N715 Exam 3 New Pt 5

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Questions and Answers

What is often a consequence of a fast-growing tumor due to its characteristics?

  • Creation of a hypoxic environment (correct)
  • Enhanced blood flow to tissues
  • Increased apoptosis in tumor cells
  • Improved oxygen supply to tumor cells

What is the primary purpose of Vascular Endothelial Growth Factor (VEGF) secreted by tumors?

  • To stimulate apoptosis in cancer cells
  • To increase cellular metabolism
  • To support immune responses
  • To promote the growth of blood vessels supplying the tumor (correct)

How do tumor cells maintain limitless replicative potential?

  • By increasing apoptosis rates
  • By decreasing their nutrient uptake
  • By upregulating telomerase expression (correct)
  • By improving immune responses

What is a characteristic of the carcinogenesis process?

<p>Involves both chemical and biological factors (C)</p> Signup and view all the answers

What defines the classifications of cancer?

<p>Histological type or primary site of origin (C)</p> Signup and view all the answers

Which of the following statements about hypoxic environments in tumors is correct?

<p>They lead to necrosis within the tumor mass (A)</p> Signup and view all the answers

What is one effect of tumor-induced angiogenesis in the context of cancer?

<p>Formation of new blood vessels leading to enhanced oxygen delivery (A)</p> Signup and view all the answers

What is a known potent carcinogen found in cigarette smoke?

<p>Benzo[a]pyrene (A)</p> Signup and view all the answers

Which of the following best describes the treatment options for Hodgkin's Lymphoma?

<p>Treatment depends on the presence of 'B' symptoms and lymph node involvement. (A)</p> Signup and view all the answers

What are the primary characteristics of Non-Hodgkin's Lymphoma?

<p>It can include both B and T cell lymphomas. (B)</p> Signup and view all the answers

What factor does NOT influence the treatment approach for brain tumors?

<p>Patient's favorite color (B)</p> Signup and view all the answers

Why is chemotherapy often administered with multiple agents rather than a single agent?

<p>It targets multiple cell types at different parts of the cell cycle. (B)</p> Signup and view all the answers

Which of the following toxicities is associated with the chemotherapy agent Doxorubicin?

<p>Heart muscle issues (D)</p> Signup and view all the answers

In what circumstance would a bone marrow transplant be considered necessary?

<p>When treating relapsed central nervous system cancers. (C)</p> Signup and view all the answers

What type of radiation is typically not used in primary therapy for Hodgkin's Lymphoma?

<p>Total body irradiation (A)</p> Signup and view all the answers

Which of the following is a characteristic of Chemotherapy as a treatment method?

<p>It disrupts the cell cycle of fast-growing cells. (B)</p> Signup and view all the answers

Which B symptoms may be relevant to the determination of treatment for lymphomas?

<p>Fever and unexplained weight loss. (C)</p> Signup and view all the answers

What is a significant risk associated with radiation therapy?

<p>Cognitive effects and secondary malignancies. (C)</p> Signup and view all the answers

What characterizes Hodgkin's Lymphoma in comparison to Non-Hodgkin's Lymphoma?

<p>Presence of Reed-Sternberg cells (D)</p> Signup and view all the answers

Which treatment option is specifically indicated for relapsed Non-Hodgkin's Lymphoma?

<p>Targeted monoclonal antibody therapy (C)</p> Signup and view all the answers

What are the primary characteristics of brain tumors associated with Neuroblastoma?

<p>Characterized by primitive neuroectodermal cells (B)</p> Signup and view all the answers

What is an essential component required for autologous stem cell transplantation?

<p>High doses of chemotherapy that may damage bone marrow (D)</p> Signup and view all the answers

Which condition makes allogeneic stem cell transplantation indicated?

<p>Relapsed leukemia (D)</p> Signup and view all the answers

What is the main function of the lymphatic system?

<p>Draining excess fluid and filtering pathogens (D)</p> Signup and view all the answers

Which type of stem cell source is commonly used for autologous transplant?

<p>Peripheral blood stem cells (A)</p> Signup and view all the answers

What is a significant consideration when using CAR-T cell therapy?

<p>It is a relatively new method for managing relapsed diseases (C)</p> Signup and view all the answers

What causes a tumor to create a hypoxic environment?

