What is Cancer?

Question 1

How often is someone diagnosed with cancer in the UK?

Answer 1

Every 2 minutes

Question 2

How many new cases were diagnosed every day in the UK in 2015?

Answer 2

990 cases

Question 3

How often does someone die from cancer in the UK?

Answer 3

Every 4 minutes

Question 4

What is the risk of of someone catching cancer in the UK if born after 1960?

Answer 4

1 in 2

Question 5

What is the survival rate of cancer in England/Wales

Answer 5

50% survive disease for 10+ years

Question 6

How many cancer cases in the UK are linked to lifestyle habits?

Answer 6

42% (4 in 10)

Question 7

List 9 carcinogens that can increase the risk of cancer

Answer 7

• Smoking
• Obesity and poor diet
• Hormones
• Alcohol consumption
• Certain workplaces
• UV light from sun/sunbeds
• Infections and HPV
• Inherited genes
• Air pollution and radon

Question 8

List 5 preventatives that can decrease the risk of cancer

Answer 8

• No smoking
• Reduced alcohol consumption
• Physical activity
• Healthy diet
• Less exposure to UV

Question 9

What is cancer?

Answer 9

The name for a group of diseases characterised by different hallmarks

Question 10

What are the 4 main stages of cancer?

Answer 10

1. Abnormal cell proliferation
2. Tumour formation
3. Invasion of neighbouring normal tissue
4. Metastasis to form new tumours at distant sites

Question 11

Define abnormal cell proliferation

Answer 11

Cells that have lost the ability to control growth and therefore multiply rapidly

Question 12

Define tumour formation

Answer 12

Has not been picked up by the immune system and has evaded cell death to form a clinically detectable tumour

Question 13

Define invasion of neighbouring normal tissue

Answer 13

Cells of the tumour have been able to move around and migrate to different tissue

Question 14

Define metastasis to form new tumours at different sites

Answer 14

The tumour cells that have invaded new tissue begin to form new tumours at these sites

Question 15

How many different types of cancer have been classified according to their origin?

Answer 15

Over 200

Question 16

What are carcinomas?

Answer 16

Cancers found in epithelial cells

Question 17

What percent of cancers are carcinomas?

Answer 17

Approx 85%

Question 18

What are sarcomas?

Answer 18

Cancers derived from mesoderm cells in bones and muscles

Question 19

What are adenocarcinomas?

Answer 19

Cancers found in glandular tissues

Question 20

What do carcinogens do to DNA?

Answer 20

Cause alterations, specifically mutations and deletions

Question 21

What is carcinogenesis?

Answer 21

The formation of cancer where normal healthy cells are transformed into cancerous cells

Question 22

What happens when the DNA mutations accumulate over time?

Answer 22

It represents the multi step process that is carcinogenesis

Question 23

When does mutation accumulation in the DNA occur?

Answer 23

After the cells defence mechanism of DNA repair has been evaded

Question 24

What happens when the DNA damage is severe?

Answer 24

Apoptosis is induced

Question 25

What is apoptosis?

Answer 25

Process of planned cell death to eliminate unwanted cells

Question 26

Can cancer cells evade DNA defence mechanisms?

Answer 26

If the system is over burdened, the possibility of cells escaping surveillance is increased

Question 27

Does our ability to live longer affect our risk of cancer?

Answer 27

Yes as cancer risk increases with age

Question 28

What are germline mutations?

Answer 28

Alterations in DNA through point mutations/deletions in egg/sperm cells which can then be inherited

Question 29

What do germline mutations result in?

Answer 29

Inherited mutation in offspring which increases their risk of developing certain cancers later in life

Question 30

How many cells are needed to form a primary tumour

Answer 30

Only 1 out of the 10^14 somatic cells in the body is used as it divides and produces many clonal cells to form a tumour

Question 31

How many mutations in tumour cells are caused my somatic mutations

Answer 31

Almost all

Question 32

How are tumour cells heterogeneous?

Answer 32

They have subclonal selection which allows a growth advantage allowing resistance and therefore heterogeneity

Question 33

Is the cell mutation in the same type of cancer in two different people identical?

Answer 33

No, it depends on the tumour cells interaction with other tumour cells and the tumour microenvironment

Question 34

What are the 4 steps of the cell cycle of normal cells?

Answer 34

1. Proliferation (controlled division and growth) 2. Differentiation 3. Perform function 4. Apoptosis (programmed cell death)

Question 35

Where in the cell cycle does carcinogenesis occur?

Answer 35

Mutations in DNA affect proliferation, differentiation and apoptosis by causing rapid division of the cells into a tumour

Question 36

What do normal genes do?

Answer 36

Regulate growth

Question 37

What is an oncogene?

Answer 37

A proto-oncogene that has been mutated to signal uncontrollable growth such as cancer

Question 38

What type of gene can be mutated into an oncogene?

Answer 38

A proto-oncogene

Question 39

What is a tumour suppressor gene?

Answer 39

A gene that inhibits growth and tumour formation by releasing signals during phase G1 to stop or slow the cell cycle before phase S

Question 40

What happens when a tumour suppressor gene is mutated?

Answer 40

Their function is disabled resulting in uncontrolled growth such as cancer

Question 41

What happens when a tumour suppressor gene is mutated?

Answer 41

Their function is disabled resulting in uncontrolled growth such as cancer

Question 42

How do cancer cells sustain proliferative signalling?

Answer 42

They are not dependant on growth factors to divide unlike normal cells and therefore can grow unregulated

Question 43

How do cancer cells evade growth suppressors?

Answer 43

They have acquired mutations or gene silencing which interfere with inhibitory pathways used for normal cells

Question 44

How do cancer cells avoid immune destruction?

Answer 44

They are able to shield themselves from immune attack and can actively immunosuppress the environment

Question 45

How does the immune system respond to cancer cells?

Answer 45

1. Protect from virus induced tumours 2. Eliminate pathogens 3. Identify and eliminate tumours All through immune surveillance

Question 46

What is cancer immunoediting?

Answer 46

The immunene system attempting to control cancer contested with the ability of some tumours still arising from cancer cells that have evaded the immune system

Question 47

What are the 3 Es of cancer immunoediting?

Answer 47

Elimination, Equilibrium, Escape

Question 48

What is elimination in cancer immunoediting?

Answer 48

The immune system is able to eradicate developing tumours

Question 49

What is equilibrium in cancer immunoediting?

Answer 49

If there is incomplete removal, tumour cells remain dormant and enter equilibrium. The immune system exerts pressure to contain the tumour however some cells may mutate to survive this

Question 50

What is escape in cancer immunoediting?

Answer 50

The expanding tumour population becomes clinically detectable

Question 51

How is breast cancer diagnosed?

Answer 51

- Mammogram - Ultrasound - Biopsy - Bone scan - MRI

Question 52

How is colon cancer diagnosed?

Answer 52

- Physical exam - Blood in stool - Colonoscopy

Question 53

How is lung cancer diagnosed?

Answer 53

- Sputum cytology - Biopsy

Question 54

How is ovarian cancer diagnosed?

Answer 54

- Pelvic examination - CA-125 assay - Ultrasound - CT - MRI

Question 55

How is prostrate cancer diagnosed?

Answer 55

- Digital rectal exam - PSA levels - Biopsy

Question 56

How is pancreatic cancer diagnosed?

Answer 56

- Physical exam - Biopsy