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Cancer Pathophysiology
Cancer Lecture
84
Medical
Graduate
10/20/2012

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Term
What are the 3 basic characteristics of Cancer?
Definition
Abnormality in cell growth, division, and/or cell differentiation, a disruption of Cellular Society, A disruption in the normal functioning of social control genes
Term
What do Social Control Genes Do?
Definition
Genes that govern cellular societies.  These genes direct, stimulate, inhibit, or regulate: Cell division, cell differentiation, cell growth, DNA repair, Cell mortality, Apoptosis
Term
Name the 4 Phases of Pathogenesis and Spread
Definition
1. Transformation 2. Growth of Transformed Cell 3. Local Invasion 4. Distant Metastasis
Term
What is transformation?  Is it enought o cause cancer?
Definition
Altered growth-proliferation control (on genetic level).  Involves mutation in social control genes. Not enough to cause cancer.  Happens all the time, could be corrected
Term
What is Growth of Transformed Cell?
Definition
Tumor formation.  Cell is hidden from Immune Sys.  Immune sys compromised
Term
What is Local Invasion?
Definition
Also known as Local Extension.  Invade surrunding tissue and creation of own blood supply.  Attack, digest, and invade surrounding tissue.
Term
Distant Metastasis? Is this always a stage of cancer?
Definition
Cells beak free from tumore colonize distant sites.  Not always a stage for cancers
Term
What is the best prediction of behavior of cancer?
Definition
Cell or organ of origin
Term
What happens during S Phase?
Definition
DNA Replication.  Chromosomes are duplicated. 
Term
What follows S phase?  What does this phase involve?
Definition
G2-RNA Replication.  Cell prepares for division.
Term
What follows G2 Phase?  What happens during this phase?
Definition
Mitosis-Active Nuclear Division
Term
What follows mitosis?
Definition
Cytokenesis- Division of Cell
Term
Which phase is the "holding pattern" and the phase that most cells in the body is found in?
Definition
G1- Period of cell growth before teh DNA is duplicated.  Enzymes for replication are produced. 
Term

What is the G0 Phase?  Where do you find this in?

Can this phase be an origin for tumor?

Definition
"Permanent holding pattern".  Non Dividing Cells such as Neuronal Cells.  NEVER origin for Tumor. 
Term

Can brain cancer be caused by Neuronal Cells?

What can it be caused by?

