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Cancer
Terminology
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Oncology (onc/o-, -ology)
Neoplasia (neo-, -plasia)
Tumor (-oma)
Benign
Malignant
Metastasis
Cancer, Carcinogen (carcin/o-)
Additional Terminology
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Differentiation
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Poorly
Divergent (mixed tumors) = pleomorphic
Heterotrophic
Anaplasia
Dysplasia
Carcinoma in situ (CIS)
Mature and immature
Autonomy
Risk Factors for Cancer
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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
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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
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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
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Growth Factors
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Signal Transduction
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Point mutations
Translocations
Nuclear regulation
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Overexpression
Amplication
Point mutations
Amplification
Translocations
Cyclins
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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
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Carcinogens
Air pollution
Ionizing radiation
UVR
Nutrition
Obesity
Alcohol
Immune System
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Surveillance
Chronic
Inflammation
ROS
NK Lymphocytes
Immunosupression
Benign v.s. Malignant
Anaplastic characteristics
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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
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Pain:
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Fatigue: inflammatory mediators
Cachexia: change in appetite center
CBC changes
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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
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Stage 1
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Stage 2
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Invasive
Moderate differentiation
Stage 3
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Local
Well differentiated
L.N. spread
Poorly differentiated
Stage 4
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Distant Sites
Undifferentiated
TNM classification
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T = primary tumor
mass
N = regional lymph
node
M = metastasis
X = cannot be
assessed
0 = not present
Number increase
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Growth of mass
Spread to other L.N.
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T
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N
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TX, T0, Ti.s.
T1, T2, T3, T4
NX, N0,
N1, N2, N3
M
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MX, M0,
M1, M2
Tumor Size
L.N.
Metastasis (MX, M0, M1, M2)
Cancer progression & spread
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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
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Chemotherapy
Radiation
Surgery
Immune
BM transplant
Gene Therapy
Chemotherapy
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Alkylating agents
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Nonspecific Cross link DNA
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Drugs
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Cyclophoshamide
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Cisplatin
Antimetabolites
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Block DNA synthesis in S phase
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Drugs
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Methotrextrate
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Mercaptopurine
Antitumor AB
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Block enzymes nonspecifically
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Change cell membrane
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Drugs
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Doxorubicin
Plant Alkaloids
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Block DNA replication
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Block enzymes in M phase
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Drugs
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Vinblastine
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Vincristine
Topoisomerase inhibitors
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Prevents DNA reassembling in S
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Drugs
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Doxorubricin
Secondary Effects of Chemotherapy
Radiation Therapy
BM Transplant
Immunotherapy
Antibodies to target Antigens
Nanotechnology
Cancer Screening Tests
Cancer Rapid Test Kits
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Alpha Fetoprotein (AFP)
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Carcinoma Embryonic Antigen
(CEA)
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Colorectal cancers
Colitis
Fecal Occult Blood (FOB)
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Present only in fetus
+ = germ cell tumor
Detect colon and rectal bleeding
Prostate Specific Antigen (PSA)
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BPH, Infection, Inflammation
Prostate cancer
Detection: CTC chip
Cancer Susceptibility
Cancer Types
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Cells of Origin
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Epithelial
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Benign
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Adenoma
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Papilloma
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Polyp
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Cystadenoma
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Malignant
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Adenosarcoma
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Carcinoma
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C.T.
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Benign
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Fibroma
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Chondroma
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Malignant
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Sarcomas
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Germ Cells
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Teratoma
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Dermoid cyst
Tumor Sources
Germ Cell Tumors
Teratomas and Dermoid Cyst
Factors in Childhood Cancers
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Cells of origin
Genetic
Congential
Prenatal Exposure
Mesoderm
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Leukemias
Neuroblastoma
Wilms Tumor
Osteosarcoma
Ewing sarcoma
Rhabdomyosarcoma
Retinoblastoma
Etiology of Childhood Cancers
Childhood Cancers
ALL
Adult Cancers
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Epithelial and
Endothelial
Tumors
Environmental
Factors
Adult Cancers
Adult Cancer Death Rates
Cancer vs Heart Disease
Cancer Summary
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Outcomes
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Death
Palliative
Curative
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5 years
symptom free
Cancer Animations
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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?