Neoplasia III: Tumour Development

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Questions and Answers

What is one of the intrinsic factors that can contribute to the development of tumors?

  • Alterations in the genetic code (correct)
  • Asbestos exposure
  • Chemicals such as nitrosamines
  • Exposure to UV radiation

Which of the following is a familial condition associated with an increased risk of tumors?

  • Chronic atrophic gastritis
  • Xeroderma pigmentosum (correct)
  • Cirrhosis
  • Ulcerative colitis

Which condition is associated with defective DNA repair mechanisms related to sensitivity to radiation damage?

  • Retinitis pigmentosa
  • Ataxia telangiectasia (correct)
  • Li Fraumeni syndrome
  • Familial breast/ovarian cancer

Which stage of carcinogenesis involves the advancement of initiated cells into a pre-malignant state?

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

What role do oncogenes play in neoplasia?

<p>They promote uncontrolled cell division. (C)</p> Signup and view all the answers

What is the primary gene involved in Familial breast/ovarian cancer?

<p>BRCA1 (A)</p> Signup and view all the answers

What type of damage can low doses of radiation primarily cause?

<p>Genomic instability (A)</p> Signup and view all the answers

Which of the following is NOT an extrinsic factor contributing to tumor development?

<p>Inherited gene mutations (C)</p> Signup and view all the answers

Which tumor suppressor gene is mentioned in relation to neoplasia?

<p>p53 (D)</p> Signup and view all the answers

Which chemical agent is an example of a direct-acting carcinogen?

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

What condition is associated with a higher risk of developing malignant tumors?

<p>Hashimoto’s thyroiditis (D)</p> Signup and view all the answers

In the context of chemical carcinogenesis, what is the role of a promoter?

<p>To induce tumors in previously initiated cells (D)</p> Signup and view all the answers

What is the mechanism by which radiation exposure can lead to different types of DNA damage?

<p>By inducing both single and double stranded breaks (B)</p> Signup and view all the answers

Which agent is linked to the development of cancer through its action as a carcinogen?

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

Which gene is altered in hereditary non-polyposis colon cancer (HNPCC)?

<p>Mismatch repair genes (A)</p> Signup and view all the answers

What type of cancer risk is increased in children undergoing radiotherapy for head and neck cancers?

<p>Thyroid carcinoma (C)</p> Signup and view all the answers

What type of cancer is primarily associated with polynuclear aromatic hydrocarbons such as coal tar and cigarette smoke?

<p>Lung cancer (A)</p> Signup and view all the answers

Which chemical is converted into an active form by hydroxylation, leading to its cancer-causing potential?

<p>3,4-Benzpyrene (C)</p> Signup and view all the answers

Which virus is associated with the development of Burkitt's lymphoma?

<p>Epstein Barr (A)</p> Signup and view all the answers

Which of the following factors contributes to increased incidence of malignant tumors based on geographical variation?

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

Which substance is associated with mesothelioma?

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

Which of the following is a characteristic of oncogenes?

<p>They are mutated forms of normal proto-oncogenes. (A)</p> Signup and view all the answers

Accumulating genetic lesions in tumor cells often involve which type of genetic changes?

<p>Point mutations, deletions, and translocations (D)</p> Signup and view all the answers

What host factor is associated with an increased risk of cancer as age increases?

<p>Cumulative exposure to carcinogens (C)</p> Signup and view all the answers

What is the primary role of tumour suppressor genes?

<p>To suppress cell growth (A)</p> Signup and view all the answers

Which gene is commonly associated with hereditary breast cancer susceptibility?

<p>BRCA1 (B)</p> Signup and view all the answers

What type of cancer is linked to mutations in the p53 gene?

<p>More than 50% of cancers (D)</p> Signup and view all the answers

Which mechanism involves a long time between stimulus exposure and cancer emergence?

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

Familial retinoblastoma is characterized by which of the following?

<p>It can lead to osteosarcoma in teens (D)</p> Signup and view all the answers

What happens to DNA repair gene mutations in relation to oncogenes?

<p>They lead to increased mutation rates affecting other genes (B)</p> Signup and view all the answers

Which of the following describes the role of the c-erbB-2 (HER-2) gene?

<p>It serves as a growth factor receptor (C)</p> Signup and view all the answers

What is the relationship between the accumulation of gene alterations and cancer development?

<p>Accumulation of alterations leads to neoplastic cells (B)</p> Signup and view all the answers

Flashcards

What causes cancer?

Genetic alterations or mutations in the DNA code are responsible for the development of tumors or cancer.

Extrinsic Factors

Factors that originate outside the body, like carcinogens, chemicals, radiation, and certain viruses, can cause cancer.

