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Pathophysiology Chapter 20 - Neoplasms and Cancer
Terms in this set (88)
What is a neoplasm?
- Tumor that consists of atypical/immature cells that can put pressure on its surroundings
What is neoplasia?
- New cellular growth that doesn't respond to normal body controls, continues to reproduce and deprives other cells
What is oncology?
Study of tumor
What are the 3 most common cancers in men?
What are the 3 most common cancers in women?
How are benign tumors named?
Tissue name + "oma"
How are malignant tumors named?
Tissue name + "carcinoma"
What are the characteristics of benign tumors?
- Well differentiated cells
- Growth in size is slow, can be months/years
- Remains localized at site of origin
What are the characteristics of malignant tumors?
- Range from well differentiated cells to poorly undifferentiated cells (anaplasia)
- Growth can be rapid & erratic
- Will not stay local, instead they spread by invasion, infiltration & destruction of the surrounding tissue
- Metastasize to different sites around the body
Name some examples of malignant tumors.
- Hodgkins disease
- Wilms' tumor
What is a sarcoma cancer of?
Connective tissue cancer
What is a carcinoma cancer of?
What does chondr/o mean?
What does aden/o mean?
What does myo/o mean?
What does lip/o mean?
What does fibr/o mean?
What is the general definition of benign?
Innocent, amenable to surgery with a higher rate of survival
What is a teratoma?
Tumor comprised of cells from more than one germ layer that arises from totipotent cells
What is a hamartoma?
Disorganized mass of tissue whose cell types are indigenous to the site of the lesion
What is a choristoma?
Ectopic focus of normal tissue
The development of a malignant tumor
What are the 4 classes of normal regulatory genes?
3. DNA repair genes
4. Apoptosis genes
What do tumor suppressor genes do?
Encode proteins that restrain cell growth
What do oncogenes do?
Promote the loss of growth control and the conversion of a cell to a malignant state
Where were oncogenes first discovered?
In the genomes of tumor viruses
What does a proto-oncogene do?
Encode proteins that function in a cell's normal activity
Which acts dominantly; proto-oncogenes or oncogenes?
How does a cell become malignant?
Both alleles of a tumor-suppressor gene must be lost and a proto-oncogene must be converted into an oncogene
What kind of tumor expands but doesn't spread?
What kind of tumor is movable upon palpitation?
What are some warning signs of cancer?
Change in bladder habits
Change in wart or mole
Sore that doesn't heal
Unexplained weight loss
Solid painless lump
What are three ways tumors can spread?
Invasion, Metastasis, and Seeding
How does the tumor spread in malignant tumors?
The tumors secrete destructive enzymes(collagenase) & they do not adhere to each other so they break off the main mass and spread to distant sites in the body
What is invasion of tumors?
A local spread where the tumor invades neighboring tissue
What is metastasis?
A piece of the tumor breaks off; spreads to a distant site by blood , or lymphatics
What is seeding?
The spread of cancer cells in body fluids along membranes
Peritoneal spread in ovarian cancer causing secondary liver tumors is an example of what category of spreading in malignant tumors?
Seeding of body cavities
Uterine carcinoma going into the vagina is an example of what?
Local spreading/Invasion (Tumor cells grow into adjacent tissues)
What 2 locations are the most frequently involved sites in cancer spread?
Liver and lungs
Explain the TNM system in staging of cancer and when it is used.
Staging of cancer is used to classify a specific malignant tumor at time of diagnosis, it will describe the extent of disease and provide basis for TREATMENT and PROGNOSIS.
The TNM system is:
T- size of primary Tumor
N- lymph Node involvement
M- metastasis (spread) of tumor
What is angiogenesis, what type of tumor does it relate to, and how?
Angiogenesis is the process from which new blood vessels form from pre existing vessels.
In malignant tumors, some tumors can secrete growth factors that stimulate the new development of capillaries , providing blood to promote growth.
What is the difference between grading and staging cancer?
In grading tumors doctors are looking at the morphology of cells to see how differentiated they are.
In staging tumors the doctor looks at the overall tumor and stages it based on size of the tumor, how far the tumor has spread (metastasis), and if the lymph nodes have become involved.
What are some treatment options?
Surgery, chemotherapy, radiation, combination of all these three, hormones therapy, Nutrition, Palliative, Curative, Angiogenesis Inhibitor therapy
None of the cells belong
All are undifferentiated
Some of the cells don't belong
What are local effects of a tumor?
Pain - Presses on nerves
Obstruction - Blocks ducts/passageways
Tissue Necrosis - Infection, bleeding, ulcerations
Effusion - Fluid buildup in cavities
What is cachexia?
