Describe the cell characteristics of benign vs malignant neoplasms
BENIGN: well differentiated and resemble original tissue
MALIGNANT: undifferentiated with anaplasia and atypical structure. Little resemblance to original tissue
Describe the rate of growth of benign vs malignant neoplasms.
BENIGN: progressive and slow growth. May stop or regress
MALIGNANT: variable and depends on lvl of differentiation; dec differentiation, inc rate of growth
Describe the mode of growth of benign vs malignant neoplasms.
BENIGN: by expansion (does not invade) and usually encapsulated.
MALIGNANT: by invasion of surrounding tissue.
Describe the metastasis of benign vs malignant neoplasms.
BENIGN: does not metastasize
MALIGNANT: gains access to blood and lymph and metastasizes to other areas
What is proliferation?
the process of cell division.
it is an adaptive mechanism for cell replacement
Describe differentiation
the process whereby new cells acquire structure and function of cells they replace.
are well differentiated cells benign or malignant?
benign
Describe anaplasia
the process of loss of cell differentiation in cancerous tissue
What is the cause (on the cellular level) of benign neoplasia?
cells that lose there ability to regulate proliferation
How are benign neoplasms named?
with the ending “oma”
note that some cancers also end in oma
What is the cause of malignant neoplasia (on the cellular level)?
loss of ability to regulate proliferation and differentiation
What are the two types of tissue that make up all tumors (benign and malignant)?
PARENCHYMAL tissue:
cells of tumor determining its growth
SUPPORTING tissue:
CT, extracellular matrix, blood vessels that are all essential to tumor growth
Define neoplasm
an abnormal tissue mass with uncontrolled proliferation of cells not coordinated with normal cells.
Describe 5 characteristics of neoplasms
1) do not wait for signals before growth
2) ignore signals to stop dividing
3) often do not mature properly to perform the function
4) do not undergo apoptosis to keep their numbers constant
What are the three ways that cancerous tumors can spread.
1) direct invasion and extension
- aided by enzymes that breakdown proteins
2) Seeding of body cavities
- shedding into cavity or from cancer
3) Metastasis (through lymphatic and vascular pathways)
What is metastasis?
the development of a secondary tumor in a location distant from the primary tumor.
secondary retains characteristics of first
What is the first lymph node that drains the area containing the cancer cells called? How is it found and what can it tell us about the cancer?
the sentinel lymph node.
It is found by injecting a radioactive die into the tumor and tracking which lymph node it drains to. Then performing a biopsy to see if it contains cancerous cells.
What is angiogenesis and how does it relate to cancer?
It is the process of proliferation for vessels
Angiogenesis marks the transition from a benign to malignant tumor
List 7 factors that are linked to cancer.
HEREDITY: some more than others
HORMONES
OBESITY: inc insulin and resistance which are associated with a certain Ca
IMMUNOLOGIC MECHANISMS
CHEMICAL CARCINOGENS: bind with DNA and RNA proteins and mutate
RADIATION
VIRAL/MICROBIAL
What are some Ca that is linked to heredity?
Breast, prostate, ovarian, pancreatic, colon
What are some common manifestations of Ca?
ANOREXIA and CACHEXIA
FATIGUE and SLEEP disorders
PARANEOPLASTIC SYNDROME
describe the manifestation of anorexia and cachexia. What is a type of Ca that it is not common in?
it is a wasting syndrome of body muscle and fat.
this loss is a result of persistent inflammation and a hypermetabolic state (tumors rely on anaerobic pathways more than aerobic b/c of dec O2 supply)
Not common in breast Ca
What is the most frequent manifestation of Ca?
Fatigue and sleep disorders
Describe the manifestation of fatigue and sleep disorders including the cause.
It is different in that it is not relieved by rest or sleep.
Occurs both as a direct effect of the Ca and as an AE of treatment.
it is related to anemia and hormonal changes
What neurotransmitter hormone can Ca treatments affect that can lead to fatigue and sleep disorders?
Serotonin in the brain
What are some components of Ca that contribute to anemia?
Treatment: cytotoxic that reduce RBC production
nutritional deficiencies
bone marrow failure
blunted erythropoietin response to hypoxia
Describe what paraneoplastic syndromes are.
manifestations in sites that are not directly affected by the Ca
often a result of inappropriate hormone/cytokine release
(unexpected symptoms)
give an example of a paraneoplastic syndrome.
some Cas release procoagulation factors resulting in clotting and thrombosis
What are the three ways of diagnosing Ca?
TUMOR MARKERS: not very reliable. Measures antigens released from the tumor or substances released in response
CYTOLOGIC STUDIES: pap smear, tissue biopsy, DNA microarray
IMAGING: ultrasound, x-ray, MRI, DT, PET
Describe what grading is and its scale.
Grading is determining the level of differentiation through microscopic examination of cells.
Grade I: well differentiated
Grade IV: poorly differentiated with marked aplasia
Describe what staging is and its scale.
The level of extent and spread. Varies with organ, size of prim tumor, lymph node involvement, and metastasis
I - IV with IV being worse
What are the six ways of treating Ca?
SURGERY
RADIATION
CHEMOTHERAPY
HORMONE therapy
BIOTHERAPY
TARGETED therapy
For what types of tumors is surgery the first line of treatment?
Solid tumors, especially with defined margins
Poor option if in vital area or poorly defined margins
Explain what cryosurgery is.
Injecting liquid nitrogen into the tumor
used in tx of liver and prostate cancers
Explain what Chemosurgery is
involves corrosive paste in combo with frozen sections
used in skin Ca
Describe radiation treatment of Ca
Uses ionizing radiation
dmgs Ca cells more than normal cells, but damages all proliferating cells (GI and bone marrow)
What is hormonal therapy?
alter abnormal hormonal activity.
only effective for some Ca (breast, prostate)
What is biotherapy?
use of interferons to inhibit viral replication or tumor protein synthesis
What is targeted therapy?
uses drugs that selectively attack the malignant cells and leave normal cells alone.
Only developed for certain types of Ca.