<p>High interstitial fluid pressure and poor vascular structure (A)</p> Signup and view all the answers

Which process allows cancer cells to invade and spread to distant sites in the body?

<p>Metastasis and tissue invasion (A)</p> Signup and view all the answers

What role does telomerase play in cancer cells?

<p>It prevents the destruction of the telomere (C)</p> Signup and view all the answers

What distinguishes carcinogens from other substances?

<p>They specifically initiate or promote cancer development (B)</p> Signup and view all the answers

What is an effect of lactate production in tumors during energy generation?

<p>Areas of necrosis due to hypoxia (D)</p> Signup and view all the answers

Which factors can contribute to the classification of cancer?

<p>Tissue type and primary developmental site (D)</p> Signup and view all the answers

Which of the following substances is known to be a potent carcinogen?

<p>Benzo[a]pyrene (C)</p> Signup and view all the answers

Which characteristic is unique to cancer cells compared to normal cells?

<p>Ability to evade immune response (C)</p> Signup and view all the answers

What is primarily responsible for the production and maturation of lymphocytes?

<p>Bone marrow (A)</p> Signup and view all the answers

Which process allows lymphocytes to increase in number upon encountering an antigen?

<p>Clonal expansion (B)</p> Signup and view all the answers

What is the primary role of lymph nodes in the lymphatic system?

<p>Filtration of lymph fluid (D)</p> Signup and view all the answers

Which structure is involved in the maturation of T-cells and ensures they recognize foreign antigens without triggering autoimmunity?

<p>Thymus (D)</p> Signup and view all the answers

Which of the following accurately describes the function of the spleen in the secondary lymphatic system?

<p>Recycling of iron and filtration of blood (C)</p> Signup and view all the answers

What unique characteristic do endothelial cells in the lymphatic system exhibit?

<p>They allow the passage of larger molecules and immune cells. (C)</p> Signup and view all the answers

What is a key function of mucosa-associated lymphoid tissue (MALT)?

<p>Protection of mucosal surfaces from pathogens (A)</p> Signup and view all the answers

What is the process through which lymphocytes rearrange their DNA to create unique antigen receptors called?

<p>DNA rearrangement (D)</p> Signup and view all the answers

What is a key characteristic of Medullary breast tumors?

<p>They are encapsulated and enveloped by lymphocytic infiltrate. (B)</p> Signup and view all the answers

Which breast cancer type is characterized by a palpable lesion under the nipple and an eczema-like rash?

<p>Paget's disease (B)</p> Signup and view all the answers

Which carcinoma is typically associated with well-defined tumors made up of well-differentiated cells?

<p>Intraductal carcinoma (B)</p> Signup and view all the answers

What is the primary role of the TP53 gene in the cell cycle?

<p>To act as a checkpoint gatekeeper (A)</p> Signup and view all the answers

How do cancer cells typically differ from normal cells in regard to apoptosis?

<p>Cancer cells exhibit suppressed apoptosis (A)</p> Signup and view all the answers

What is the typical size of Cystosarcoma Phyllodes tumors?

<p>Greater than 17 cm in diameter (B)</p> Signup and view all the answers

What distinguishes Triple Negative Breast Cancer from other subtypes?

<p>It is negative for Estrogen receptors, Progesterone receptors, and HER2. (D)</p> Signup and view all the answers

Which characteristic allows cancer cells to grow without external growth signals?

<p>Autocrine signaling (C)</p> Signup and view all the answers

What typically occurs when cancer cells come into contact with other cells?

<p>They continue to grow and divide (D)</p> Signup and view all the answers

What is the general characteristic of Squamous Cell carcinoma in breast cancer?

<p>It begins in the ducts' epithelium. (B)</p> Signup and view all the answers

What is one of the primary reasons cancer cells are classified as being self-sufficient in growth signals?

<p>They can replicate without environmental stimuli (A)</p> Signup and view all the answers

Which type of tumor is most likely to affect male breast cancer patients who carry BRCA 2 mutations?

<p>Hormone receptor positive and HER2 negative (B)</p> Signup and view all the answers

What mechanism do cancer cells use to disregard antigrowth signals?

<p>Mutations in tumor suppressor genes (C)</p> Signup and view all the answers

What defines the main origin of Fibrosarcoma in breast cancer?

