PATH 2300 Week 4

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Questions and Answers

Which of the following best describes the term 'neoplasia'?

Abnormal, disorganized growth in a tissue or organ, forming a mass. (correct)

Normal, well-organized cell growth in a tissue or organ.

A specific type of malignant growth that has metastasized.

A benign growth that always has a life-threatening impact.

What is a primary characteristic that distinguishes a malignant neoplasm from a benign one?

The presence of angiogenesis and potential for metastasis. (correct)

A slow, non-invasive growth pattern.

Lack of potential to cause any physical harm.

The ability to perform normal cellular functions.

What does the concept of 'in situ' refer to in the context of neoplasms?

A tumor that is rapidly growing and causing severe symptoms.

A tumor that is confined to its original location. (correct)

A tumor that has metastasized to a distant location.

A tumor that is actively being removed via surgery.

Which of these is NOT typically a local effect of a benign neoplasm?

Metastasis to distant organs. (B) Signup and view all the answers

What is a primary factor that determines the stage of cancer and often dictates the course of treatment?

How much the cancer has spread. (D) Signup and view all the answers

A tumor originating from smooth muscle tissue would be described with which prefix?

leiomyo- (A) Signup and view all the answers

A malignant tumor of epithelial tissue is classified as a:

carcinoma (B) Signup and view all the answers

Which of the following best describes a tumor with the prefix 'lip-'?

A benign tumor of adipose tissue (B) Signup and view all the answers

What is the term for a malignant tumor of smooth muscle?

leiomyosarcoma (C) Signup and view all the answers

Which of these is NOT a characteristic of cancer cells?

Controlled replicative potential (B) Signup and view all the answers

The process of carcinogenesis primarily involves which of the following?

A multistage process of genetic damage (mutations) affecting the cell cycle (B) Signup and view all the answers

What is the function of proto-oncogenes in cells?

To activate cell growth and division (B) Signup and view all the answers

Which outcome would be a result of a mutated tumor suppressor gene?

Uncontrolled cell cycle progression (A) Signup and view all the answers

What is the role of the p53 gene?

To produce a protein involved in DNA repair, growth inhibition, and apoptosis (C) Signup and view all the answers

What is meant by 'metastasis' in the process of cancer spread?

The spread of cancer cells to a distant site from the primary tumor (B) Signup and view all the answers

Which of the following is considered a common route for distant metastases?

Via lymphatic channels (A) Signup and view all the answers

What does 'trans-coelomic spread' typically refer to in metastasis?

Seeding of cancer cells through body cavities (C) Signup and view all the answers

Which of the following can promote angiogenesis?

Tumor cells (C) Signup and view all the answers

Why is cancer more common with age?

Because there are more mutations and errors as we age (B) Signup and view all the answers

What is the implication of a single amino acid change in the Ras protein?

It converts Ras into an oncogene, always signalling the nucleus to divide (C) Signup and view all the answers

What is the primary characteristic of occult breast cancer (OBC)?

Axillary lymph node metastasis without an identifiable primary tumor in the breast. (A) Signup and view all the answers

Which of the following is NOT a typical cause of pain experienced by cancer patients?

Decreased metabolic toxin production. (D) Signup and view all the answers

A patient experiences early satiety, weight loss, and anemia. Which cancer-related syndrome are they most likely exhibiting?

Cachexia (A) Signup and view all the answers

Which of these is NOT typically considered a cause of anemia in cancer patients?

Increased red blood cell production (B) Signup and view all the answers

What is a key characteristic of paraneoplastic syndromes?

They are the result of hormone production by cancerous cells. (D) Signup and view all the answers

What is the primary goal of cancer screening?

To identify cancer in asymptomatic individuals. (D) Signup and view all the answers

Which of the following is NOT a common method used for cancer screening?

Radiation therapy. (D) Signup and view all the answers

What is the main purpose of multiple doses in radiation therapy?

To minimize damage to healthy cells and increase cell death during division. (D) Signup and view all the answers

Which characteristics of a cancer would make it suitable to treat with chemotherapy?

Widespread, fast-growing cancer or those with micro-metastasis. (D) Signup and view all the answers

What is the primary reason for using a combination of chemotherapy drugs?

To attack cancer cells more effectively using multiple modes of action. (C) Signup and view all the answers

What does the therapeutic index of a drug indicate?

The ratio of drug dose required to kill cancer cells, to the dose that is harmful to normal cells. (D) Signup and view all the answers

Which of the following is NOT a common side effect of therapies like chemotherapy and radiotherapy?

Increased red blood cell production. (A) Signup and view all the answers

What factor has been identified as a potential unfavorable prognostic indicator for those with Occult Breast Cancer?

Older age at diagnosis (D) Signup and view all the answers

What does the term organ tropism refer to in the context of cancer metastasis?

The preference of cancer cells to metastasize to specific organs. (D) Signup and view all the answers

What is the importance of using a systemic treatment such as chemotherapy?

It ensures effective coverage of the body without being limited to one location. (A) Signup and view all the answers

Study Notes

Cancer: A Disease of Cell Growth, Division, and Differentiation

Cancer is a class of diseases characterized by altered differentiation, uncontrolled cell division, and genetic mutations.
Prostate cancer is most common in males, and breast cancer is most common in females.

Neoplasia

A tumor is an abnormal growth of tissue, not necessarily cancerous.
Neoplasia is abnormal, disorganized growth forming a neoplasm (benign or malignant).
Cancer is malignant growth, not benign.
In situ means the growth is in the same place.

