Unit 2 Pathophysiology - Chapter 13 Cancer epidemoiology

Question 1

Dietary factors

Answer 1

r/t cancer development; how it interacts w/ genomics, epigenomics, transcription factors, proteomics (proteins), and metabolic factors => nutrigenomics

Question 2

What can influence risks of developing cancer and other diseases?

Answer 2

What you eat, weight, and how much they move!

Question 3

Food components w/ cancer preventing potential

Answer 3

• polyphenols
• selenium
• methyl group donors
• retinoids
• isothiocyanates
• allyl compounds
• mono- , poly- unsaturated fatty acids

Question 4

Source of carcinogenic substances

Answer 4

cooking fat, meat or protein
plants - alkaloids or mold byproducts

Question 5

Dietary components as mutagens?

Answer 5

Some components can act directly as mutagens or interfere w/ mutagen elimination

Question 6

Dietary factors can affect what specfically?

Answer 6

cell cycle, differentiation, DNA damage and repair, stem cell renewal, hormonal axes, cellular proliferation, and cell death, cell signaling/inflammation/immunity

Question 7

Xenobiotics

Answer 7

toxic, mutagenic, and carcinogenic chemicals found in human diet

Question 8

What other food and nutrition tips can change carinogen metabolism?

Answer 8

sulforaphane (Sulforaphane is found in cruciferous vegetables like broccoli, cauliflower, and kale. It may offer anticancer, antidiabetes, and other benefits.) and isoflavonoids (Evidence suggests that eating a diet rich in soy foods may offer protection against certain cancers and cardiovascular disease. Isoflavones also appear to play a role in preventing bone loss — legume seeds or lentils, beans, peas)

Question 9

Diets high in red meat and processed meat

Answer 9

colorectal cancer; N-nitroso compounds can increase nitogenous residues in colon and cause DNA damage

Question 10

Undernutrition

Answer 10

factor in cancer d/t infectious agents

Question 11

Obesity at risk for?

Answer 11

At risk for liver, advanced prostate, ovarian, gallbladder, kidney, colorectal, esophageal (adenocarcinoma), postmenopausal breast, pancreatic, endometrial, and stomach cancer.

lower body fatness lowers cancer risk for thyroid and multiple myeloma

Question 12

3 main factors r/t to obesity and cancer

Answer 12

insulin-insulin-like growth factor axis, sex hormones, and adipokines (cytokines produced by adipose)

Question 13

Obseity and metabolic changes

Answer 13

insulin resistance, hyperglycemia, dyslipidemia, hypoxia, anad chronic inflammation

Question 14

Adipocyte dysfunction and obesity

Answer 14

secretions of abnormal levels of cytokines linked to insulin resistance, impairments in triglyceride storage and increases in lipolysis

adipocyte function as endocrine cells (alpha cells which secrete glucagon, beta cells which secrete insulin, and delta cells which inhibit the secretion on glucagon and insulin) and shape tumor microenvironment

Question 15

Obesity and immune cell recruitment

Answer 15

increased cytokine production, inflammation, and fibrosis and reduced response to chemotherapy

Question 16

obesity and aromatase expression

Answer 16

Aromatase is an enzyme that converts androgens into estrogens,

increased estradiol levels, promote growth of estrogen-dependent cancers

Question 17

Warburg effect

Answer 17

tumors consume tons of glucose => to make cellular building blocks

Question 18

Food metabolism and circadian cycles

Answer 18

linked; impairment of clock dysregulates metabolism

Question 19

Alcohol and cancer

Answer 19

mouth, pharynx, esophagus, and liver; colorectal cancer in men and postmenopausal breast cancer

Question 20

Factors that l/t alcohol-induced cancer developmetn

Answer 20

acetaldehyde (broken down from ETOH), oxidative stress, nutritional deficiency (folate and vitamin B)

Question 21

Abberrant patterns (deviating) of DNA methylation

Answer 21

contribute to alcohol-induced carcinogenesis

Question 22

Physical activity

Answer 22

reduce risk of breast cancer, colon cancer, and endo metrial cancer

Question 23

Other protective effects of exercise

Answer 23

decrease insulin, IGF levels (aging)
* decrease obesity
* increase free-radical scavenger systems
* change inflammatory mediators
* decrease oncogenes
* decrease metabolic hormones and circulating sex hormones
* improve immune fx
* enhance cytochrome p-450 fx (detoxification and metabolism of foreign material and drugs) => modify carcinogen activation and increase gut motility

Question 24

Exposure to outdoor air pollution and to particulate matter (PM in outdoor air

Answer 24

carcinogenic to humans and causes lung cancer; fine or ultrafine particles absorbed by lungs and phagocytosed by macrophages and neutrophils that release tissue-damaging inflammatory mediators