<p>It originates from connective tissues. (D)</p> Signup and view all the answers

What is a common consequence of uncontrolled cell growth in cancer cells?

<p>Stiffness and compression of tissues (D)</p> Signup and view all the answers

What characteristic distinguishes cancer cells from normal cells in terms of their response to physical space?

<p>Cancer cells ignore signals that regulate space filling (B)</p> Signup and view all the answers

What indicates a favorable outcome for a bone marrow transplant?

<p>A good match with a healthy donor (B)</p> Signup and view all the answers

Which treatment approach is necessary for conditions where the bone marrow is the primary problem?

<p>Allogeneic stem cell transplantation (A)</p> Signup and view all the answers

What is a key requirement before proceeding with autologous stem cell transplantation?

<p>Higher doses of chemotherapy to the patient (C)</p> Signup and view all the answers

In the context of CAR-T cell therapy, what is a critical challenge that this treatment aims to address?

<p>Resistance to chemotherapy agents (B)</p> Signup and view all the answers

Which statement accurately reflects the cellular source utilized for autologous stem cell transplantation?

<p>Stem cells are harvested from the patient's own body (C)</p> Signup and view all the answers

What characterizes the lymphatic system's involvement in immune response?

<p>Initiating adaptive immune responses (D)</p> Signup and view all the answers

What is an advantage of using allogeneic stem cell transplantation over autologous?

<p>It introduces healthy donor's immunity (D)</p> Signup and view all the answers

What is a common challenge faced by patients receiving CAR-T cell therapy?

<p>Management of potential cytokine release syndrome (C)</p> Signup and view all the answers

Which mutation is known to be associated with a significantly increased risk of developing prostate cancer?

<p>BRCA2 (D)</p> Signup and view all the answers

What is the primary mechanism by which DHT activates androgen receptors in the prostate gland?

<p>Transcriptional activation (B)</p> Signup and view all the answers

Which of the following best describes the function of alpha estrogen receptors in the prostate?

<p>Facilitate sperm maturation (A)</p> Signup and view all the answers

The primary treatment approach for prostate cancer is based on which biological pathway?

<p>Androgen receptor pathway (A)</p> Signup and view all the answers

What role does chronic inflammation play in the development of prostate cancer?

<p>Leads to cellular injury (A)</p> Signup and view all the answers

During which stage do urinary symptoms such as nocturia and dysuria typically manifest in prostate cancer?

<p>Late stage (D)</p> Signup and view all the answers

Which dietary factor is associated with an increased risk of prostate cancer?

<p>High char-grilled meats (A)</p> Signup and view all the answers

What is the consequence of excessive androgen production outside the testes in prostate cancer pathogenesis?

<p>Altered androgen receptor function (C)</p> Signup and view all the answers

Which zone of the prostate gland is most commonly associated with cancer development?

<p>Peripheral zone (A)</p> Signup and view all the answers

Which process is characterized by changes in cellular polarity and morphology, often linked to tumor invasion in prostate cancer?

<p>Epithelial Mesenchymal Transition (A)</p> Signup and view all the answers

What is a significant metabolic effect observed with increasing age and testosterone levels in men?

<p>Increased conversion of testosterone to estrogens (C)</p> Signup and view all the answers

Which of the following signs is NOT typically associated with metastatic prostate cancer?

<p>Increased libido (C)</p> Signup and view all the answers

What type of receptor is associated with bone density and libido in the context of prostate cancer?

<p>Beta estrogen receptor (D)</p> Signup and view all the answers

What is the role of 5 alpha reductase in testosterone metabolism?

<p>Converts testosterone into DHT (A)</p> Signup and view all the answers

Flashcards

Hypoxic Environment in Tumors

Tumors often lack oxygen due to rapid growth, poor blood vessel structure, and high fluid pressure.

Tumor Necrosis

Areas of cell death in a tumor due to lack of oxygen.

VEGF (Vascular Endothelial Growth Factor)

Growth factor secreted by solid tumors to promote blood vessel formation.

Cancer Metastasis

Cancer cells spreading to distant parts of the body.

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Telomerase

Enzyme that prevents the shortening of chromosomes, allowing cancer cells to divide indefinitely.

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Carcinogen

Substance that causes cancer.

