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PHCY320 - Oncology Exam Latest Update
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PHCY320 - Oncology Exam LatestUpdate
Define cancer and state the different types - Answer What is cancer?
- a malignant tumor
- a tumor is the name given to a mass of cells in which cell division/cell cycle is no longer
regulated
- the tumor is benign if it does not spread (but may still cause tissue damage)
- malignant cells invade neigbouring tissues, enter blood vessels, and metastasize to
different sites
- the tumor is malignant or cancerous if it spreads
- the spread of a cancer to a secondary site is called metastasis
Types of cancer
* Some common carcinomas:
- lung
- breast
- colon
- bladder
- prostate
* Leukemias:
- blood stream
* Lymphomas:
- lymph nodes
* Sarcomas:
- fat
- bone
,- muscle
Explain the process of metastasis - Answer Actually a really compliex process with
many steps
- *L1, S4*
Aggressive phenotype
- oncogenic mutations
- epi/genomic instability
Prerequisites
- self renewal, invasiveness
- motility, detachment survival
Microenvironment
- angiogenesis, inflammation
- cancerized stroma
Intravasation
- epithelial-to-mesenchymal transitions
Life in transit
- platelet association, embolism
- vascular adhesion
Distant accomplices
- vascular progenitors
- metastatic niche precursors
Homing
- attachment
- attraction to survival signals
Extravasation
- motility, vascular remodeling
Micrometastasis
,- survival in dormancy
Co-opted stroma
- angiogenesis, inflammation
- cancerized stroma
Full colonization
- organ specific metastasis factors and functions
Metastasis - complex multi-step process, not all tumors sufficiently mutated to do this
1. Tumor cells proliferate (cell cycle unregulated)
2. Avoid immune system recognition
3. Tumor must vascularise (angiogenesis)
4. Local invasion
5. Penetration of blood vessel
6. Spread - accumulation of cells in small vessels
7. Exit from the vessels
8. Invasion and proliferation
Vascularisation
- angiogenesis necessary fto supply oxygen and nutrients for growth
- existing blood vessel will sprout and develop into the tumor
- multiple factors/pathways used = low efficacy/short term nature of anti-angiogenic
therapies
- also get development of new lymphatic vassels (lyphangiogenesis)
- new vessels (blood and lymphatic) that develop are leaky and inefficient
Invasion
- adhesion must be decreased, e.g. E-cadherin, integrin mutations
- must be able to move - multiple gene activations
- must be able to disrupt/breakdown extracellular matrix and other physical barriers
(e.g. activate MMPs)
Penetration of blood vessel
, - move towards vessels in response to oxygen and nutrients
- enter into leaky n
State the epidemiology of cancer in NZ - Answer NZ Cancer Stats
- 2017 = 24,453 new cases
- 70% of cases and deaths in > 60 year olds
- some cancer registration rates were higher for those residing in more deprived areas
- some cancers more prevalent in more deprived areas (e.g. lung), some in less
deprived (e.g. prostate)
- 2017 = 9,638 deaths (rate decreasing but population increasing)
- leading cause of death (depending on how you count it) in NZ = 30.3%
- M/P people are more likely to get cancer and to die from cancer
Explain the screening of cancer (ONW01) - Answer Detect the possibility of cancer, not
difinitive, often population based tests
At home or in clinics, variable sensitivity and specificity
Explain the diagnosis & grading of cancer - Answer How to find out
- imaging - x-ray, CT, PET or MRI
- biochemical tests - tumor biomarkers in the blood (e.g. PSA, CEA)
- biopsy - from tumor (& lymph nodes) to examine the cells microscopy to grade the
cancer
Cancer grading
- grading system depends on cancer
- 4 or 10 scale, higher number worse
- low grade = normal tissue structure, cell well differentiated
- high grade = undifferentiated, disorganised mass
* Characteristics
- large number of irregular shaped dividing cells
- large, variably shaped nuclei
- small cytoplasmic volume relative to nuclei
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