Podcast
Questions and Answers
What is a key role of the adenomatous polyposis coli tumor-suppressor gene (APC)?
What is a key role of the adenomatous polyposis coli tumor-suppressor gene (APC)?
- Cell adhesion
- Regulation of β-catenin (correct)
- Inhibition of apoptosis
- Promotion of cell migration
Which of the following alterations does the dysregulation of APC NOT affect?
Which of the following alterations does the dysregulation of APC NOT affect?
- Migration
- Differentiation
- Cell-cycle progression
- Nutrient uptake (correct)
Which cancer syndrome is typically associated with hereditary nonpolyposis colorectal cancer (HNPCC)?
Which cancer syndrome is typically associated with hereditary nonpolyposis colorectal cancer (HNPCC)?
- Li-Fraumeni syndrome
- Cowden syndrome
- Lynch syndrome (correct)
- Tubular adenoma syndrome
At what age is early onset of colorectal cancer typically observed in Lynch syndrome?
At what age is early onset of colorectal cancer typically observed in Lynch syndrome?
What is required for the formation of a malignant tumor compared to a benign tumor?
What is required for the formation of a malignant tumor compared to a benign tumor?
Which of the following is NOT included in the high-risk profiles associated with Lynch syndrome?
Which of the following is NOT included in the high-risk profiles associated with Lynch syndrome?
Which phase of the cell cycle allows preparation for DNA replication?
Which phase of the cell cycle allows preparation for DNA replication?
What is the Amsterdam criteria used for?
What is the Amsterdam criteria used for?
What denotes the normal counterpart of an oncogene?
What denotes the normal counterpart of an oncogene?
How can oncogenes be activated or overexpressed?
How can oncogenes be activated or overexpressed?
Which gene was the first tumor suppressor to be cloned?
Which gene was the first tumor suppressor to be cloned?
What is the function of growth factors in relation to oncogenes?
What is the function of growth factors in relation to oncogenes?
Which of the following is a physiological process regulated by alterations in APC?
Which of the following is a physiological process regulated by alterations in APC?
Which aspect of tumor cells allows them to bypass the quiescent state?
Which aspect of tumor cells allows them to bypass the quiescent state?
What is indicated by the prefix 'v-' in oncogene nomenclature?
What is indicated by the prefix 'v-' in oncogene nomenclature?
In which phase do cells exit to enter a quiescent state?
In which phase do cells exit to enter a quiescent state?
Which of the following is NOT a role of the Rb protein in normal development?
Which of the following is NOT a role of the Rb protein in normal development?
What characteristic is associated with the diagnosis of HNPCC-related cancers?
What characteristic is associated with the diagnosis of HNPCC-related cancers?
What is the consequence of the RET gene being associated with multiple endocrine neoplasia type 2?
What is the consequence of the RET gene being associated with multiple endocrine neoplasia type 2?
Which statement accurately describes the inheritance pattern of retinoblastoma in children?
Which statement accurately describes the inheritance pattern of retinoblastoma in children?
What is a significant indicator for diagnosis related to familial cancer syndromes?
What is a significant indicator for diagnosis related to familial cancer syndromes?
Which of the following is a definitive requirement for confirming HNPCC criteria?
Which of the following is a definitive requirement for confirming HNPCC criteria?
How does the Rb protein contribute to cellular processes?
How does the Rb protein contribute to cellular processes?
Which factor is NOT relevant to the specification of HNPCC-associated cancers?
Which factor is NOT relevant to the specification of HNPCC-associated cancers?
What is the primary goal of surgical therapy in cancer treatment?
What is the primary goal of surgical therapy in cancer treatment?
What must surgeons understand in addition to performing cancer operations?
What must surgeons understand in addition to performing cancer operations?
What does a negative surgical margin indicate?
What does a negative surgical margin indicate?
What are second-echelon nodes in the context of cancer metastasis?
What are second-echelon nodes in the context of cancer metastasis?