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Carcinogenesis

Process of cancer development.

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Cancer Classification (by type)

Classifying cancers based on the tissue they originate from.

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Childhood Cancer Peaks

Certain types of cancer show a higher incidence in childhood and again in young adulthood.

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Hodgkin's Disease Curable%

Approximately 90-95% of Hodgkin's disease cases are curable.

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Hodgkin's Lymphoma Symptoms

Hodgkin's lymphoma can be completely asymptomatic or only involve lymph nodes (e.g., supraclavicular, cervical) and may show "B" symptoms (unexplained weight loss, night sweats, fever). These symptoms inform treatment decisions

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Non-Hodgkin's Lymphoma Cell Types

Non-Hodgkin's lymphomas are a category of cancers arising from B and T cells.

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Non-Hodgkin's Lymphoma Treatment Factors

Treatment for Non-Hodgkin's Lymphoma depends on cell types, location of the disease (including bone marrow involvement), and might resemble Leukemia treatments.

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Brain Tumor Treatment Factors

Brain tumor treatment mainly depends on location, size, and cell type (histology).

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Chemotherapy Targets

Chemotherapy targets rapidly dividing cells.

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Chemotherapy Multiple Agents Reason

Multiple chemotherapy agents are used to affect cancerous cells at different phases of the cell cycle.

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Radiation Therapy Types

Radiation therapy can external or internal (placed during surgery).

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Bone Marrow Transplant Use

Bone marrow transplants are considered for specific types of cancers, often involving bone marrow or blood system involvement.

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Bone Marrow Transplant (BMT)

A procedure where healthy stem cells are transplanted to replace damaged or diseased bone marrow.

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Autologous BMT

A BMT where the stem cells come from the patient themselves. Usually used to target cancer cells after high-dose chemotherapy.

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Allogeneic BMT

A BMT where the stem cells come from a healthy donor. This is used when the bone marrow itself is the problem, like in certain immunodeficiencies.

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Lymphatic System

A network of vessels and tissues responsible for filtering fluid, fighting infection, and maintaining immune function.

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Lymph Nodes

Small, bean-shaped organs that filter lymph fluid and contain immune cells.

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CAR-T Cell Therapy

A new treatment where a patient's T-cells are genetically modified to target specific cancer cells.

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Relapse in Cancer

The return or worsening of cancer after treatment.

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Stem Cells

Undifferentiated cells that have the ability to become any type of cell in the body.

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G1/S Checkpoint

A critical point in the cell cycle where the cell checks for DNA damage and decides whether to proceed to DNA replication. If damaged DNA is detected, the cell cycle is halted, giving time for repair.

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TP53 Gene

A gene that acts as a crucial tumor suppressor. It plays a vital role in detecting and preventing the growth of cancerous cells by halting the cell cycle when DNA damage is detected.

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Autocrine Signaling

A process where cancer cells make their own growth signals, stimulating their own proliferation without the need for external signals. This leads to unregulated growth.

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Tumor Suppressor Genes

These genes act like 'brakes' for cell growth and division. They prevent cancerous cells from developing by stopping uncontrolled cell growth and proliferation.

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Antigrowth Signals

Signals that normally tell a cell to stop growing or dividing. These signals are usually triggered by cell-to-cell contact or by the presence of enough cells in a tissue.

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What are the 6 main characteristics of Cancer Cells?

  1. Self-sufficiency in growth signals, 2. Insensitivity to antigrowth signals, 3. Evasion of apoptosis, 4. Limitless replicative potential, 5. Sustained angiogenesis, 6. Tissue invasion and metastasis.
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Evasion of Apoptosis

Cancer cells ignore the signals that normally tell them to self-destruct when damaged or abnormal. This allows them to survive and continue growing abnormally.

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Limitless Replicative Potential

Cancer cells have mechanisms that prevent them from aging and dying, allowing them to divide indefinitely. This is unlike normal cells, which have a limited lifespan.

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What are the main uses of a Bone Marrow Transplant?

Bone Marrow Transplant (BMT) is used for: Relapse of certain diseases, bad cytogenetics, disease progression while on treatment, as primary treatment (for certain brain tumors and neuroblastoma), illnesses where the bone marrow is the problem (immunodeficiencies, sickle cell), and when there's a good match for a bad disease.