Classifying Neoplasms

Benign Neoplasms

Benign cells may perform normal functions.
They are not life-threatening.
Local effects can range from minor to lethal, including occupying space, obstructing blood flow or air flow, obstructing passages, compressing healthy tissue, ulcerating, becoming infected, or hemorrhaging.

Malignant Neoplasms

Malignant cells are anaplastic (undifferentiated).
They are more aggressive and invasive compared to benign neoplasms.
A characteristic clinical course progresses rapidly to metastasis and death.
Angiogenesis is the formation of new blood vessels crucial for tumor growth.

Staging of Cancers

Cancer stage indicates the extent of spread.
Staging is a significant predictor of survival.
Treatment often depends on the cancer stage.
Two common methods are the TNM system (tumor, nodes, metastases) and the stages 0-IV system.

Cancer Names (Tumour Nomenclature)

The prefix for a tumor's name depends on the tissue of origin (e.g., leiomyo- for smooth muscle).
Benign tumors are named with the prefix + oma (e.g., leiomyoma).
Malignant tumors are named with the prefix + carcinoma (for epithelial tissue) or sarcoma (for mesenchymal tissue).
Adenoma is a benign glandular tumor.
Squamous cell carcinoma is a malignant squamous epithelial tumor.
Fibrosarcoma is a malignant fibrous connective tissue tumor.
Chondroma is a benign cartilaginous tumor.
Leiomyosarcoma is a malignant smooth muscle tumor.
Melanoma is a malignant melanocyte tumor.

Characteristics of Cancer Cells

Cancer cells exhibit several abnormalities:
- Loss of differentiation (anaplasia).
- Genetic instability.
- Growth factor independence.
- Autonomous behavior (loss of connections with neighbors).
- Limitless replicative potential (cells don't age).
- Avoidance of apoptosis (programmed cell death).
- Promotion of angiogenesis.
- Tissue invasion and metastasis.

Genetics and Environmental Basis of Cancer

Cancer development is a multistage process involving genetic damage.
Most cancers arise spontaneously, but frequency of mutation increases with exposure to carcinogens (e.g., cigarette smoke).
The cell cycle is crucial to cancer development.

Cell Cycle Control

Proto-oncogene activation leads to inappropriate cell growth and division (dominant mutation).
Tumor suppressor gene inactivation prevents the normal arrest of cell cycle progression (recessive mutation).
Proto-oncogenes are normal genes that activate cell growth and division (example: VEGF, EGFR, transcription factors).
Oncogenes are mutated proto-oncogenes that always remain "on," driving tumor formation.
A gain of function in proto-oncogenes causes tumor formation.

Tumor Suppressor Genes

Tumor suppressor genes produce proteins that inhibit growth, enhance differentiation, promote DNA repair, and induce apoptosis.
Loss of function in tumor suppressor genes causes tumor formation.
- Example genes: p53, Rb, BRCA1

Ras Protein

Located on the plasma membrane, Ras conveys growth factor signals to the nucleus.
Mutations make Ras an oncogene, always signaling cell division.
Present in about 30% of human cancers.

p53 (Tumor Suppressor Gene)

A key tumor suppressor gene.
Produces p53 protein that activates DNA repair, growth inhibition, and apoptosis.

Tumor Heterogeneity

Tumors vary in their genetic makeup and behavior (heterogeneity).

Gene-Environment Interaction

Environmental factors influence cancer development.
Lifestyle and environmental factors explain varied cancer rates internationally.

Metastasis

Metastasis is the spread of cancer cells from a primary tumor to a distant site.
Cancer cells detach from the primary tumor, travel to a distant site, and form a secondary mass..
Pathways include seeding, lymphatic spread, and hematogenous spread.

Metastatic Distribution

Organ tropism (selection) exists, as certain cancer cells specialize in metastasizing to specific organs.
The environment of the secondary site could predict metastasis.

Clinical Manifestations of Cancer

Symptoms vary by location and extent of cancer.
Early stages are often asymptomatic.

Local Effects

Disrupts tissue integrity and function.
Can produce destructive enzymes and toxins.
Effusion (fluid buildup) near serous membranes is common.

Pain

Usually absent in early stages.
Common in advanced cancer.
Caused by pressure, obstruction, invasion, stretching of visceral surfaces, infections, inflammation, or tissue death.

Fatigue

A common cancer symptom.
Can be caused by the cancer or treatment.

Cachexia

Severe malnutrition, loss of fat and muscle, and a common cause of cancer-related death.
Includes anorexia, early satiety, taste alterations, weight loss, anemia, asthenia, and increased infection risk.

Anemia

Caused by chronic bleeding, malnutrition, bone marrow impairment, or therapy.

Leukopenia, Thrombocytopenia

Reduced white blood cell and platelet counts, increasing the risk of infection.

Infection

A significant cancer complication.
Increased risk due to weakened immunity, malnutrition, and treatment.

Paraneoplastic Syndromes

Manifestations in areas not directly affected by the cancer.
Cancer cells may produce hormones or other substances with systemic effects.

Cancer Screening and Treatment

Early identification improves cancer outcomes.
Screening includes observation, palpation, imaging, blood tests, and cytologic/histologic methods.

Surgery

Surgery in cancer management involves diagnosis, prevention, treatment, and palliation.

Radiation

High-energy radiation precisely targets tumor tissue.
Damages DNA to kill cancer cells.

Chemotherapy

Systemic treatment for widespread, rapidly growing tumors.
Uses cytotoxic drugs that target critically important cellular machinery/ pathways.

Side Effects of Chemotherapy and Radiotherapy

Rapidly dividing cells are the primary targets, potentially affecting bone marrow, the gastrointestinal tract, hair, skin, and the reproductive system.

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