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BIO170 - Obj 13
BIO170 - Obj 13 - Cancer, Staging, etc
| Question | Answer |
|---|---|
| What are the 4 factors involvled with local manifestation of tumors? | cellular multiplication, mechanical invasion & decreased cell adhesion, lytic enzymes, and increased motility |
| What is the significance of cellular multiplication? | there is an increase in the number of transformed cancel cells |
| How many divisions before a clinically detected tumor is formed? How big is that? | mitosis through approx 20 cell cycles produces the smallest clinically detectable tumor, 1 gram in size |
| How do tumors grow and what enables them to adhere locally? | as tumors grow, they induce pressure along the lines of least resistance; fibronectins are degraded -> loss of anchoring proteins; additionally, there is an increase in the # of laminin receptors that bind to collagen |
| Where do tumors adhere locally? | the tumor cells to adhere to the extracellular matrix of the basement membrane or the interstitial connective tissue; this is possible because of the degradation of fibronectins & the increase in the # of laminin receptors which bind to collagen |
| What is the effect of lytic enzymes and protease inhibitors on the local manifestation of tumors? | there is increased secretion of lytic enzymes by tumor cels and tumor induced host cells which destroys the extracellular matrix; additionally, there is a decrease in the activity of protease inhibitors |
| What are 2 lytic enzymes involved in destroying the extracellular matrix? | collagenase destroys collagen proteins; proteasae destroys digestive proteins |
| What is the effect of increased motility in the local manifestation of tumors? | tumors acquire pseudopodia (finger-like projections) which are stimulated by growth factors or autocrine motility factors secreted by tumor cells; these pseudopods attach to the blood vessel walls |
| What is metastasis? | the spread of cancer cells from a primary site to distant tissues |
| What event occur in metastasis (in order)? | EPRT, AAP - 1) extension into surrounding tissue, 2) penetration of blood (venous) and/or lymphatic vessels, 3) release, 4) transport to secondary site, 5) AAP - arrest, adherence, and proliferation at secondary site |
| What is extension into surround tissue called? | "seeding" - the penetration of the wall of the organ or body cavity; seeding in a tumor fragment broken off from the original tumor |
| What is the release step in metastasis? | a cell or group of cells break off into systemic or lymphatic circulation |
| Why doesn't the immune system recognize & destroy the tumor? | the immune system attacks cancer cells as evidenced by lumps in the lymph nodes surrounding a primary tumor; cancer cells are frequently surrounded by platelets and fibrin from blood, which makes is easier for them to avoid the immune response |
| To which secondary sites are tumor cells are transported? | if tumor cells are not destroyed by the immune system, they are transported to distant sites; certain tumor cells invade the 1st capillary bed encountered; other tumors perfer the environment of specific organs |
| What is AAP at the secondary site? | arrest, adherence, and proliferation |
| What happens during AAP? | cancer cells develop into a secondary tumor at a distant site; defective mechanisms allow the cancer cells to metastasis; and stimulation of angiogenesis occurs |
| What are the defective mechanisms which allow cancer cells to metastasize? | the p53 suppressor gene must be defective to avoid apoptosis; the secondary tissue must be undable to stop adherence from cancer cells |
| Why is angiogenesis stimulated by the secondary tumor? | blood vessel development is increased to supply the secondary tumor with oxygen & nutrients for proliferation |
| What are the 7 characteristics of a malignant tumor? | 1) more lethal; 2) invasive to local tissue; 3) anaplasia (many transformed cells); 4) fast growth; 5) vascular; 6) the tumor causes necrosis of surrounding tissue; 7) the tumor recurs (LIAFVNR) |
| What are the 7 characteristics of a benign tumor? | 1) less lethal; 2) encapsulated; 3) resembles parent cells; 4) slow growth; 5) little vascularity; 6) no necrosis of surrounding tissue; 7) non-recurrent |
| What are the 3 factors considered when staging cancer? | TNM - tumor size, node movement through regional lymph nodes, and extent of metastasis |
| What are the classifications of tumor size? | T0 - no tumor; T1 - tumor less than 2cm; T2 - lesion 2-5 cm; T3 - tumor invades skin, serous membrane, or body wall |
