cancer. terminology oncology (onc/o-, -ology) neoplasia (neo-, -plasia) tumor (-oma) benign...
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Cancer
Terminology
Oncology (onc/o-, -ology) Neoplasia (neo-, -plasia) Tumor (-oma) Benign Malignant Metastasis Cancer, Carcinogen (carcin/o-)
Additional Terminology
Differentiation Poorly Divergent (mixed tumors) = pleomorphic Heterotrophic
Anaplasia Dysplasia Carcinoma in situ (CIS) Mature and immature Autonomy
Risk Factors for Cancer
Sex and reproductive history Race and geographical location Infection (virus, STDs) Immunosuppression Age Family history Nutrition Environment (chemicals, drugs, toxins) Lifestyle (exercise) Occupation
Cancer Types: Male / Female
Risk Factors
Creation of Cancer
Hep BHep CHPVHerpesHTLVEpstein Barr
Telomeres and Immortality
Chromosomal Translocation Mutations
Berkett’s Lymphoma CML
Epigenics
Lifestyle and environment changes gene expression Silencing of gene expression by hypermethylation http://www.pbs.org/wgbh/nova/sciencenow/3411/02.
html
Genetic Changes that can occur
Activate oncogenes Inactivate tumor suppressor genes Inactivate genes that regulate apoptosis Inactivate genes that regulate DNA repair Inactivate genes that regulate cell cycle Inactivate genes that regulate membrane
proteins
Oncogenes and their functions
Growth Factors Overexpression Amplication Point mutations
Signal Transduction Point mutations Translocations
Nuclear regulation Amplification Translocations
Cyclins Amplification
p53: Tumor Suppressor Gene
p53 regulates cell cycle, DNA repair, and apoptosis
Rb: Tumor Suppressor Gene
Rb normally inhibits the cell cycle
Ras: Signal Transducer
APC: Adhesion protein
Loss of adhesion proteins allows for metastasis
Cancer Clusters
Environmental factors
Carcinogens Air pollution Ionizing radiation UVR Nutrition Obesity Alcohol
Immune System
Surveillance Chronic
Inflammation ROS
NK Lymphocytes
Immunosupression
Benign v.s. Malignant
Anaplastic characteristics
Hyperchromic nuclei 1:1 cytoplasmic ratio Variable size and
shape of cell Atypical and numerous
spindle cells Prominent nucleoli Loss of polarity Mitotic figures
Cancer cell structure
Cancer cells
Cytological Changes
metaplasia carcinoma
Cell Cycle of Cancer
Cancer cell functions
Clinical Manifestations
Pain: Pressure tumor and fluid inflammatory mediators (IL-1, IL-6, TNF-a)
Fatigue: inflammatory mediators Cachexia: change in appetite center CBC changes
Anemia: chronic bleeding, cancer growth, Tx Leukopenia: metastasis, Tx Thrombocytopenia: metastasis, Tx
Infections: 2nd to Tx Hormonal imbalance (hypercalcemia)
Tumor Staging
Stage 1 Local Well differentiated
Stage 2 Invasive Moderate differentiation
Stage 3 L.N. spread Poorly differentiated
Stage 4 Distant Sites Undifferentiated
TNM classification
T = primary tumor mass
N = regional lymph node
M = metastasis X = cannot be
assessed 0 = not present Number increase
Growth of mass Spread to other L.N.
T TX, T0, Ti.s. T1, T2, T3, T4
N NX, N0, N1, N2, N3
M MX, M0, M1, M2
Tumor Size
L.N.
Metastasis (MX, M0, M1, M2)
Cancer progression & spread
BV growth Decrease in cell to
cell adhesion Cells through
tissue planes Body cavity, BV, or
Lymphatic spread Tissue selectivity
Primary and Secondary Sites
Liver and Lung are frequently involved secondary sites
Favorable Sites
Ovarian Cancer Metastasis Sites
Liver Mets
Lung Mets
Brain Met (secondary to Lung Cancer)
Tumor Treatment
Chemotherapy Radiation Surgery Immune BM transplant Gene Therapy
Chemotherapy Alkylating agents
Nonspecific Cross link DNA Drugs
Cyclophoshamide Cisplatin
Antimetabolites Block DNA synthesis in S phase Drugs
Methotrextrate Mercaptopurine
Antitumor AB Block enzymes nonspecifically Change cell membrane Drugs
Doxorubicin Plant Alkaloids
Block DNA replication Block enzymes in M phase Drugs
Vinblastine Vincristine
Topoisomerase inhibitors Prevents DNA reassembling in S Drugs
Doxorubricin
Secondary Effects of Chemotherapy
Radiation Therapy
BM Transplant
Immunotherapy
Antibodies to target Antigens
Nanotechnology
Cancer Screening Tests
Cancer Rapid Test Kits
Alpha Fetoprotein (AFP) Present only in fetus + = germ cell tumor
Carcinoma Embryonic Antigen (CEA) Colorectal cancers Colitis
Fecal Occult Blood (FOB) Detect colon and rectal bleeding
Prostate Specific Antigen (PSA) BPH, Infection, Inflammation Prostate cancer
Detection: CTC chip
Cancer Susceptibility
Cancer Types Cells of Origin
Epithelial Benign
Adenoma Papilloma Polyp Cystadenoma
Malignant Adenosarcoma Carcinoma
C.T. Benign
Fibroma Chondroma
Malignant Sarcomas
Germ Cells Teratoma Dermoid cyst
Tumor Sources
Germ Cell Tumors
Teratomas and Dermoid Cyst
Factors in Childhood Cancers
Cells of origin Genetic Congential Prenatal Exposure
Mesoderm Leukemias Neuroblastoma Wilms Tumor Osteosarcoma Ewing sarcoma Rhabdomyosarcoma Retinoblastoma
Etiology of Childhood Cancers
Childhood Cancers
ALL
Adult Cancers
Epithelial and Endothelial Tumors
Environmental Factors
Adult Cancers
Adult Cancer Death Rates
Cancer vs Heart Disease
Cancer Summary
Outcomes Death Palliative Curative
5 years symptom free
Cancer Animations
http://www.insidecancer.org/ http://www.pbs.org/wgbh/nova/cancer/
grow_flash.html http://biology-animations.blogspot.com
/search/label/cancer http://www.sinauer.com/cooper/4e/ani
mations1801.html
Questions?