Intrinsic Factors

Factors that originate within the body, such as inheritance and host factors like age, immune system, and hormones, can contribute to cancer development.

Inherited Susceptibility to Tumors

Genetic conditions that make individuals more susceptible to developing tumors due to impaired DNA repair mechanisms.

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Examples of Inherited Susceptibility to Tumors

Conditions like Xeroderma pigmentosum and Ataxia telangiectasia are examples of inherited conditions.

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Oncogenes

Genes that regulate cell growth and division, and when they mutate, they can contribute to tumor development. They are often involved in signaling pathways that control cell proliferation.

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Tumor Suppressor Genes (TSG)

Genes that normally suppress tumor formation. When inactivated or mutated, they lose their ability to control cell growth and division, leading to tumor development.

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Stages in Carcinogenesis

Cancer development involves a series of steps, including the initiation of mutations and the promotion of cell growth and division.

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Xeroderma Pigmentosum

A disorder characterized by extreme sensitivity to sunlight, leading to skin cancer and other health problems.

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Ataxia Telangiectasia

A rare genetic disorder causing a deficiency in DNA repair mechanisms, especially in response to radiation damage. This can lead to developmental and immune problems.

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Fanconi's Anemia

A genetic disorder that affects the ability to repair DNA damage caused by cross-linking agents. This can lead to bone marrow failure, developmental problems, and an increased risk of cancer.

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Extrinsic Factors in Cancer Development

Radiation, chemicals, and viruses can all directly damage DNA, leading to mutations and cancer.

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Consequences of Radiation Exposure

Exposure to low doses of radiation can lead to genomic instability, while high doses can cause double-strand breaks, translocations, and sometimes point mutations. Defective DNA repair mechanisms can further increase the risk of mutations.

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Chemicals and DNA Damage

Chemicals can cause various types of DNA damage, including base damage, single-stranded breaks, and imperfect repair leading to mutations. This can be a direct effect or require metabolic activation.

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Initiation and Promotion in Chemical Carcinogenesis

A chemical initiating agent causes permanent DNA damage and increased cancer risk. However, it may not be enough to induce a tumor on its own. A promoting agent, when applied after initiation, can contribute to tumor formation in initiated cells.

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Directly and Indirectly Acting Chemical Carcinogens

Directly acting chemicals, like alkylating agents, readily interact with DNA without metabolic conversion. Indirectly acting agents, like polycyclic hydrocarbons, require metabolic conversion to become ultimate carcinogens.

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Tumor Suppressor Gene

A gene that normally suppresses cell growth and division. When inactivated or mutated, it loses its ability to control cell growth, contributing to tumor formation.

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DNA Repair Gene

A gene that encodes a protein involved in the repair of DNA damage. Mutations in these genes can increase the risk of cancer by allowing mutations to accumulate.

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Ras

A common oncogene that is frequently mutated in colon and lung cancer. It's involved in intracellular signaling pathways that regulate cell growth and division.

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c-erbB-2 (HER-2)

A growth factor receptor oncogene frequently amplified in breast cancer. It's involved in cell signaling pathways that promote growth and division.

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Retinoblastoma (RB)

A tumor suppressor gene associated with childhood eye cancer. Inherited mutations can increase the risk of developing retinoblastoma and other cancers.

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p53

A key tumor suppressor gene known as the 'guardian of the genome'. Mutations in p53 are found in more than half of all cancers.

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BRCA1

A gene involved in DNA repair by homologous recombination. Mutations can increase the risk of breast and other cancers.

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Polycyclic Aromatic Hydrocarbons (PAHs)

Polycyclic aromatic hydrocarbons (PAHs) are a group of chemicals found in coal tar and cigarette smoke. One particularly important member is 3,4-benzopyrene, which is converted into its active form by the enzyme aryl carbonate hydroxylase.

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Aromatic Amines

Aromatic amines are chemicals used in rubber and aniline dye production. When metabolized, they can be converted into a form that can cause bladder cancer.

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Nitrosamines

Nitrosamines are compounds formed from nitrates and nitrites found in food. They are linked to an increased risk of gastrointestinal cancer.

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Hepatitis B Virus and Liver Cancer

Hepatitis B virus is a major risk factor for the development of hepatocellular carcinoma, a type of liver cancer.

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Epstein-Barr Virus (EBV) and Cancers

The Epstein-Barr virus (EBV) is associated with several cancers, including Burkitt’s lymphoma and nasopharyngeal carcinoma.

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Human Papillomavirus (HPV) & Cervical Cancer

Human papillomavirus (HPV) is a common sexually transmitted infection linked to cervical cancer.