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What is Lymphoma?

A type of blood cancer affecting the lymphatic system, which is responsible for filtering and fighting infection.

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Lymphatic System: Fluid Absorption

The lymphatic system absorbs interstitial fluid, proteins, and cells from surrounding tissues. This helps maintain fluid balance and prevent swelling.

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Lymphatic System: Permeability

The lymphatic system's endothelial cells have unique junctions that allow larger molecules and immune cells to pass through.

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Primary Lymphatic System

The primary lymphatic system produces and matures lymphocytes (B-cells and T-cells), responsible for adaptive immunity.

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Bone Marrow: B-cell Origin

Both B-cells and T-cells originate in the bone marrow, but only B-cells mature there.

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Thymus: T-cell Maturation

T-cells migrate from the bone marrow to the thymus, where they mature and learn to distinguish foreign antigens from self-antigens.

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Secondary Lymphatic System: Lymph Nodes

Lymph nodes filter lymph fluid and contain a high concentration of lymphocytes, playing a crucial role in immune responses.

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Secondary Lymphatic System: Spleen

The spleen filters blood, removing old or damaged red blood cells and recycling iron.

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Secondary Lymphatic System: MALT

Mucosa-associated lymphoid tissue (MALT) protects mucosal surfaces, like the tonsils and Peyer's patches, from pathogens.

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Pure Type Breast Cancer

Breast cancer subtype with mucin surrounding the tumor cells, most common in women over 70.

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Medullary Breast Cancer

Large, encapsulated breast cancer with a lymphocytic infiltrate surrounding it.

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Tubular Breast Cancer

Well-differentiated breast cancer characterized by organized tubules in the center of the tumor.

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Adenoid Cystic Breast Cancer

Breast cancer that arises from the nipple and areola and is well-circumscribed.

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Metaplastic Breast Cancer

Breast cancer with unusual cell types, including bone or cartilage.

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Squamous Cell Breast Cancer

Breast cancer that starts in the epithelial lining of the ducts.

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Papillary Breast Cancer

Breast cancer with many cystic masses, often with bleeding, and potential skin involvement.

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Intraductal Breast Cancer

Well-defined breast cancer within the ducts, characterized by well-differentiated tumor cells.

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Prostate Cancer Risk Factor

Older age is a significant independent risk factor for prostate cancer, increasing the chance of developing the disease.

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Prostate Cancer & Inflammation

Chronic inflammation, including from conditions like autoimmune disease, is associated with an increased risk of prostate cancer.

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Diet & Prostate Cancer

A diet high in char-grilled meats and deficient in vitamins E, D, and calcium may contribute to prostate cancer risk.

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Testosterone & Estrogen in Prostate

As men age, testosterone gets metabolized into estrogen in peripheral tissues, potentially affecting prostate cancer risk by influencing tumor-regulating receptors.

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Senescence & Prostate Cancer

Aging vascular structures, like in the testicular metabolic system, can contribute to chronic inflammation, potentially increasing prostate cancer risk.

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Testosterone Function

Testosterone plays several crucial roles in men, including gonadal development, sperm production, secondary sex characteristics, and muscle mass.

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DHEA & Testosterone in Prostate

DHEA, a precursor to testosterone, is converted to testosterone within the prostate gland. This testosterone can then bind to androgen receptors and contribute to prostate function.

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Aromatase & Prostate Cancer

Aromatase converts testosterone into estrogens. Aromatase inhibitors are used to treat some prostate cancer.

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Androgen Receptors: Second Messenger

When DHT activates androgen receptors, it acts as a second messenger, triggering signals within prostate cells to promote growth and function.

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Prostate Zones & Cancer

The peripheral zone of the prostate contains the majority of prostate cancer cells, while the transitional zone is where benign prostatic hypertrophy typically occurs.

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Estrogen Receptors in Prostate

Estrogen receptors in the prostate gland are predominantly found in the stromal cells, which contain fibrous and muscular tissue.

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Alpha Estrogen Receptors & Prostate Cancer

Alpha estrogen receptors play a role in sperm maturation. Their dysfunction can lead to the development of prostate cancer.

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Epithelial Mesenchymal Transition (EMT)

EMT involves changes in cell polarity, adhesion, morphology, and gene expression, leading to increased invasion and metastasis in prostate cancer.