Definition
NO!  Neuronal Cells are non dividing.  Brain cancer is caused by Glial Cells
Term
What must happen in order to complete cell cycle?  What is an example of when a chemical allows cells to comlete cell cycle?
Definition
Must remove all inhibitors of each phase.  Cytokines released by T Cells stimulate cell division by allowing cells to complete cell cycle.
Term
When examining cells, what are the easiest phases to see?
Definition
Metaphase & anaphase
Term
What are the phases of Mitosis?
Definition
Preprophase, prophase, metaphase, early anaphase, late anaphase, Telophase
Term
In high grade cancer, what phases are seen most often?
Definition
Metaphse & Anaphase
Term
What is the process of Cell Differentiation?
Definition
Process of producing new cells from stem cell line.
Term
What happens after stem cell mitotically divide?
Definition
50% becomes terminally differentiated cell.  50% stay as stem cells so to keep constant supply
Term
What is the characteristic of terminally differentiated cells?  Give an exmple of terminally differentiated cell
Definition
They are the most functionally mature.  They lose ability to mitotically divide.  B Cells's terminally mature form are Plasma Cells
Term
What happens to cancer cells' cell differentiation process?
Definition
2 Possibilities: Loss of differentiation (cancer cells don't want to divide or is resistant to differentiation)-->Lead to Loss of Tissue Function.  OR they differentiate but continue to divide
Term
What does the transformation of a cell into cancer cell involve?
Definition
A mutation in a social control gene to form an oncogene
Term
What does a Proto-Oncogene do?  Mutation causes this gene to do what?
Definition
Promotes normal cell division or growth.  Mutatation causes hyperactivity of the gene-->Oncogenes-->promotes cancerous cell growth
Term
What do Tumor-Suppressor Genes do?  Mutation of this gene causes it to do what?
Definition
Limits normal cell division/growth or promotes cell differentiation/cell death.  Mutation causes inactivity of the gene-->Oncogene-->Promotes cancerous Cell growth
Term
Mutations in Proto-Oncogenes and Tumor-Suppressor Genes result in what?
Definition
Oncogenes
Term
What are Oncogenes?
Definition
Genes that cuases cancer.  Produce cancerous patterns of growth.  Result of mutaiton.  
Term
What is an example of the Stimulatory Abnormality?
Definition
Growth Factor (Go Signal) such as Cytokine, or receptor to cytokine, or signal factor to turn on DNA Replication (Transcrpiton Factor)
Term
What is an example of Inhibitory Abnormality?
Definition
Inhibitor (Stop signal) Differentiation Inducer.  
Term
What are aspects of cell function under social control?
Definition
Signal Transduction, Cell Cycle Control, DNA Repair, Cell Growth, Cell Differentiation, Transcriptional Regulation, Senescene, Apoptosis
Term
What is Signal Transduction?
Definition
Protein that convey signal at membrane for regulation of gene expression
Term
What kind of genes are under Cell Cycle Control?
Definition
Tumore Suppressor
Term
What is DNA Repair?  What kind of gene is this?
Definition
Proteins looking for DNA error.  Bind to mistake until it is repaired.  Tumor Suppressor Gene
Term
What do Broca I & II do?
Definition
Code for DNA repair proteins.  When mutated, increase risk of breast cancer by 80%.  
Term
What is Senescene?
Definition
Regulation on the # of times cells can replicate.  Normally 50-60 times maximum.  Because DNA become less stable after that.  
Term
What is apoptosis?
Definition
Triggered when cell discovers multiple gene mutations.  If blocked, could be oncogenic.  
Term
Most inherited genes are what kind of genes?
Definition
Tumor Suppressor Genes.
Term
What do Cell Cycle Inhibitors (Rb) do? What kind of Gene is this?
Definition
Codes for (Rb) protein.  "Master Break" of Cell Cycle.  Binds to transcription factors and prevent replication.  Tumor Suppressor Gene
Term
What are Cell Cycle and Apoptosis Regulators (P53)?  What kind of gene is this?
Definition
Inhibitor of cell cycle.  Produced when cell suffers DNA damage.  Binds to site of damage and prevent transcription.  If enough P53, it will induce apoptosis.  
Term
What is the most common Tumor Suppressor Gene?
Definition
Cell Cycle and apoptosis Regulator (P53)
Term
Which Tumor Suppressor Gene is involved with Ovarian and Breast Cancer?
Definition
DNA Repair (BRCA 1 and 2)
Term
What are the 5 Properties/Behaviors of Cancer Cells?
Definition
1. Proliferate despite lack of growth-initiating signals  2.  Unlimited replication 3.  Lose of differentiated features  4. accumulate new mutaion at much faster rate (sometimes could work against cancer) 5. Invades local tissue and overrun neighbors.
Term
What is the Autonomy characteristics of Cancer?
Definition
Ability to grow and divide regardless if there are signals to grow & divide.  
Term
How do cancer cells display Autocrine characteristic?
Definition
Some cells release their own growth factors, or have grwoth receptors that are always active.
Term
What is Anaplasia?
Definition
Loss of differentiation
Term
What is the First Shut Off Point?
Definition
Senescence.  NOrmal cells divide 50-60 Times before shut off.
Term
What is the Second Shut off Point?
Definition
Crisis.  All cells beyond Senesence die off.  Dying off in large numbers
Term