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Asbestos and Mesothelioma

Asbestos fibers, when inhaled, can cause mesothelioma, a rare and aggressive cancer of the lining of the lungs and chest cavity.

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Aflatoxins and Liver Cancer

Aflatoxins, produced by certain molds, can cause liver cancer.

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Study Notes

Neoplasia III: Tumour Development

  • Tumour development is a result of alterations in the genetic code.
  • Tumour development can be caused by intrinsic factors (inherited) and extrinsic factors (environmental).
  •  Intrinsic factors include inheritance, host factors (age, immune system, hormones).
  • Extrinsic factors include radiation, chemicals, viruses.

Objectives

  • Understanding inherited susceptibility to tumour development (Xeroderma pigmentosum, Ataxia telangiectasia)
  • Understanding the inheritance of certain tumours (Familial adenomatous polyposis, Breast cancer, Retinoblastoma)
  • Understanding the functions of oncogenes and tumour suppressor genes (TSG) and changes in neoplasia.
  • Understanding the role of certain oncogenes (ras, c-myc, c-erbB-2 (HER-2)) and TSG (retinoblastoma, p53)
  • Understanding the stages in carcinogenesis (initiation, promotion)
  • Identifying agents that cause tumours and their mechanisms of action (radiation (UV, ionizing), chemicals (polycyclic hydrocarbons, aromatic amines, nitrosamines), viruses (Epstein Barr, hepatitis), other factors (hormones, aflatoxins, parasites)
  • Understanding occupations associated with tumour development (asbestos exposure, dye industry)
  • Understanding medical conditions increasing the risk of malignancy (ulcerative colitis, cirrhosis, Hashimoto's thyroiditis, chronic atrophic gastritis)
  • Understanding geographical variation in malignant tumour incidence (gastric cancer, breast cancer, Burkitt's lymphoma)

Mechanisms of Carcinogenesis

  • Tumour development and progression involve a long period between exposure to a stimulus and the emergence of clinical cancer.
  • Carcinogenesis stages: Initiation, Promotion, Progression
  • Initiating stimulus-effect is modified through genetic factors, DNA repair.
  • Promotion leads to local tissue response and immune response.
  • Progression is influenced by the number and type of genes.
  • Tumour development is a complex process involving the accumulation of alterations in multiple genes and factors.

Hallmarks of Cancer

  • Evading apoptosis
  • Self-sufficiency in growth signals
  • Insensitivity to anti-growth signals
  • Sustained angiogenesis
  • Limitless replicative potential
  • Tissue invasion & metastasis

Intrinsic factors

  • Inheritance: Inherited conditions increase tumour risk due to DNA repair deficiencies.
  • Host factors: Age, immune system, hormones affect risks and development of tumours.

Defective DNA Repair

  • Individuals with inherited DNA repair defects have a significantly increased risk of cancer.

Radiation

  • Exposure to radiation, especially ionizing radiation, increases the risk for certain cancers (e.g., lung cancer in miners, thyroid cancer in children treated for head and neck cancer).

Chemicals

  • Carcinogens interact with DNA in various ways, including causing specific base damage and single-strand breaks; resulting in mutations.
  • Initiator (chemicals): Causes permanent changes for tumour formation.
  • Promoter (chemicals): Stimulates tumour development in already initiated cells; they themselves are not tumorigenic.

Oncogenes

  • Derived from proto-oncogenes, genes involved in normal cell growth and differentiation.
  • Alterations (mutation, amplification, translocation) can activate oncogenes and contribute to uncontrolled cell growth.
  • Specific examples: c-myc, Ras, c-erbB-2 (HER-2).

Tumour Suppressor Genes

  • Normal function is to inhibit cell proliferation and promote cell death, protecting against tumours.
  • Loss or alteration of these critical genes can eliminate growth suppression and increase cancer risk.
  • Examples: p53, retinoblastoma (RB) genes.

DNA Repair Genes

  • Critical for accurately copying DNA during cell division, preventing mutations.
  • Defects in DNA repair genes increase the likelihood of other gene mutations, contributing to cancer development.
  • Specific examples: BRCA1, BRCA2.

p53

  • A key tumour suppressor gene.
  • Encodes a protein that helps regulate cell division and DNA repair processes, initiating apoptosis if damage is too substantial.
  • Commonly mutated in various cancer types.
  • Important in multiple crucial processes, including cell cycle regulation, DNA repair, and apoptosis.

Other Agents

  • Asbestos: Causes mesothelioma.
  • Aflatoxins: Linked to liver cancer.
  • Schistosoma: Associated with bladder cancer.
  • Helicobacter: Linked to gastric cancer (and lymphoma).
  • Hormones: Estrogen is linked to breast cancer; androgens are connected to liver cancer.

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