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Prostatic Intraepithelial Neoplasia (PIN)

PIN is characterized by abnormal cell growth in the prostate, often associated with chronic inflammation and cellular injury.

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MYC Oncogene & Prostate Cancer

The MYC oncogene promotes cell growth and metabolism. Its mutation can contribute to prostate cancer development.

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Study Notes

Cancer Cell Characteristics

  • Normal cells stop growing when enough are present, repair themselves, or die in the cell cycle. They do not spread, and when removed they do not grow back.
  • Cancer cells continue to grow, spread, and invade nearby tissues. They ignore signals to stop growing and dividing. They may grow back if removed, thus making them difficult to treat.

G1/S Checkpoint

  • The TP53 gene acts as a gatekeeper at the G1/S checkpoint.
  • Mutations in TP53 can disrupt proper checkpoint functioning, leading to uncontrolled cell growth.

Cancer Cell Growth

  • Cancer cells can grow without external signals.
  • They can produce their own growth signals (autocrine signaling).
  • They can also disable tumor suppressor genes, which normally act as "off switches" for cell division and growth.
  • These processes lead to uncontrolled growth and chaotic cell division.

Cancer Cell Immortality

  •  Cancer cells evade apoptosis (programmed cell death), allowing them to live and divide indefinitely. This contrasts with normal cells that die after a certain number of divisions.

Cancer Cell Sustained Angiogenesis

  • Tumors require a blood supply to grow and survive.
  • Cancer cells stimulate the growth of new blood vessels (angiogenesis) to supply themselves with oxygen and nutrients.

Cancer Cells Resistance to Treatment

  • Cancer cells are more resistant to treatment like chemotherapy and radiotherapy compared to normal cells due to mutations and adaptations to the environment.

Cancer Cell Necrosis

  • Tumors have limited oxygen supply, causing areas of necrosis.
  • The need for energy leads to glucose uptake and glycolysis, producing lactate.
  • This results in tumor cells lighting up on PET scans.

Importance of developing Circulatory System for Tumors to Live

  • Tumors need to develop a circulatory system to survive and grow.
  • They secrete a growth factor (VEGF) to foster growth of their own oxygen supply.

Cancer Classification

  • Cancers are classified by the tissue of origin and the primary site of development.
  • Six major types include carcinomas, sarcomas, lymphomas, leukemia, and mixed types.

Carcinogens

  • Carcinogens are substances that cause cancer
  • Some examples include asbestos, nickel, cadmium, radon, vinyl chloride, benzidene, and benzene.
  • One potent carcinogen is benzo[a]pyrene, found in cigarette smoke.
  • Viruses and bacteria can cause cancer.

Cancer Treatment

  • Cancer treatment depends on location, size, and histology of tumor.
  • Cancer treatment includes chemotherapy, radiation.
  • Treatment varies depending on the type of solid tumor.

Blood Cancers (Leukemia)

  • Blood cells start as stem cells in the bone marrow.
  • Leukemias occur in three different areas of the body including blood/bone marrow, spinal fluid, and testes.
  • Treatment is often a combination of outpatient and inpatient therapy for an extended period depending on the specific type.

Types of Leukemia

  • Acute lymphoblastic leukemia (ALL): Most common in children.
  • Acute myelogenous leukemia(AML): Second most common, mostly inpatient treatment, commonly requires bone marrow transplant if relapse occurs.
  • Chronic myelogenous leukemia (CML): Characterized by specific genetic markers.

Lymphomas

  • Hodgkin's lymphoma is similar to the adult form but peaks during childhood and young adulthood. The majority of cases can be cured (90-95%).
  • Non-Hodgkin's Lymphoma.  Includes several types of cancer of the lymphatic system.

Brain Tumors

  • Treatments vary depending on the location and size of the tumor and its histology.
  • This includes Astrocytomas, Gliomas, etc.

Radiation Therapy

  • Dose and type depend on cancer type and location.
  • External or internal placement is common.
  • The use of radiation is specific to the type of cancer.

DNA damage and mutations-

  • Cancer development involves DNA damage and genetic mutations.
  • Mutations in genes like BRCA1, BRCA2, and others cause significant predisposition.

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