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Questions and Answers
Which of the following is NOT a common side effect of chemotherapy?
Which of the following is NOT a common side effect of chemotherapy?
How do targeted cancer therapies operate?
How do targeted cancer therapies operate?
Which term is synonymous with targeted cancer therapies?
Which term is synonymous with targeted cancer therapies?
What compound is mentioned as having an inhibitory effect on the cell cycle?
What compound is mentioned as having an inhibitory effect on the cell cycle?
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Which of the following statements is true regarding the side effects of chemotherapy?
Which of the following statements is true regarding the side effects of chemotherapy?
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What characterizes cancer cells in contrast to normal cells?
What characterizes cancer cells in contrast to normal cells?
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Which process describes the spreading of cancer cells through the lymphatic system?
Which process describes the spreading of cancer cells through the lymphatic system?
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What is a hallmark feature of cancer that involves the growth of new blood vessels?
What is a hallmark feature of cancer that involves the growth of new blood vessels?
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During which phase do cancer cells typically enter the circulatory system?
During which phase do cancer cells typically enter the circulatory system?
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Which term refers to the presence of small, undetected groups of cancer cells within a host?
Which term refers to the presence of small, undetected groups of cancer cells within a host?
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What process is defined as the exit of cancer cells from the bloodstream to colonize new tissues?
What process is defined as the exit of cancer cells from the bloodstream to colonize new tissues?
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Which of the following best describes the ability of cancer cells to grow without the need for anchorage?
Which of the following best describes the ability of cancer cells to grow without the need for anchorage?
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What type of mutations are involved in hereditary cancers such as breast and ovarian cancer?
What type of mutations are involved in hereditary cancers such as breast and ovarian cancer?
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Which of the following genetic mutations is linked to an increased risk of chronic myelogenous leukaemia (CML)?
Which of the following genetic mutations is linked to an increased risk of chronic myelogenous leukaemia (CML)?
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What is characterized by the presence of hypoxia in the cancer microenvironment?
What is characterized by the presence of hypoxia in the cancer microenvironment?
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Which of the following syndromes is associated with mutations in the p53 gene?
Which of the following syndromes is associated with mutations in the p53 gene?
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Which environmental factor is associated with the aetiology of cancer?
Which environmental factor is associated with the aetiology of cancer?
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The BRCA1 and BRCA2 mutations predominantly increase the risk for which types of cancer?
The BRCA1 and BRCA2 mutations predominantly increase the risk for which types of cancer?
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What type of cancer is associated with mutations at the 11p13 locus?
What type of cancer is associated with mutations at the 11p13 locus?
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Which gene is involved in colorectal cancer through the adenomatous polyposis coli pathway?
Which gene is involved in colorectal cancer through the adenomatous polyposis coli pathway?
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What type of mutation is predominantly acquired during a person's lifetime rather than inherited?
What type of mutation is predominantly acquired during a person's lifetime rather than inherited?
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Which clinical sign is typically associated with cancer diagnosis?
Which clinical sign is typically associated with cancer diagnosis?
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What is a common screening method for early detection of cervical cancer?
What is a common screening method for early detection of cervical cancer?
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Which imaging method is not typically used in cancer diagnosis?
Which imaging method is not typically used in cancer diagnosis?
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Which of the following is NOT considered a routine investigation for cancer diagnosis?
Which of the following is NOT considered a routine investigation for cancer diagnosis?
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What type of marker can be used for special investigations in diagnosing cancer?
What type of marker can be used for special investigations in diagnosing cancer?
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Which method is primarily used for visualizing internal organs for cancer diagnosis?
Which method is primarily used for visualizing internal organs for cancer diagnosis?
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Which of the following clinical signs can indicate cancer?
Which of the following clinical signs can indicate cancer?
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What is the role of RANKL in cancer-related processes?
What is the role of RANKL in cancer-related processes?
