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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 B Hep C HPV Herpes HTLV Epstein 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 Signal Transduction Point mutations Translocations Nuclear regulation Overexpression Amplication Point mutations 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: Fatigue: inflammatory mediators Cachexia: change in appetite center CBC changes Pressure tumor and fluid inflammatory mediators (IL-1, IL-6, TNF-a) Anemia: chronic bleeding, cancer growth, Tx Leukopenia: metastasis, Tx Thrombocytopenia: metastasis, Tx Infections: 2nd to Tx Hormonal imbalance (hypercalcemia) Tumor Staging Stage 1 Stage 2 Invasive Moderate differentiation Stage 3 Local Well differentiated 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 N TX, T0, Ti.s. T1, T2, T3, T4 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) Carcinoma Embryonic Antigen (CEA) Colorectal cancers Colitis Fecal Occult Blood (FOB) Present only in fetus + = germ cell tumor 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://biologyanimations.blogspot.com/search/label/ cancer http://www.sinauer.com/cooper/4e/ani mations1801.html Questions?