Severe tissue wasting (Sunken face)
What are systemic effects of tumors?
Fatigue - From anemia, cachexia, depression
Anemia - Caused by bleeding tumors and poor nutrition
Weight loss/Cachexia - Caused by increase demands from tumor cells
Infections - Resistance declines
Bleeding - Tumor erodes blood vessels
What is paraneoplastic syndrome?
Rare disorders that are triggered by an altered immune system response to a neoplasm and not caused by the cancer itself
(Example: the production of hormones ACTH & PTH by bronchogeneic carcinoma causing bushings syndrome)
What are some diagnostic tests?
Blood tests- Hemoglobin levels, and Erythrocyte (RBC) count
What are some routine screenings?
What are some risk factors of cancer?
Genetics - Oncogenes that regulate all growth
Viruses (HPV) - Oncoviruses alter host cells DNA
Radiation - UV, X-ray, Gamma, radioactive isotopes
Biological factors - Age, hormones, diet
What is curative treatment?
Used to recover patient when cancer is small and localized
What is palliative treatment?
For advanced cancer that reduces manifestations and complications to prolong life
Does NOT cure
What is adjuvant/prophylactic treatment?
Used to treat micrometastasis for cancers that metastasize early (Breast cancer)
What type of therapy is most effective in rapidly dividing cells?
What are the adverse effects of radiation?
- Bone marrow depression
- Epithelial cell damage
What are the adverse effects of chemotherapy?
- Bone marrow depression
- Epithelial cell damage
- Damage to specific areas
What are other drugs used for cancer treatment?
- Hormones (Glucocorticoids)
- Sex hormones
- Blocking agents (Block cell receptors)
- Biological response modifiers/BMRs - Increase natural immune response
- Angiogenesis inhibitors (Inhibit growth of blood vessels)
- Analgesics (For pain)
What is total parenteral nutrition?
Nutrient mixture is injected directly into patients vein
_______ is known as cellular growth that no longer responds to normal controls.
T/F- neoplasm will increase in size regardless of their local environment & nutritional status of host.
Neoplasms grow rapidly and the extensive growth deprives other cells of nutrients
T/F: most malignant tumors arise from a single transformed cell
What is carcinogenesis?
Process where normal cells are transformed into cancer cells
Why is cancer said to be multifactorial?
It can be caused by environmental effects, heredity and infection
Name the stages in carcinogenesis and describe them.
1st Stage - Initiating factors (pro carcinogens) cause first irreversible change in cell DNA (mutation) but do not create an active neoplasm
2nd Stage - Exposure to promoters (hormones/environmental chemicals) that causes further changes in DNA, less differentiation, increased rate of mitosis and leads to tumor development.
Explain why the first initial factors that cause mutation does not create an active neoplasm
The cell would need to grow, replicate and spread to become cancerous
Which blood counts are a general sign of cancer and are they high or low?
What are tumor markers produced by?
Specifically, what will be removed in surgery? (for cancer)
Removal of tumor & surrounding tissues INCLUDING the nearby lymph nodes
Decreased platelets in CBC means what?
Decreased leukocytes in CBC means what?
Increase risk of INFECTION
Decreased erythrocytes in CBC means what?
What is nadir?
It is the point of lowest cell count in relation to chemotherapy.
Definition of a "cancer free state"
5 year survival without recurrence
What is remission?
No clinical signs of cancer
Extent to how much tumor cells resemble their normal cells of origin functionally & morphologically
What are some "misnomers" in benign cancer? (they are phonetically presented like benign but are NOT benign)
- Hepatoma (Malignant liver tumor)
- Melanoma (Malignant skin tumor)
- Seminoma (Malignant testicular tumor)
- Lymphoma (Malignant tumor of lymphocytes)
What do cells look like in Grade 1 Cancer?
The cells are well differentiated and look like original cells
What do cells look like in Grade 4 Cancer?
The cells are undifferentiated, anaplastic, highly malignant, and fast-progressing.
Tumor marker tested for in colon cancer?
Tumor marker tested for in testicular cancer?
Tumor marker tested for in hepatocellular carcinoma?
Tumor marker tested for in ovarian cancer?
Tumor marker tested for in prostate cancer?
3 types of skin cancer
Basal cell carcinoma
Squamous cell carcinoma
What do cytological tests require and what do they determine?
MOST DEPENDABLE CONFIRMATION OF MALIGNANCY
Biopsy or cell sample
Determine degree of differentiation and tumor type
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