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Which imaging technique uses radioactive substances to assess cancer?
Which imaging technique uses radioactive substances to assess cancer?
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Which factor is NOT commonly evaluated in routine cancer investigations?
Which factor is NOT commonly evaluated in routine cancer investigations?
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What is indicated by the presence of the Philadelphia chromosome?
What is indicated by the presence of the Philadelphia chromosome?
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What genetic tests are available for BRCA1 and BRCA2?
What genetic tests are available for BRCA1 and BRCA2?
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What is the result of increased growth of granulocytes and their precursors?
What is the result of increased growth of granulocytes and their precursors?
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What mechanism do oncogenic viruses use to affect host cell genes?
What mechanism do oncogenic viruses use to affect host cell genes?
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What genetic alteration is commonly seen in retinoblastomas?
What genetic alteration is commonly seen in retinoblastomas?
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Which type of cancer is primarily associated with the BRCA1 mutation?
Which type of cancer is primarily associated with the BRCA1 mutation?
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What is leucocoria a symptom of?
What is leucocoria a symptom of?
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What type of virus uses reverse transcriptase in its replication?
What type of virus uses reverse transcriptase in its replication?
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What is a characteristic feature of oncogenic viruses?
What is a characteristic feature of oncogenic viruses?
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Which of the following is NOT a common characteristic of chronic myeloid leukemia?
Which of the following is NOT a common characteristic of chronic myeloid leukemia?
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Study Notes
Learning Outcomes
- Distinguish benign growth disorders from malignant disease
- Describe malignant cell characteristics
- Discuss the etiology of malignant disease, relating specific risk factors to cancer types
- Explain the mechanisms responsible for malignant disease
- Understand the clinical effects of tumors
- Appraise diagnostic and treatment approaches for malignant diseases
Learning Resources
- Lakhani, S.R., Dilly, S.A., Finlayson, C.J. (2016) Basic Pathology: an introduction to the mechanisms of disease. CRC Press.
- Weinberg, R.A. (2014). The Biology of Cancer. USA: Garland Science
- Other relevant materials (journal articles, websites)
Revision Reading
- Chapter 16, Thrive in Cell Biology (2013): Eukaryotic cell cycle, mitosis, and meiosis
- Chapter 17, Thrive in Cell Biology (2013): Cell death
- Moodle URL link: Cancer cell biology e-book chapter
What is Cancer?
- Cancer is a multicellular organism problem
- Cancer is a cellular phenomenon, cells acquire abnormal properties
- Cancer is a collection of different diseases
- Cancer's core feature is uncontrolled growth
Characteristics of Malignant Cells
- Loss of growth control (autonomous growth signals, insensitivity to inhibitory signals)
- Resistance to apoptosis
- Unlimited replicative potential (telomeres, telomerase)
- Sustained angiogenesis
- Ability to invade surrounding tissue
- Ability to colonize and survive in new environments (metastasis)
- Loss of contact inhibition
Causes of Cancer (Etiology of Cancer)
- Acquisition of mutations (inborn zygotic, somatic mutations)
- Environmental factors (viruses, chemicals, radiation)
- Abnormal tissue microenvironment (blood/lymphatic, fibroblasts, immune cells, extracellular matrix signaling, hypoxia)
- Other factors (age, lifestyle)
Genetic Mutations and Increased Cancer Risk
- Inborn zygotic mutations, somatic mutations
- Breast cancer / ovarian cancer: BRCA1 and BRCA2
- Li-Fraumeni syndrome (LFS): p53, CHK2
- Childhood cancers: Wilm's tumor (del 11p13)
- Chronic myelogenous leukemia (CML): t(9,22), Philadelphia chromosome
- Retinoblastoma: RB
- Colorectal cancer: APC (adenomatous polyposis coli gene)
Cancer Cells: Loss of Contact Inhibition
- Normal cells exhibit contact inhibition
- Cancer cells lose contact inhibition and continue to proliferate even when in contact with other cells
Clinical Effects of Tumors
- General effects
- Local effects (compression, obstruction, ulceration, haemorrhage, perforation, infarction)
- Endocrine effects
- Paraneoplastic syndromes
Cancer Cachexia
- Multifactorial syndrome, associated with various diseases (tuberculosis, AIDS, heart failure, cancer)
- Characterized by progressive skeletal muscle loss (sarcopenia), adipose tissue wasting, systemic inflammation, metabolic abnormalities.