Which factor is crucial in determining the operability of a tumor?
Which factor is crucial in determining the operability of a tumor?
What might cause false negative biopsy results?
What might cause false negative biopsy results?
Which therapy can decrease local recurrence rates in cases with positive margins?
Which therapy can decrease local recurrence rates in cases with positive margins?
What is a significant complication of preoperative chemotherapy and radiation therapy?
What is a significant complication of preoperative chemotherapy and radiation therapy?
Which model is used for estimating the likelihood of a BRCA mutation being present?
Which model is used for estimating the likelihood of a BRCA mutation being present?
What is the primary purpose of prognostic markers in cancer assessment?
What is the primary purpose of prognostic markers in cancer assessment?
Which of the following is NOT a risk factor used in the Gail Model for breast cancer risk assessment?
Which of the following is NOT a risk factor used in the Gail Model for breast cancer risk assessment?
MammaPrint is used in the context of what aspect of breast cancer treatment?
MammaPrint is used in the context of what aspect of breast cancer treatment?
What distinguishes predictive tissue markers from prognostic markers?
What distinguishes predictive tissue markers from prognostic markers?
Which assay is specifically highlighted for predicting recurrence in node-negative, ER-positive breast cancer?
Which assay is specifically highlighted for predicting recurrence in node-negative, ER-positive breast cancer?
What is a critical benefit of early cancer screening as stated?
What is a critical benefit of early cancer screening as stated?
What is the main goal of targeted therapies in molecular therapeutics?
What is the main goal of targeted therapies in molecular therapeutics?
Which tumor marker is specifically associated with identifying patients who may benefit from anti-HER2 therapies?
Which tumor marker is specifically associated with identifying patients who may benefit from anti-HER2 therapies?
Which of the following is not classified as a major group of targeted therapy agents?
Which of the following is not classified as a major group of targeted therapy agents?
What is a primary characteristic of protein kinase inhibitors in cancer treatment?
What is a primary characteristic of protein kinase inhibitors in cancer treatment?
What is the function of the BOADICEA model in breast cancer assessment?
What is the function of the BOADICEA model in breast cancer assessment?
Which of the following statements regarding tumor markers is false?
Which of the following statements regarding tumor markers is false?
Which of the following statements about Trastuzumab (Herceptin) is correct?
Which of the following statements about Trastuzumab (Herceptin) is correct?
What mechanism does non-specific immunotherapy primarily utilize?
What mechanism does non-specific immunotherapy primarily utilize?
Which option highlights a common misconception about cancer screening?
Which option highlights a common misconception about cancer screening?
What major factor influences cancer screening guidelines?
What major factor influences cancer screening guidelines?
What role do tumor-associated antigens play in cancer treatment?
What role do tumor-associated antigens play in cancer treatment?
Which of the following markers is primarily involved in predicting outcomes related to anti-estrogen therapies?
Which of the following markers is primarily involved in predicting outcomes related to anti-estrogen therapies?
Which of the following describes a potential application of gene therapy in cancer treatment?
Which of the following describes a potential application of gene therapy in cancer treatment?
Which compound is associated with the treatment of Melanoma?
Which compound is associated with the treatment of Melanoma?
What is the significance of the Tyrer-Cuzick model in breast cancer risk assessment?
What is the significance of the Tyrer-Cuzick model in breast cancer risk assessment?
Flashcards
Oncogene
Oncogene
A gene that, when mutated or overexpressed, contributes to cancer development.
Proto-oncogene
Proto-oncogene
The normal, non-mutated version of an oncogene. It plays a role in normal cell growth and regulation.
Cell cycle proteins
Cell cycle proteins
These genes can influence how the cell cycle progresses, potentially leading to unregulated cell growth and proliferation.
