marker for end stage renal failure?
Bench Jones proteins
50
Protein markers for cancer (2)
- immunoglobulins
| - Bence Jones proteins
51
enzyme markers for cancer (3)
- lactate dehydrogenase
- alkaline phosphatase
- prostate specific antigen
52
hormone markers for cancer (3)
- HCG
- ACTH
- catecholamines
53
oncofetal antigen markers for cancer (2)
- CEA
| - AFP
54
What are oncofetal antigens?
Antigens produced during early development of the fetus, but should not be present after that stage
55
carbohydrate markers for cancer (3)
- CA 19-9
- CA 125
- CA 15-3
56
hormone receptor markers for cancer (2)
- estrogen
| - progesterone
57
genetic markers for cancer (6)
- Ras
- Myc
- HER-2/neu
- p53
- BRCA 1
- BRCA 2
58
Clinical utility of tumour markers (5)
- monitoring treatment
- follow up / reoccurence
- prognosis
- diagnosis (CAN'T BE USED ALONE)
- screening of high risk populations (not very sensitive / specific)
59
Marker for prostate cancer
PSA
60
Marker for breast cancer (3)
- estrogen & progesterone receptors
- CA27.29
- CA15-3
61
Marker for colorectal cancer
CEA
62
Marker for testicular cancer
AFT
63
Marker for ovarian cancer
CA 125
64
Marker for hepatoma
AFP
65
Marker for thyroid cancer
calcitonin
66
Marker for adrenal cancer
catecholamines
67
thyroid cancer is also known as...
medullary carcinoma
68
PSA is produced by the...
prostate epithelium
69
Advantages of PSA
organ specific
70
Disadvantages of PSA
not cancer specific; can also be caused by...
- growth of prostate (benign prostate hyperplasia)
- inflammation of prostate (prostatitis)
71
Clinical utility of PSA
- early detection of prostate cancer
- stage of cancer
- monitor patient
72
How can PSA be made more cancer-specific?
- free vs. total PSA
- age specific reference intervals
-
73
Who has more PSA: older or younger?
older
74
PSA
prostate specific antigen
75
define: pheochromocytoma
neuroendocrine tumour of the adrenal gland (medulla)
| --> secrete high amounts of catecholamines
76
What is multiple endocrine neoplasia (MEN)?
- inherited tumour predisposition syndrome (AD)
- tumours in 2 or more endocrine glands
- tumours overproduce hormones
77
MEN 1 is due to...
mutations in MEN 1 gene
78
MEN 1 gene is a...
tumour supressor
79
MEN2 is due to...
mutations in Ret gene
80
Ret gene is a ...
Tyrosine kinase receptor (protein)
81
Symptoms of MEN 1 (what is usually affected?)
- parathyroid adenomas
- pancratic adenomas
- pituitary adenomas
- adrenal cortex adenomas
- carcinoid tumours
82
define: carcinoid tumours
a tumor of a type occurring in the glands of the intestine (esp. the appendix) or in the bronchi
83
symptoms of MEN 2 (what is usually affected?)
- medullary carcinoma of the thyroid
- phaeochomocytoma
- hyperparathyroidism
84
Which geographic / racial groups are more predispositioned to what type of cancer?
- stomach cancer in Japan
| - lung carcinoma in USA
85
What environmental factors increase risk of cancer?
- asbestos
| - smoking
86
Which age groups are more at risk for cancer?
> 55
87
Which cancers are due to genetics?
- 5% of breast cancer
- MEN
- pediatric lukemias
- lymphomas
88
which genes are responsible for breast cancer?
brca1 and brca2
89
define: lympohas
cancer of the lymph nodes
90
Acquired preneoplastic disorders
Some diseases increase risk of getting cancer
preneoplastic = before tumour formation
???
91
Children are most affected with which type of cancer?
1. leukemia
2. lymphomas
3. CNS
