Ch 7

Cancer is a disorder of altered cell ___________ & _________.

differentiation, growth

The process of cell division results in cellular ____________.


_________ is the process of specialization whereby new cells acquire the structure and function of the cells they replace.


Proteins called ______ control entry and progression of cells through the cell cycle.


Kinases are enzymes that ______ proteins.


Continually renewing cell populations rely on ___________ cells of the same lineage that have not yet differentiated to the extent that they have lost their ability to divide.


_______ cells remain incompletely undifferentiated throughout life.


_______ stem cells are pluripotent cells derived from the inner cell mass of the blastocyst stage of the embryo.


______ do not usually cause death unless the location interferes with a vital organs function.

benign tumors

Malignant neoplasms are less well _______and have the ability to break loose, enter the circulatory or lymphatic systems, and from secondary malignant tumors at other sites.


Tumors usually are named by adding the suffix- _______ to the parenchymal tissue type from which the growth originate.


A _________ is growth that projects from a mucosal surface.


The term ______ is used to designate a malignant tumor of the epithelial tissue origin.


There are two categories of malignant neoplasms, _______ & _______ cancers.

solid tumors, hematological (pg134)

The term ______ is used to describe the loss of cell differentiation in cancerous tissue.


Characteristic of cancer cells as the ability to proliferate even in the absence of _________.

growth factors

With homologous loss of ______ gene activity, DNA damage goes unrepaired and mutations occur in dividing cells, leading to malignant transformations.


The types of genes involved in cancer are numerous, with two main categories being the ______, which control cell growth and replication, and tumor _______ genes, which are growth-inhibiting regulatory genes.

protooncogenes, suppressor

________ is the only known retrovirus to cause cancer in humans.

human T-cell leukemia virus-1

Tumor cells must double _______ times before there will be a palpable mass.


The common manifestation of solid tumors is the cancer _______ syndrome.


As cancers grow, they compress and erode blood vessels, causing ________ and _______ along with frank bleeding and sometimes hemorrhage.

ulceration, necrosis

______ is a common side effect of many cancers. It is related to blood loss, hemolysis, impaired red cell production, or treatment effects.


A tissue _________ involves the removal of a tissue specimen for microscopic study.


_______ therapy uses high-energy particles or waves to destroy or damage cancer cells.


_______ is a systemic treatment that enables drugs to reach the site of the tumor as well as other distant sites.



Refers to an abnormal mass of tissue in which the growth exceeds and is uncoordinated with that of the normal tissues.
Neoplasms are commonly classified as benign or malignant.


Process of cell division: is an inherent adapted mechanism for cell replacement when old cells die or additional cells are needed.
Fundamental to the origin of all neoplasms are the genetic changes that allow excessive and uncontrolled proliferation that


Process of cell specialization whereby new cells acquire the structural, microscopic, and functional characteristics of the cells they replace.

Benign mass or neoplasm

Well-differentiated mass of cells that resemble the normal counterpart both in terms of structure and function but have lost the ability to control cell proliferation.
Characterized by a slow progress of a rate of growth that may come to a standstill or t

What have benign tumors lost the ability to suppress

The genetic program for cell proliferation but have retained the program for normal cell differentiation.
They grow by expansion and remain localized to their site of origin
do not have the capacity to infiltrate, invade, or metastasize to distant sites

Malignant mass or neoplasm

Defines the differentiation potential of stem cells: are less differentiated and have lost the ability to control both cell proliferation and differentiation

What occurs with better differentiation of neoplasm

The slower its rate of growth and the more completely it retains the functional capabilities found in its normal counterparts.


Process that eliminates senescent, DNA, and damaged or unwanted cells

In adult issues what is the size of a population of cells determined by?

By the rates of cell proliferation and death by apoptosis.

What might the accumulation of neoplastic cells in malignant neoplasms result from

Not only from excessive and uncontrolled proliferation, but also from invasion of apoptosis.

What two types of tissue are benign and malignant tumors composed of that?

Parenchymal and supporting

Parenchymal tissue

Is made up of the transformed or neoplastic cells of a tumor; determines its behavior and is the component for which the tumor is named

Supporting nonneoplastic stromal tissue

Is made up of connective tissue, extracellular matrix, and blood vessels; is essential to the growth of the tumor since it carries the blood supply and provides support for parenchymal tumor cells.

Relate the process of cell differentiation to the development of a Benign cell line and the behavior of the tumor.

they expand slowly, develop a surrounding rim of compressed connective tissue called fibrous capsule
capsule is responsible for a sharp line of demarcation between the benign tumor and the adjacent tissues

Relate the process of cell differentiation to the development of a cancer cell line and the behavior of the tumor.

Grow rapidly, invade and infiltrate nearby tissue, and spread to other parts of the body. Lack a well defined capsule and margins are not clearly separated from the normal surrounding tissue.

