Cancer Pathophysiology

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Questions and Answers

What is the term for the study of all forms of cancer?

Carcinoma

Carciogenesis

Pathophysiology

Oncology (correct)

What is the process by which a normal cell becomes a cancer cell?

Tumor formation

Carcinogenesis (correct)

Oncogenesis

Apoptosis

What percentage of all cancers are believed to be caused by inherited genetic alterations?

1%-5%

5%-10% (correct)

15%-20%

20%-25%

What is the term for altered genes that promote tumor growth and change programmed cell death?

Oncogenes Signup and view all the answers

What is the term for a physical, chemical, or viral agent that induces cancer?

Carcinogen Signup and view all the answers

What is the term for the transformation of cells produced by the interaction of chemicals, radiation, or viruses with DNA?

Initiation Signup and view all the answers

What is the term for new and abnormal tissue with no useful function?

Neoplasm Signup and view all the answers

What is the third phase of carcinogenesis?

Progression Signup and view all the answers

What is the primary goal of cancer treatment when a cure is not possible?

Control tumor growth Signup and view all the answers

What is a major factor that affects response to cancer treatment?

Tumor burden Signup and view all the answers

What is the term for a complete response to cancer treatment?

Cure Signup and view all the answers

What is the primary focus of hospice care?

Relieving symptoms and providing support Signup and view all the answers

What occurs when tumors grow and become resistant to therapy?

Drug resistance Signup and view all the answers

What is assessed as part of a patient's overall response to cancer treatment?

Symptoms, weight status, and laboratory studies Signup and view all the answers

What is necessary for a cancer to metastasize?

It must develop its own blood supply Signup and view all the answers

What percentage of causal factors for cancer is attributed to nutrition and diet?

35% Signup and view all the answers

What type of compounds can form when grilling meat?

Polycyclic aromatic hydrocarbons Signup and view all the answers

What is the term for the process by which tumors release substances to aid in the development of new blood vessels?

Tumor angiogenesis Signup and view all the answers

Which of the following nutrients can promote or alter gene expression?

Nutrients during pregnancy, childhood, and throughout a lifetime Signup and view all the answers

What is the result of combining alcohol consumption with tobacco use?

The risk of cancer is higher than for alcohol or tobacco alone Signup and view all the answers

Which of the following is NOT an inhibitor of carcinogenesis?

Fat in red meat Signup and view all the answers

What is the effect of malnutrition associated with alcoholism on cancer risk?

It increases the risk of certain cancers Signup and view all the answers

What is recommended to evaluate fully nutrition status and degree of risk?

A nutrition-focused physical examination Signup and view all the answers

Why do energy needs increase?

In the presence of fever, stress, infection, and metabolic complication Signup and view all the answers

What is the primary reason for increased protein needs in a catabolic client?

To repair and rebuild tissues Signup and view all the answers

How are daily protein requirements generally calculated?

Using actual body weight Signup and view all the answers

What is a sign of dehydration?

Fatigue Signup and view all the answers

What is the recommended fluid intake in terms of calories?

1 ml/ kcal Signup and view all the answers

What is the purpose of a standard multivitamin and mineral supplement?

To support individuals experiencing difficulty with eating and treatment-related side effects Signup and view all the answers

What is the primary goal of oral nutrition management strategies?

To support oral feeding Signup and view all the answers

What is the purpose of liquid medical food supplements in cancer treatment?

To maintain weight and nutrition status Signup and view all the answers

Which of the following is a common problem associated with cancer treatment?

Alterations in taste and smell Signup and view all the answers

What is the result of tumor-induced increased demand for glucose?

Increased anaerobic glycolysis and lactate production Signup and view all the answers

What is characterized by progressive weight loss, anorexia, and wasting?

Cancer cachexia Signup and view all the answers

What is the role of pro-inflammatory cytokines in cancer cachexia?

They play a role in cancer cachexia Signup and view all the answers

What is the result of increased lipolysis in cancer cachexia?

Increased loss of adipose tissue Signup and view all the answers

What is the effect of lipid-mobilizing factor and proteolysis-inducing factor secreted by tumor cells?

Increased loss of fat and muscle mass Signup and view all the answers

What is the relationship between cancer cachexia and death?

Cancer cachexia increases before death Signup and view all the answers

Study Notes

Carcinogenesis and Pathophysiology

Carcinogenesis is the development of cancer
Oncogenes are altered genes that promote tumor growth and change programmed cell death (apoptosis)
Tumor suppressor genes are the opposite of oncogenes; these genes become deactivated in cancer cells
Approximately 5%-10% of all cancers have been shown to occur as a result of inherited genetic alterations

Phases of Cancer

A carcinogen is a physical, chemical, or viral agent that induces cancer
Carcinogenesis is a biologic, multistage process that proceeds on a continuum in three distinct phases: initiation, promotion, and progression
Initiation involves transformation of cells produced by the interaction of chemicals, radiation, or viruses with DNA
Transformation occurs rapidly, but cells can remain dormant for a variable period until they are activated by a promoting agent
During promotion, initiated cells multiply and escape the mechanisms set in place to protect the body from the growth and spread of such cells
A neoplasm, new and abnormal tissue with no useful function, is established
In the third phase (progression), tumor cells aggregate and grow into a fully malignant neoplasm or a tumor
In the process known as metastasis, the neoplasm has the capacity for tissue invasion that can spread to distant tissues and organs

Etiology

Nutrition may modify the carcinogenic process at any stage, including carcinogen metabolism, cellular and host defense, cell differentiation, and tumor growth
Gene expression can be promoted or altered by nutrients during pregnancy, childhood, and throughout a lifetime
Thus, nutrition and diet contribute approximately 35% to causal factors for cancer
Food preparation and preservation methods may also provide dietary carcinogens
Diets contain both inhibitors and enhancers of carcinogenesis
Inhibitors: antioxidants (vit C, vit E, selenium, carotenoids), phytochemicals (anthocyanins, lycopene, indoles, sulforaphanes)
Enhancers: fat in red meat, polycyclic aromatic hydrocarbons that form with grilling meat, alcohol

Treatment and Response

Goals of treatment: cure, control, palliate
Factors that affect response: tumor burden, rate of tumor growth, drug resistance, comorbid diseases
Response to treatment: complete or partial response (improvement), stable disease (stable), disease progression (worsening)

Nutrition and Cancer

Nutrition-focused physical examination is recommended to evaluate fully nutrition status and degree of risk
Energy needs increase in the presence of fever, stress, infection, metabolic complication, and tumor burden
Protein needs increase because of metabolic stress and illness, with requirements of 1.2g/kg/day or more
Vitamins, minerals, and supplementation: controversial studies, standard multivitamin and mineral supplement recommended
Nutrition intervention strategies: oral nutrition management, food and presentation modification, liquid medical food supplements, managing anorexia and alterations in taste and smell

Cancer Cachexia

Tumor increases demand for glucose, leading to anaerobic glycolysis and lactate production
Protein breakdown and lipolysis increase to compensate for glucose need and energy needs
Glucose intolerance and insulin resistance occur
Loss of protein: amino acids are taken by the tumor to increase in size
Cancer cachexia is characterized by progressive weight loss, anorexia, wasting, weakness, immunosuppression, and abnormal fluid and energy metabolism

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Description

Learn about the origin and development of cancer, including carcinogenesis, oncology, oncogenes, and tumor suppressor genes. Understand the role of gene function changes in transforming normal cells into cancerous cells.