Neoplasia

Question 1

Incidence

Answer 1

Number of people who develop the disorder

Question 2

Mortality

Answer 2

Number of people who die from the disorder

Question 3

Neoplasm

Answer 3

New growth

Question 4

Proliferation

Answer 4

Process of cell division

Question 5

Differentiation

Answer 5

Specialization of cells
Regulated by genes and environment
Rely on progenitor cells (cells in earlier stage of differentiation)

Question 6

Maturity

Answer 6

Differentiated cells having reached full functional potential

Question 7

Stem cells

Answer 7

Properties:
- Self-renewal
- Potency
Divide into:
- Daughter cell
- Stem cell

Question 8

-oma suffix

Answer 8

• Benign

- Preceded by name of tissue origin

Question 9

-carcinoma suffix

Answer 9

• Malignant neoplasm of epithelial tissue

Question 10

-sarcoma suffix

Answer 10

• Malignant neoplasm of mesenchymal cells

Question 11

Benign tumors

Answer 11

• Well differentiated, resemble tissue of origin
• Slow growth
• Grow by expansion, usually encapsulated
• No metastasis
• Low potential for death

Question 12

Malignant tumors

Answer 12

• Poorly differentiated, little resemblance to tissue of origin
• Variable rate of growth; the more undifferentiated, the more rapid
• Grows by invasion
• Will spread with access to blood and lymph channels
• High potential for death

Question 13

Solid tumors

Answer 13

• Category of malignant neoplasm
• Confined to tissue or organ
• Cells detach and invade surrounding tissue
• Very fragile
• Cells can fall off and create cancer (seeding)

Question 14

Hematologic cancers

Answer 14

• Category of malignant neoplasm

- Involve cells already in circulation

Question 15

Carcinoma in situ

Answer 15

• Localized, pre-invasive lesion

- Lesion that has not spread

Question 16

Cancer cell characteristics

Answer 16

• Abnormal, rapid proliferation
• Loss of differentiation - anaplasia - no normal features of differentiated cells
• Genetic instability
• Growth factor independence
• Cell density - dependent inhibition
• Loss of cell cohesiveness and adhesion
• Do not require anchorage to neighboring cells to develop
• Cell-to-cell communication is lost
• Immortal life span
• Produce antigens immunologically different than host
• Produce enzymes, hormones, etc
• Cytoskeletal changes

Question 17

Loss of differentiation in cancer cells

Answer 17

• Cells and nuclei variable in shape (pleiomorphic)
• Clumped chromatin
• Large nucleoli
• Neoplasms with cells in various stages of mitosis
• Mitosis is abnormal
• Grade I to IV

Question 18

Genetic instability in cancer cells

Answer 18

• Inherent stability that contributes to development and progression of cancer

Question 19

Growth factor independence in cancer cells

Answer 19

• Ability to proliferate without growth factor

Question 20

Cell density in cancer cells

Answer 20

• Dependent inhibition

- Cessation of growth when cells reach a pre-determined density

Question 21

Paraneoplastic syndrome

Answer 21

Ability of cancer to produce hormones made in another part of the body
Can continue secreting despite feedback mechanisms

Question 22

Cancer spread

Answer 22

Direct invasion
- Direct extension
- Seeding
Metastasis
- Blood - hepatic portal vein
- Lymph - sentinel node

Question 23

Angiogenesis

Answer 23

Creation of new blood vessels

• Outer rim usually has better blood supply
• Center of cancer often becomes ischemic and necrotic

Question 24

Cancer growth

Answer 24

Continue to divide until limits in blood supply and nutrients affect it
Double time - time taken for a tumor to double in size

Question 25

Etiology

Answer 25

Genetic basis - originate due to genetic damage or mutation Under-activity or silencing of normal regulatory genes or overactivity of proto-oncogenes Evasion of apoptosis Evasion of cellular senescence Development of sustained angiogenesis Invasion and metastasis

Question 26

Proto-oncogenes

Answer 26

Code for growth factors, growth factor receptors, transcription factors, etc Overactivity can promote cancer

Question 27

Tumor suppressor genes

Answer 27

Under-activity can interfere with normal processes Cancerous cells not eliminated and are allowed to grow Ex: BRCA gene

Question 28

Cancer causes related to host

Answer 28

``` Heredity - Genetic predisposition Hormones - Mechanism is unclear Immunology - Impaired ability to suppress tumor growth (immunocompromised, elderly_ ```

Question 29

Cancer causes related to environment

Answer 29

Chemical carcinogens Radiation (ionizing, ultraviolet) Viruses (HPV, EBV, HBV, HHV-8) Bacteria (H. pylori)

Question 30

Systemic symptoms of cancer

Answer 30

Anorexia-cachexia | Fatigue

Question 31

Cancer-induced anemia

Answer 31

Nutritional deficiency Bone marrow failure - Fast growing cancers can cause crowding Inflammatory cytokines - Body's attempt to remove tumor can interfere with ability to create RBC

Question 32

Paraneoplastic syndromes

Answer 32

Cancer producing manifestation in sites not affected by primary cancer Can be due to hormones or other chemicals released by neoplasm Benign and malignant tumors Most common in lung, breast, and hematologic cancers

Question 33

SIADH

Answer 33

Paraneoplastic syndrome | Syndrome of increased ADH by a tumor

Question 34

Cushing syndrome

Answer 34

Paraneoplastic syndrome | Elevated cortisol from tumor that secretes ACTH

Question 35

Hypercalcemia

Answer 35

Paraneoplastic syndrome | Cancer secretes peptide similar to PTH

Question 36

Venous thrombosis

Answer 36

Paraneoplastic syndrome | Cancer secretes procoagulation factors

Question 37

Acanthosis nigricans

Answer 37

Paraneoplastic syndrome Skin changes Possible due to epidermal growth factors from cancer

Question 38

Modes of cancer treatment

Answer 38

Radiation - Destroy/damage cells by creating free radicals - Rapidly proliferating cancer cells are more susceptible Chemotherapy - Prevent cell growth Inhibit DNA, RNA, protein synthesis Hormone therapy - Disrupt hormonal environment of cancer cells Biotherapy - Change person's immune response to cancer