Growth factors
Growth factors
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Growth Factor Receptors
Growth Factor Receptors
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Intracellular signal transduction Proteins
Intracellular signal transduction Proteins
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Nuclear Transcription Factors
Nuclear Transcription Factors
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Cell Cycle
Cell Cycle
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APC protein
APC protein
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Hereditary Nonpolyposis Colorectal Cancer (HNPCC)
Hereditary Nonpolyposis Colorectal Cancer (HNPCC)
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Amsterdam Criteria
Amsterdam Criteria
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Lynch Syndrome
Lynch Syndrome
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Lynch Syndrome: Associated Cancers
Lynch Syndrome: Associated Cancers
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APC gene: Tumor Suppressor
APC gene: Tumor Suppressor
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APC Mutations: Effects
APC Mutations: Effects
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RB1 gene
RB1 gene
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Multiple Endocrine Neoplasia Type 2 (MEN2)
Multiple Endocrine Neoplasia Type 2 (MEN2)
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Retinoblastoma
Retinoblastoma
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Cell cycle arrest
Cell cycle arrest
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Apoptosis
Apoptosis
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Multimodal Cancer Therapy
Multimodal Cancer Therapy
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Alternatives to Cancer Surgery
Alternatives to Cancer Surgery
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Complications of Pre- and Post-Op Chemo/RT
Complications of Pre- and Post-Op Chemo/RT
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Negative Surgical Margin
Negative Surgical Margin
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Inoperable Disease
Inoperable Disease
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Operability Assessment
Operability Assessment
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Second-Echelon Lymph Nodes
Second-Echelon Lymph Nodes
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Treatment of Distant Metastases
Treatment of Distant Metastases
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Tumor marker
Tumor marker
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Prognostic marker
Prognostic marker
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Predictive tissue marker
Predictive tissue marker
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Risk assessment model
Risk assessment model
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Cancer screening
Cancer screening
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Gail model
Gail model
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Estrogen receptor (ER)
Estrogen receptor (ER)
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HER2
HER2
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Oncotype DX
Oncotype DX
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MammaPrint
MammaPrint
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MIND-ACT trial
MIND-ACT trial
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BRCA mutation
BRCA mutation
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BRCAPRO model
BRCAPRO model
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Tyrer-Cuzick model
Tyrer-Cuzick model
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BOADICEA model
BOADICEA model
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Targeted Therapy
Targeted Therapy
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Immunotherapy
Immunotherapy
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Protein Kinases
Protein Kinases
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Inhibitors of Intracellular Signal Transduction
Inhibitors of Intracellular Signal Transduction
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Cell Cycle Inhibitors
Cell Cycle Inhibitors
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Non-Specific Immunotherapy
Non-Specific Immunotherapy
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Gene Therapy
Gene Therapy
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Anti-angiogenic Compounds
Anti-angiogenic Compounds
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Study Notes
Surgical Oncology
- Surgical oncology is a crucial part of surgical practice, responsible for initial diagnosis and management of solid tumors.
- Surgeons need knowledge of cancer epidemiology, etiology, staging, and natural history to assess patients and select optimal surgical therapy.
- The primary surgical therapy involves definitive en bloc resection of tumors with adequate margins of healthy tissue and regional lymph nodes.
- Adjuvant therapy follows, involving radiation therapy, chemotherapy, immunotherapy, or hormonal therapy.
- Modern cancer therapy is multidisciplinary, including surgeons, medical oncologists, radiation oncologists, reconstructive surgeons, pathologists, radiologists, and primary care physicians.
- Personalized care incorporates patient tumor characteristics, genome, host immune response, and tumor microenvironment, requiring understanding of molecular oncology.
Epidemiology of Cancer
- Cancer incidence varies geographically due to genetic differences and environmental/dietary exposures.
- Incidence represents new cases per 100,000 persons per year.
- Mortality represents deaths per 100,000 persons per year.
- Cohort studies follow a disease-free group over time to measure disease development.
- Case-control studies compare patients with and without a disease to identify risk factor relationships.