- Tumor size does not determine cachexia presence
- Incidence varies by tumor type (gastric/pancreatic cancer >80%)
- Cachexia severity depends on tumor stage
Paraneoplastic Syndromes
- Symptoms not explained by local or metastatic disease
- Examples include hypercalcemia, endocrine effects (Cushing's syndrome), clubbing of fingers, skin rashes, hypertrophic osteoarthropathy, peripheral neuropathy, cerebellar degeneration
Hypercalcemia-Osteolytic Bone Lesions
- Multiple myeloma as an example
- Receptor activator of NF-κB ligand (RANKL) and Dickkopf-related protein 1 (DKK1) involve in bone metabolism
Endocrine Effects
- Insulinoma: tumor of the pancreas, causing excessive insulin production
Cancer Diagnosis
- Typical clinical signs (lump, bleeding, mole changes)
- Screening (pap smear, X-rays, blood tests)
- Imaging methods (CT, MRI, PET, ultrasound)
- Fiber optic scope/endoscopy
- Special investigations (tumor markers)
- Surgical biopsy (histopathology, immunohistochemistry, histochemistry, electron microscopy)
- Genetic testing
Malignant Tumor Histology
- Loss of differentiation
- Loss of cellular cohesion
- Nuclear enlargement
- Increased mitotic activity
Tumor Markers
- Substances in blood/urine/tissue, associated with malignancy.
- Used for screening, diagnosis, staging, monitoring therapy/recurrence, determining optimal treatment, imaging/therapy targeting
- Examples include: alpha-fetoprotein (AFP), CA15-3, CA19-9, CA-125, calcitonin, glial fibrillary acidic protein (GFAP), Myo D1, prostate-specific antigen (PSA), synaptophysin
Management of cancers
- Treatment depends on the aggressiveness, spread predictability, procedure related morbidity/mortality, cure rate.
- Survival generally measured by 5-year survival without recurrence.
- Common treatment includes surgery, chemotherapy, immunotherapy, hormone therapy, radiotherapy, bone marrow transplants, targeted therapy, proton beam therapy, gene therapy
Chemotherapy
- Treatments designed to block cancer growth / spread by interfering with specific molecules in tumour growth/progression
- Also referred to as 'molecularly targeted drugs' or 'molecularly targeted therapies'
- Specific therapies target cell growth signaling/tumor blood vessel development, promote cancer cell death.
- Treatments tailored to a patient's tumor characteristics
Targeted Cancer Therapy
- Drugs/substances that disrupt specific molecules involved in cancer growth and spread
- Also referred to as molecularly targeted drugs/therapies
- Approved therapies interfere with cell growth signaling or tumor blood vessel development
- Treatment based on tumor's unique molecular targets
Proton Therapy
- Radiation treatment using protons instead of X-rays.
- Protons are positively charged particles.
- May be used alone or combined with other treatments.
Common Side Effects of Chemotherapy
- Frequent infections
- Diarrhoea
- Nausea/loss of appetite
- Hair loss
- Anemia
Human Papilloma Virus (HPV) Vaccine
- Information on different countries' introduction dates, gender/age targeting of HPV vaccine.
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Description
This quiz covers key concepts in cancer biology, focusing on distinguishing between benign and malignant disorders. Participants will explore malignant cell characteristics, the etiology of cancer, and treatment approaches, integrating foundational knowledge from recommended readings.