Cellular potency

Defines the differential potential of stem cells


Stem cells undergoing numerous mitotic divisions while maintaining an undifferentiated state

Tumor-initiating cells

Cancer stem cells


Mass of cells due to overgrowth


Study of tumors and their treatment


Normal gene that can cause cancer if mutated

Tumor suppressor gene

Promote cancer when less active

Genetic instability

Marked by chromosomal aberrations

Epigenetic effects

Changes in gene expression without DNA mutation


Loss of cell differentiation

Anchorage dependence vs independence

Most normal cells must be anchored to either neighboring cells or the underlying extracellular matrix to live and grow.
Cancer cells often survive in its microenvironments different from those of the normal cells. They frequently remain viable and multipl


Tumor suppressor gene

What is the correct order for cellular potency from the least differentiated to the most differentiated

Totipotent, Pluripotent, Multipotnet, Unipotent

Not all cells in the body can re-enter the cell cycle, but some will do so continuously. In terms of regeneration and differentiation, which types of cells will or will not re-enter the cell cycle?

In terms of cell proliferation, the cells may be divided into three groups: 1-The well-differentiated neurons and cells of skeletal and cardiac muscle that rarely divide and reproduce; 2- The progenitor or parent cells that continue to divide and reproduc

Compare and contrast benign tumors and malignant tumors.

Both benign and malignant tumors have lost the ability to suppress growth. As a result, the tumor cells continue to proliferate. benign tumors are composed of well-differentiated cells and are confined to the area of tissue origin. In contrast malignant t

List the five factors use to describe benign and malignant neoplasm.

1-cell characteristics, 2-rate of growth, 3-manner of growth, 4-capacity to invade and metastasize to other parts of the body, 5-potential for causing death.

Describe the process and routes of metastasis.

Metastasis occurs via lymph channels and blood vessels. When metastasis occurs by way of the lymphatic channels, the tumor cells lodge first in the initial lymph node that receives drainage from the tumor site. If they survive, cancer cells may spread fro

Explain how a diminished immune system may play a role in carcinogenesis.

Cancer cells express abnormal cell surface proteins. Normally, the immune system recognizes these abnormal proteins and destroys the cancerous cell. With a compromised immune system, these abnormalities are missed and allowed to persist in the body.

Chemical carcinogens act in two distinct ways. What are they?

Chemicals will cause cellular transformation either directly (direct reacting agents) or indirectly, only becoming activated by a metabolic process (initiators).

Cachexia is marked by a hypermetabolic state. Give two reasons for this and explain the consequences.

Hypermetabolism is the result of the rapidly growing tumor and the increased expression of uncoupling proteins. The tumor uses large quantities of glucose via glycolysis, therefore producing high levels of lactic acid. The lactic acid undergoes the energy

What is paraneoplastic syndrome?

Paraneoplastic syndromes are characterized by manifestations in sites that are not directly affected by the disease. Most commonly, manifestations are caused by the elaboration of hormones by cancer cells, and others from the production of circulation fac

List some of the common methods used for diagnosing cancer.

Blood tests for tumor markers, cytologic studies and tissue biopsy, and endoscopic examinations, ultrasound, X-ray studies, MRI, CT, and positron-emission tomography

Cancers are graded and staged on their characteristics in order to determine a treatment regimen. Explain the grading and staging system and how it is met.

The clinical staging of cancer is intended to group patients according to the extent of their disease. Grading of tumors involves the microscopic examination of cancer cells to determine their level of differentiation and the number of mitoses. Cancers ar

Use the concept of growth fraction and doubling time to explain the growth of cancerous tissue.

Growth fraction is the ratio of dividing cells to resting cells in a tissue mass.
Doubling time is the length of time it takes for the total mass of cells in a tumor to double.
As the growth fraction increases, the doubling time decreases.
When normal tis

State the importance of angiogenesis in cancer growth and metastasis

Angiogenesis is the physiological process through which new blood vessels form from pre-existing vessels. It is also a fundamental step in the transition of tumors from a benign state to a malignant one. Tumors cannot grow beyond a certain size due to a l

What are identified risk factors for cancer?

Hormonal factors, chemicals, and immunological mechanisms that

What is one of the most potent procarcinogens (a group of dietary carcinogens) called?

Polycyclic aromatic hydrocarbons
-become active only after metallic conversion

Which cancers are often found because of effusions?

Lung and ovarian cancers

Which serum tumor markers have been proven to be among the most useful in clinical practice?

Alpha-fetoprotein and human chorionic gonadotropin

Childhood cancer survivors who had cranial radiation therapy for their cancers are prone to growth hormone deficiency. In adults what is growth hormone deficiency associated with?


What is the difference in the treatment of childhood cancer as opposed to adult cancer by chemotherapy as the most widely used treatment therapy for childhood cancer?

Pediatric tumors are more responsive to chemotherapy than adult cancers

What is radiosensitivity in relation to radiation treatment?

The inherent properties of a tumor that determine how the tumor responds to the radiation.
When radiation is combined with cytotoxic drugs it has been noted that there is a radiosensitizing effect on tumor cells.

What drug is considered a radiosensitizer?