- Relative risk below 1 indicates a protective effect, while above 1 indicates an increased risk.
Cancer Biology
- Over 100 cancer types share these six essential alterations for malignant growth:
- Self-sufficiency of growth signals
- Insensitivity to growth-inhibitory signals
- Evasion of apoptosis (programmed cell death)
- Potential for limitless replication
- Angiogenesis
- Invasion and metastasis
Cell Proliferation and Transformation
- Normal cells have strict growth control, unlike cancer cells which lack this control.
- Cancer cell transformation requires multiple genetic changes.
- Transformed cells often display abnormal characteristics: loss of contact inhibition, altered appearance/adherence, loss of anchorage dependence, immortalization, and tumorigenicity.
Cell Cycle Dysregulation in Cancer
- Mutations affecting cell cycle proteins, growth factors, growth factor receptors, intracellular signal transduction proteins, and nuclear transcription factors cause unregulated cell growth.
- The cell cycle phases (G1, S, G2, and M) are disrupted.
Oncogenes
- Oncogenes are abnormal genes linked to cancer formation.
- Their normal counterparts are proto-oncogenes.
- Oncogenes are often triggered by translocation, promoter insertion, mutation, or amplification.
Apoptosis and Autophagy
- Apoptosis is a genetically controlled cell-death process.
- Cancer cells often evade apoptosis for tumor growth.
- Caspases, intrinsic/extrinsic pathways, and Bcl-2 family proteins are key components.
- Autophagy also contributes to cancer cell elimination.
Cancer Invasion
- A hallmark is the ability to invade surrounding normal tissue.
- In situ cancer cells remain within the basement membrane.
- Invasive cancer cells breach the basement membrane and enter the surrounding stroma.
- Cadherins and cell-surface proteins affect adhesion and migration.
- Extracellular matrix components (ECM) regulate migration through integrin interactions
- Angiogenesis, the formation of new blood vessels, is crucial for tumor growth and metastasis
Cancer Etiology and Genomics
- Cancer is a genetic disease stemming from genomic alterations.
- Alterations involve gain-of-function in oncogenes and loss-of-function in tumor suppressor genes.
- Somatic mutations occur within the tumor only, germinal mutations are inherited.
Genes Associated with Hereditary Cancer Risk
- Genes like BRCA1/2, APC, and others are involved in hereditary risk.
- Factors indicating hereditary cancer risk include :early-onset, bilateral, multiple cancers in a family, cancer in the less affected sex and cancer cluster in relatives.
- Hereditary cancers frequently affect multiple tissues.
Viral Carcinogens
- Certain viruses contribute to cancer development through various mechanisms (including direct transformation and cytokine secretion), including: Epstein-Barr, Hepatitis B, C, HIV, Human herpes virus 8, human papillomaviruses, Human T-cell Lymphotropic viruses.
Cancer Diagnosis
- Physical examination, imaging, and tissue biopsies (fine needle aspiration, core needle, incisional and excisional) are used to diagnose cancer.
- Serum markers and tissue pathology assessment are used to evaluate cancer type.
- Staging is essential for treatment planning. Different diagnostic methods will vary depending on type of tissue involved.
Radiation Therapy
- Ionizing radiation removes orbital electrons from atoms via electromagnetic or particulate radiation (e.g., X-rays, gamma rays).
- This damages DNA through single- and double- strand breaks.
- Varying radiation types penetrate tissue to varying depths and are used based on particular types of tumors.
Chemotherapy
- Chemotherapy targets cancer cells via first-order kinetics.
- This eliminates a fixed percentage of cells rather than a constant number of cells.
Hormone Therapy
- Some tumors develop under hormonal control.
- This is targeted by hormone therapies.
- Hormonal manipulation (e.g., drugs stopping production or affecting hormone receptors) are used.
Immunotherapy
- Immune responses to cancer cells are manipulated.
- This approach can involve non-specific immunostimulation or more targeted treatments.
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