Treatment of Cancer

Question 1

Metastasis definition:

Answer 1

Invasion of cancer into surrounding tissue, and colonization of other locations in the body

Question 2

Angiogenesis definition:

Answer 2

Growth of new blood vessels from existing vasculature

Question 3

Why is angiogenesis critical for tumour growth?

Answer 3

Allows new abnormal cells to grow by providing oxygen and nutrients

Question 4

Tumours secrete ___ to induce blood vessel growth:

Answer 4

GFs

Question 5

Metastasis occurs when:

Answer 5

Cells detach from parent tumor, enter blood/lymph vessel, exit from circulation, proliferate into the new environment

Question 6

Carcinoma:

Answer 6

Cancers of epithelial cells lining the surface of organs

Question 7

Sarcoma:

Answer 7

Cancer of muscle, bone, fat, cartilage, or connective tissue

Question 8

Leukemia:

Answer 8

Cancer of white blood cells or blood precursor cells

Question 9

Lymphoma:

Answer 9

Cancers of bone-marrow derived cells that affect the lymphatic system

Question 10

Blastoma:

Answer 10

Cancer thought to arise from immature or embryonic tissue

Question 11

80-90% of cancers are what type?

Answer 11

Carcinomas

Question 12

Why are the majority of cancers carcinomas?

Answer 12

Epithelial cells are the site of extensive cell proliferation and frequent exposure to chemical and/or physical damage

Question 13

Certain genes that are reported to play a critical role in cancer development:

Answer 13

• DNA proofreading/ repair genes
• Genes that maintain chromosomal integrity
• Oncogenes
• Tumour suppression genes

Question 14

Tumour progression depends on various factors:

Answer 14

• Mutation rate
• Number of cells in the population
• Rate of cell division

Question 15

In a healthy cell, rate of damage is equal to ____

Answer 15

Rate of repair

Question 16

During pathological situations, rate of DNA damage is ____ than the rate of repair:

Answer 16

Greater

Question 17

How is the risk of developing cancer affected in an individual with inherited cellular DNA mutations?

Answer 17

Increased risk of developing cancer

Question 18

Following mutations, oncogenes acquire ____

Answer 18

Gain-of-function

Question 19

Following mutations, tumour suppressor cells acquire ___

Answer 19

Loss-of-function

Question 20

What does gain-of-function refer to in mutated oncogenes?

Answer 20

Mutated oncogenes are expressed at high levels, resulting in cell growth & an increase in mitosis

Question 21

Examples of oncogenes:

Answer 21

• Hormones
• GFs
• Receptors
• Cell signaling molecules
• TFs

Question 22

What is a tumour suppression gene’s main function?

Answer 22

To protect cells from cancer pathology

Question 23

End result following mutation of an oncogene or tumour suppressor gene:

Answer 23

Increase in cell growth

Question 24

The seven principles of cancer therapy:

Answer 24

1. Cure requires death of all tumour cells
2. Drugs kill a constant proportion of tumour
3. Tumours detected later require prolonged treatment
4. Drugs have narrow therapeutic index
5. Drug combinations can increase effectiveness and decrease adverse cells
6. Intermittent high-dose therapy is more effective
7. Adjuvant therapy may decrease metastases

Question 25

Cancer therapy for terminal patients:

Answer 25

Palliative care, focuses on relieving and preventing suffering

Question 26

Localized therapies:

Answer 26

Surgery, radiation

Question 27

Systemic therapy:

Answer 27

Chemotherapy, hormone therapy (has effects on all regions of the body)

Question 28

The ultimate goal of pharmacologic cancer treatment:

Answer 28

Targeted therapy

Question 29

Factors influencing patient survival:

Answer 29

- Time of initiation of treatment - Timing of the treatments - Drug combinations

Question 30

Cellular activity during G0 phase:

Answer 30

Cells cease division

Question 31

Cellular activity during G1 phase:

Answer 31

Cells grow

Question 32

Cellular activity during S phase:

Answer 32

DNA replicates

Question 33

Cellular activity during G2 phase:

Answer 33

Cells prepare to divide

Question 34

The addition of therapeutics during ___ phase would allow slow-growing tumours to be treated early:

Answer 34

Proliferative

Question 35

First-order kinetics:

Answer 35

Elimination of the drug is proportional to the plasma concentration of that same drug

Question 36

Chemotherapy kills cancer cells via:

Answer 36

First-order kinetics

Question 37

At the time of detection, how many cancerous cells are there?

Answer 37

Over one billion

Question 38

Failure of anticancer drugs can be due to:

Answer 38

1. Lack of specificity (side effects and dosage limitations) 2. Cancer has developed resistance to the treatment

Question 39

Ways cancerous cells may acquire resistance to treatment:

Answer 39

1. Some neoplastic cells are inherently resistant 2. Develop mutations through growth 3. Multidrug resistance- A selection of cells expressing amplified p-glycoprotein that pumps drugs out of the cell

Question 40

Chemotherapy side effects:

Answer 40

- Myelosuppression - Nausea, vomiting, diarrhea - Alopecia - Decreased sperm count, menopause, teratogenicity - Secondary carcinogenicity

Question 41

Ideal combination of cancer chemotherapy drugs:

Answer 41

- Drugs that offer synergistic action - Drugs that have different mechanisms of action and resistance pathways

Question 42

Main things to consider when deciding on cancer treatment:

Answer 42

- Long term gain vs. the risk - Chance of successful treatment vs. the quality of life