| What are the classifications for node involvement? | N0 - no lymph nodes involved; N1 - mobile lymph nodes involved; N2 - fixed lymph nodes involved |
| What are the classifications for extent of metastasis? | M0 - no metastasis; M1- demonstrable metastasis; M2-suspected metastasis |
| What is Class I through IV staging? | combines the TNM system:I-small tumor, no lymph node involvement, no metastasis;II-small tumor, some lymph node involvement; no metastasis;III-large tumor, much lymph node involvement, no metastasis;IV-large tumor, much lymph node involvement, metastasis |
| How do risk factors affect cancer? What are the 2 variables for these risk factors? | risk factors initiate, promote, or cause progression of cancer; in general, increased level and time of exposure to a risk factor increases the probability of developing cancer |
| What are the 5 risk factors for cancer? Which is most important? | ARHID - 1) air pollution; 2) radiation; 3) hormones; 4) infection; and 5) diet |
| What is the dual role of diet in cancer? | proper diet can guard against cancer and keep it from progressing by enhancing the immune response against cancer; alternately, other components of the diet might actually initiate cancer |
| What are the risk factors for lung cancer? | air pollution (smoking, occupational chemicals) and diet (lack of antioxidants, consumption of alcohol) |
| What are the risk factors for colorectal cancer? | diet (low fiber, high fat, and alcohol) |
| What are the risk factors for breast cancer? | radiation (ionizing), hormones (estrogen, progesterone), and diet (obesity, alcohol) |
| What are the risk factors for prostate cancer? | hormones (testosterone) and diet (lack of antioxidants, obesity) |
| What are the risk factors for skin cancer? | radiation (UV) |
| What are the risk factors for endometrial cancer? | infections (herpes simplex virus 6 and 11), hormones (estrogen, progesterone), and diet (obesity) |
| What are the risk factors for leukemia? | radiation (ionizing) |
| What are the risk factors for ovarian cancer? | hormones (estrogen, progesterone) and diet (obesity) |
| What are the risk factors for cervical cancer? | infection (herpes simplex virus 16) |
| What are the risk factors for stomach cancer? | diet (nitrates, charbroiling) |
| Which cancers can be initiated/promoted/or progessed by air pollution? | lung cancer |
| Which cancers can be initiated/promoted/or progessed by radiation? | breast (ionizing), skin (u/v), and leukemia (ionizing) |
| Which cancers can be initiated/promoted/or progessed by infection? | endometrial (herpes simplex virus 6 and 11) and cervical (herpes simplex virus 16) |
| Which cancers can be initiated/promoted/or progessed by hormones? | breast, endometrial, and ovarian (estrogen, progesterone); prostate (testosterone) |
| Which cancers can be initiated/promoted/or progessed by diet? | lung (lack of antioxidants, alcohol), colorectal (low fiber, high fat, alcohol); breast (obesity, alcohol), prostate (lack of antioxidants, obesity), endometrial & ovarian (obesity); stomach (nitrates, charbroiling) |
| What cancers is dietary fat a risk factor? | most types of cancer; consumin polyunsaturated fat cooked at high temperatures (deep frying) is a risk factor; consumption of omega-3 fatty acids from fish oil correlates w/a decreased risk of cancer |
| What are the cancer effects of smoking? | initiates oral & lung cancer in all exposed tissue; cigarette smoke contains 20 known carcinogens; direct contact to carcinogens increases oral cancer |
| Which has a greater lung cancer effect - cigarette smoking or cigar/pipe smoking? | cigarette smoking has a higher risk of cancer as more smoke is inhaled |
| What are the effects of second-hand smoke? | has similar effect to smoking; also exacerbates other respiratory problems such as asthma and bronchitis |
| What are examples of occupational exposure to air pollution? | aerosol carcinogens can cause lung and other cancers; chemicals include are=senicals, benzene, chloroform, vinl chloride, acrylonitrile, asbestos, and radon |
| Where is ultraviolet radiation found? What are its effects? | ultraviolet radiation occurs from sunlight and tanning bed lights; UV radiation initiates skin cancer by inducing DNA changes |
| What is the effect of melanin in skin cancer? | melanin is the dark pigment in the skin which protects the skin from UV light; |
| What type of cancer is elevated from an increase in UV light? What happens to children who have had multiple sunburns? | an increase in UV light yields an increase of melanoma; sunburn in children increases cancer of the melanocytes |
