Cancer. Terminology Oncology (onc/o-, -ology) Neoplasia (neo-, -plasia) Tumor (-oma) Benign...

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?