Question 25

Mechanisms of adverse cellular effects d/t PM particulate matter

Answer 25

* cytotoxicity via oxidative stress * ROS generation * DNA oxidative damage * mutagenicity (ability to induce mutagens) * stimulation of proinflammatory factors * induce cell senescence (eventually stop multiplying, don't die off)

Question 26

Indoor air pollution environmental tobacco smoke (ETS; passive smoking)

Answer 26

form reactive oxygen free radicals and thus DNA damage; ETS => human carcinogen

Question 27

2012 Diesal exhaust

Answer 27

carcinogen as well

Question 28

Central hypothesis for cancer pathogenesis via respiratory

Answer 28

1. insoluble particles => pulmonary inflammation 2. oxidative stress 3. oxidation of DNA 4. proliferative response => tissue remodeling via fibrosis 5. tumor development

Question 29

Atomic bomb exposure in japan

Answer 29

acute leukemias in adults and children; increased thyroid and breast carcinomas including lung, stomach, colon, esophageal, and urinary tract cancers + multiple myeloma

Question 30

Ionizing radiation (IR) in radiation carcinogenesis

Answer 30

* initiator of premaligant cell clones * promoter of preexisting premalignant cell alterations

Question 31

Ionizing radiation

Answer 31

mutagen and carcinogen => penetrate cells and tissues and deposit energy in tissues @ random in form of ionizations

Question 32

Exposure to ionizing radiation induces?...

Answer 32

apoptosis and senescence; evident in endothelial cells and radiation induced CV disease

Question 33

innocent bystander cells

Answer 33

radiation may induce type of genomic instability to progeny of directly irradiated cells over many cell generations

Question 34

Epigenetic events after radiation

Answer 34

altered pathways: * cell adhesion * extracellular matrix interactions * cell-to-cell communication

Question 35

Sun and UV radiation

Answer 35

basal cell carcinoma and squamous cell carcinoma

Question 36

Intermittent acute sun exposure l/t

Answer 36

sunburn associated w/ increased risk of melanoma

Question 37

degree of damage in skin

Answer 37

intensity and wavelength content - ultraviolet A (UVA) or ultraviolet B (UVB)

Question 38

Pathogenesis of nonmelanoma skin cancers

Answer 38

involves: * specific gene mutations * DNA methylation and histone modifications * oxidative stress * inflammation * reduced immune surveillance

Question 39

Inflammation and ROS

Answer 39

ROS can induce # of transcription factors: * activator protein 1 [AP-1] * NF-KB and increasea regulating genes that induce inflammation => critical in tumor progression

Question 40

EMR controversey

Answer 40

non ionizing and low-frequency radiation

Question 41

Radiofrequency-EMF

Answer 41

Electromagnetic field possibly carcinogenic to humans * genotoxicity * impaired immune * gene and protein expression * cell signaling * oxidative stress * apoptosis * blood-brain barrier

Question 42

Certain viruses, bacteria, and parasite

Answer 42

main contributor to cancer worldwide (15.4% in 2012)

Question 43

Helicobacter pylori (H pylori), human papillomavirus (HPV), hepatitis B virus (HBV), hepatitis C (HCV), and Epstein-barr virus (EBV)

Answer 43

top notable infection and cancer cases EBV => affect a person's blood and bone marrow. The virus can cause the body to produce an excessive number of white blood cells called lymphocytes (lymphocytosis). EBV can also weaken the immune system

Question 44

Large majority of liver cancer diagnoses

Answer 44

Hepatitis B and hepatitis C

Question 45

Reproductive tract viral infection

Answer 45

HPV; most for both genders will be infected at some point and may be repeatedly infected

Question 46

75% of stomach cancer

Answer 46

H. pylori

Question 47

EBV

Answer 47

associated w/ subset of hodgkin lymphoma (white blood cells called lymphocytes grow out of control, causing swollen lymph nodes in neck, chest, or armpits, and growths throughout the body) and burkitt lymphoma (non-Hodgkin lymphoma, cancer of lympathic system, makes abnormal B lymphocytes, start anywhere in the body) If a specific type of cell called a Reed-Sternberg cell is seen, the lymphoma is classified as Hodgkin's. If the Reed-Sternberg cell is not present, the lymphoma is classified as non-Hodgkin's. Many subtypes of lymphoma exist.

Question 48

HPVs

Answer 48

13 are cancer causing; types 16 and 18 - high risk or oncogenic cause 70% of cervical cancers and precancerous cervical lesions also linked w/ anus, vulva, vagina, and penis cancer infection w/ HPV-16 precedes several years diagnosis of oropharyngeal cancer

Question 49

Factors that inc risk for cancer following high-risk HPV infection

Answer 49

smoking, decreased immunity, having multiple children, long-term oral contraceptive, poor oral hygiene, chronic inflammation