| Why is basal cell and squamous cell carcinoma initiated? | tumor suppressor genes TP53 (p53 on chromosome 17) and PTCH genes are affected; these abnormal tumor suppressor genes no longer work to inhibit the growth of cancer cells |
| How are we exposed to ionizing radiation? What are its effects? | 1)nuclear fission initiates leukemia, thryoid, and breast cancer; exposure to high levels for even a short time greatly increases cancer incidence; 2) LT exposure to diagnostic x-rays may initiate chronic myelogenous leukemia |
| What is the effect of STD infections on cancer? What are the risk factors for acquiring these infections? | STDs can initiate cancers of the reproductive tract, particularly in womer; STD infections are most common as a result of unprotected sexual intercourse and multiple sexual partners |
| Which 2 STDs are of particular concern with regards to cancer? | Human papillomavirus (esp HPV 16) initiates cervical cancer along with other factors; herpes simplex virus (esp HSV 6 & 11) causes genital warts |
| How is cervical cancer detected? | abnormal Papanicolaou (PAP) smears indicate a possibility of future cervical cancer |
| What hormone effects prostate cancer? How? | testosterone promotes prostate cancer |
| Which hormones effect female reproductive cancers? Which cancers? | estrogens promote breast, endometrial and ovarian cancer; synthetic progesterone potentiated the effect of estrogen; additionally estrogen may initiate reproductive cancers |
| What is the main theory of reproductive cancers? What is an example? | increased cell proliferation increases the chances of cells becoming cancerous; ex: estrogen increases the proliferation of breast cells |
| What are the natural factors which increase/decrease female reproductive cancer risk? | decreased ovulation due to pregnancy or birth control decreases the incidence of ovarian and endometrial cancer; early menarche and late menopause increases the incidence of breast cancer |
| What is the effect of synthetic hormones on female reproductive cancers? | birth control (synthetic estrogens & progesterone) appears to increase the incidence of breast cancer in some populations; estrogen replacement therapy increases incidence of breast and endometrial cancer |
| What are some carcinogenic substance in diet? Where are they found? | 1) xenobiotics - found in pesticides; 2) animal protein/fat - esp in deep frying/high temp cooking; 3) alkaloids in plants; 4) mold contamination; 5) preservatives (i.e. nitrates) - in meat, fish, water, etc |
| Explain the carcinogenic effects of nitrates: | nitrates are converted to nitrites and finally carcinogens in acidic environment of the stomach; increase in uptake of nitrates = increase in stomach cancer; the effect of nitrates is potentiated (intensified) by adding salt |
| What are some theories of the initiation of cancer through diet? | exact mechanism is unknown; xenobiotics might diretly damage DNA or production of free radicals from the partial oxidation of nutrients |
| What are cancer neutralizers found in our diet? | 1) chemoproctors are antioxidants; 2) cruciferous vegatables, grape skins, and certain fruits; 3) antioxidants: beta-carotene, vit A, C, E and the trace mineral selenium (which is toxic in large qtys) |
| What risk factor is associated with colorectal cancer? | low fiber diets, although this is probably due not to the lack of fiber, but instead to the increase in polyunsatured fat and/or increased blood hormone levels |
| What occurs with high polyunsaturated fat intake? | increase of polyunsatured fat -> increase of production of free radicals causing DNA damage |
| What are the effects of hormones on colorectal cancer? | some hormones promote proliferation of cancerous cells in the colon |
| What is the effect of omega-3 fatty acids? Where are these fatty acids found? | omega-3 fatty acid from fish oil decrease the incidence of cancer |
| What is the impact of obesity on cancer? | elevated fat intake is correlated w/obesity; obesity is correlated w/elevated blood hormone levels (i.e. estrogen) which promotes reproductive cancer |
| What is the effect of alcohol on cancer? | alcohol exacerbates lung cancer in smokers & is correlated w/higher risk for colon, breast, other cancers; alcohol probably impairs liver's ability to process absorbed carcinogens; alcohol is also associated w/elevated blood estrogen & insulin levels |
Created by:
debmurph
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