What happens when cells escape both Senesence & Crisis?
Definition
Acuire Immortality
Term
What do Telomeres Do?
Definition
Prevent fraying of DNA.  At the end of DNA act as "plastic tips".  Everytime DNA replicate, Telomeres get a bit shorter.  Requires repair.
Term
What retores Telomeres?  What kind of gene is this?
Definition
Telomerase Enzyme restores Telomeres.  Telomerase is a Proto-oncogene.  Gene that code for protein that shut off Telomerase is Tumor Suppressor Gene
Term
What happens to Telomerase under normal conditions?
Definition
Telomerase decrease with cell aging.  If telomerase is no longer present, Telomeres will not be restored, therefore Telomeres degrade-->DNA Error-->Accumulate-->Crisis
Term
How do Cancer Cells behave with Telomere and Telomerase?
Definition
1.  Produce Telomerase all the time!  Replicate as many times as they like.  Unlimited! 2. Prevention of protein that shuts off Telomerase (Tumor Suppressor)
Term
What are 4 Major Structural and Functional Changes in Cancer Cells?
Definition
1.  Cytoskeletal Change. 2. Changes in Cell Adhesion/motility 3.  Nuclear Change  4. Enzyme Production
Term
What are cytoskeletal changes in cancer cells?
Definition
Disorganized bc it is so mitotically active
Term
What is the adhesion protein that is so important for Cell Adhesion/Motility?
Definition
Fibronectin-Adhesion protein that secure cells w. their neighbors in tissue.  Also allow cells to sense neighbors-This is an important inhibitor for "Density Dependent Growth".  
Term
What is Density Dependent Growth?
Definition
Stops growth when it is too dense.
Term
What are changes in Cell Adhesion/Motility in Cancers?
Definition
Cancer won't stop growing.  Fibronectin is absent or abnormal.  Bc they are not secure to neighbers, they are MORE MOBILE-->shed off of tumor and matastisize or leave tumor and enter lymphatic sys and seed else where.
Term
What are Nuclear Changes in Cancer Cells?
Definition
They are disorganized chromosome and nuclei
Term
What are changes in Enzyme production of Cancer Cells?
Definition
1.Release lysosomal enzymes outside to promote invasion. 2. Tumor antigens produced by tumors (highly specific.  Could give immune sys chance to recongize them and kill them)
Term
What are the routes of mutagenesis?
Definition
1. Gene-Environment Interaction. 2. Inherited Cancer Genes. 3. Oncogenic Viruses 4. Oncogenic Bacteria
Term
What is the most common route of mutagenesis?
Definition
Gene-Environment Interaction
Term
What is Gene-Environment Interaction?
Definition
Environmental factors that interact w. gene and cause mutation.
Term
What is the most common inherited Cancer Genes?
Definition
Tumor Suppressor Genes
Term
How do Oncogenic Viruses cause Direct and Indirect mutagenesis?  Example of Direct and Indirect?
Definition
Direct Mutagenesis-Exogenous Source.  Insertional (ex HPV).  Infect cervical cells by insert oncogene.  Related to 75 % cervical cancer.  Indirect- Viral infection that create environment that will allow mutation to go unnoticed by immune sys.  Ex:  HIV
Term
How do Oncogenic Bacteria cause mutagenesis?  Give example.
Definition
Bacteria that release toxins that are mutagenic.  Ex:  H Pylori has been implicated for certain stomach carcinoma. OR they create chronic inflammatory response (Ex:  LIver Cirosissis)
Term
What is the theory behind cancer?
Definition
Initiation, Promotion, Progression Theory
Term
How do you grade cancer?
Definition
1.  Degree of Malignancy 2. Aggressiveness (cell turnover, degree of anaplasia, etc.)
Term
What is Cell Turnover Rate?
Definition
Rate of Cell division is greater than Rate of Cell Death
Term
What is Cancer Stage?
Definition
from I-IV.  1. Degree of Spread 2. Stage in disease progression. Based on behavior of cancer and how it tends to spread.  
Term
What occurs in Local Invasion?
Definition
Tumor grows in size and invade surrounding tissue.  Can matastasize without breaking away from organ.
Term
What are characteristics of a Benign Tumor?
Definition
Incapsulated, Uniform in size, Displace surrounding tissue
Term
What are characteristics of a Malignant Tumor?
Definition
1. Not incapsulated 2. Not uniform 3. Have own direct blood supply 4. Eat through surrounding tissue (sore that won't heal).  
Term
What is angiogenesis?  How does cancers use a normal mechanism to its advantage?
Definition
When nearby blood vessels provide colaterals.  When tissue becomes hypoxic, as a part of normal protective feature, nearby blood vessels provide colateral.  
Term
What is Carcinoma?
Definition
any cancer that arises from epithelial cells
Term
What is Sarcoma?
Definition
Cancer of connective or supportive tissue (bone, cartilage, fat, muscle, blood vessels)
Term
Lymphoma and Leukemia?
Definition
Malignant tumors derived from blood or bone marrow cells
Term
Mesothelioma?
Definition
Tumors derived from Mesothelial Cells lining the peritoneum and the pleura
Term
Glioma Astrocytoma?
Definition
Tumors deried from brain cells (glial cells & astrocytes)
Term
Germ Cell Tumours
Definition
Tumors derived from Germ Cells, normally found in the testicle and ovary
Term
Melanoma?
Definition
Malignant tumor of melanocytes?
Term
Adenocarcinoma?
Definition
Form of carcinoma that originates in glandular tissue.  Ex:  Breast and mammory)
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