Cancer
Rapidly reproducing cells!
Benign grows..
slowly, not invasive
Benign spreading?
Does not metastasize, low mitotic index
Malignant grows...
rapidly, invasive
Malignant spreading?
metastasis, high mitotic index
Malignant capsule?
not encapsulated
Benign capsule?
Well defined capsule
Lipoma
(B)tumor in fat tissue
Glioma
(B)tumor in brain/spine tissue
Leiomyoma
(B)tumor in uterine tissue
Chrondroma
(B)tumor in cartilage tissue
Carcinomas
Malignant epithelial tumors
Sarcomas
Malignant connective tissue tumors
Anaplasia
Loss of cellular differentiation
Angiogenesis
create own blood supply (malignancy), decreases p53 gene
stem cells
Multipotent
Tumor markers
subs. produced by cancer cells or that are found on plasma membrane , in the blood, CSF for urine :hormones, enzymes,genes,antigens, antibodies
Cancer Causing Mutations
aging and increased growth rate/ decreased apoptosis
Mutations
Multiple required before cancer develops
Autocrine Stimulation
secretion of growth factors/stimulate own growth
Growth factor receptors
Increase with cancer
ras
ezyme stimulating more rapid growth(proto-oncogene)
Rb
tumor suppressor that's decreased
p53 gene
causes apoptosis in all cells "suicide gene
protein kinases
drives the cell cycle (increases)
Body cells
not immortal/divide limited # of times
Telomeres
protective caps on each chromosome
Telomerase
deleted by cancer/ holds together telomeres
Oncogenes
mutant genes that direct protein synthesis and cell growth(GO!)
Tumor-Suppressor genes
STOP! encode proteins that negatively regulate proliferation
point mutations
change in one/few nucleotide base pairs
Chromosome mutations
piece on one chromosome is transferred to another
Gene Amplification
Dup. piece of chromosome. increased expression of oncogene
Mutation of tumor suppressor gene
allows unregulated cellular growth
care taker genes
(decrease) involved in repairing damaged DNA
Chronic Inflammation
releases ROS, free radicals
Somatic cell mutation
not passed to progeny
Germline cells
passed to future generations
HPV
increases chance of cervical cancer
H. Pylori
decreases stomach acid causing irritation to increase inflammation
Ionizing radiation
x rays, atomic bombs- cell death, gene mutations and chromosome aberrations
UV radiation
basal cell carcinoma, squamous cell carcinoma and melanoma.. produces skin inflammation and free radicals
Alcohol
irritant to cause inflammation
Physical Activity
decrease, insulin, obesity, inflammation, free radicals, gut motility
Occupational Hazards
asbestos, dyes, rubber, paint, explosives, radon
Xenobiotics
toxic, mutagenic and carcinogenic chemicals in food EX burnt meat and moldy food
Obesity
increases estrogen, insulin resistance, hyperinsulinemia
Local Spread
direct invasion of contiguous organs
Metastases to distant organs
through lymphatics and blood
Implantation Metastasis
seeding from dropping cells in removal of tumor
Invasion
slippery cells, release lytic enzymes, increase cell multiplication
Metastasis occurs in
first capillary bed encountered by circulating cells
Organ tropism
preferred growth of cancerous cells on certain secondary organ
Stage 1
cancer is confined to organ of origin
Stage 2
locally invasive
Stage 3
metastasized to regional structures
Stage 4
metastasized to distant sites
N
Lymph node involvement
N0
no axillary nodes involved
N1
mobile nodes involved
N2
fixed nodes involved
T0
Breast free of tumor
T1
lesion <2cm
T2
lesion 2-5cm
T3
skin/chest wall involved by invasion
Clinical Manifestations
Pain, Fatigue, cachexia, anemia, leukopenia,paraneoplastic syndrome
Cachexia
sever form of malnutrition (80% of pts at death)
Cancer needs more energy so it takes it from your body
Anemia
caused by chemotherapy
Chemotherapy
nonselective cytotoxic drug that targets rapidly reproducing cells
Chemotherapy compartment 1
Cells undergoing mitosis and cytokinesis
Chemotherapy compartment 2
cells capable of entering the cell cycle in G1
Chemotherapy compartment 3
die a natural death
Neoadjuvant chemotherapy
radiation therapy
Radiation
eradicate cancer w/o excess toxin but increases inflammation
Palliative surgery
remove tumor for comfort
BRM
Biologic response modifiers (immunotherapy)