Cancer Concepts Final

Front 1

What Are Protein Kinases?

Back 1

1. Kinases add LARGE, CHARGED PO3 to proteins --> conformational change (change protein func.)
2. ATP and GTP are P03 donors.
3. PK are drug targets.
4.Tyrosine, Serine, Threonine are aa that are phosphorylated.

Front 2

What is involved in the process of metastasis?

Back 2

1. Cellular discohension
2. Invasion through BM
3.Invasion to blood/lymphatics.
4. Survival in blood/lymphatics.
5. Growth in "foreign soil"
6. Recruit new vasculature.

Front 3

Cells are normally anchored to:

Back 3

BM, ECM and other cells.

Front 4

Invasion through BM requires?

Back 4

Enzymes and cell motility!

Front 5

Invasion Into Blood/Lymphatic Vessels requires that:

Back 5

Blood and Lymphatic vessels be breached.

Front 6

Survival in blood/lymphatics requires that cancer avoid?

Back 6

immune system

Front 7

For cancer to exist the blood and lymphatics what is required?

Back 7

that vessels be breached!

Front 8

Metastasis necessarily means the ability to grow in an environment that is

Back 8

FOREIGN to the one the cell originated in.

Front 9

In the absence of blood vessels, growth of a colony of cells is limited to?

Back 9

Diffusion of oxygen and nutrients.

Front 10

What is angiogenesis and why do cancers need it?

Back 10

No blood No life

Front 11

What is angiogenisis and why do cancers need it?

Back 11

1. degrade BM of existing vessel.
2. migration of endothelial cells into interstium
3. lumen formation
3. Generation of new BM.
4. Fusion of newly formed vessels.

Front 12

MMPs are invovled in what step of what pathway?

Back 12

angiogenesis - first step and they allow pericytes to detach

Front 13

Pericytes are associated with what?

Back 13

angiogenesis

Front 14

Where does lung cancer spread?

Back 14

Bone, liver adrenal glands brain

Front 15

Where does breast cancer spread?

Back 15

Bone liver lungs brain

Front 16

Where does colon cancer spread?

Back 16

Abdominal cavity, liver, lungs

Front 17

Where does prostate cancer spread?

Back 17

bone

Front 18

Where does pancreatic cancer spread?

Back 18

Liver, abdominal cavity

Front 19

Where does renal cell carcinoma spread?

Back 19

Lungs, Bones, Brain

Front 20

What are the major reasons that surgery is used when approaching cancer?

Back 20

1.Dx (biopsy)
2.Cure (R0 all out) R2 (still gross tumor left)
3.Palliation

Front 21

What are the major reasons that radiation is used when approaching cancer?

Back 21

1. Radical cure
2. Adjuvant Radiation After Surgery
3. Palliative Radiation

Front 22

Adjuvant Radiation After Surgery does what?

Back 22

Improves survival and local disease!

Front 23

Cranial radiation is done to "control" what?

Back 23

metastatic disease

Front 24

What are the major reasons that drugs are used when approaching cancer? Chemo:

Back 24

1. Curative
2. Adjuvant
3. Palliative

Front 25

What diseases can we cure with chemo?

Back 25

Leukemia, Lymphoma, Germ Cell Cancer

Front 26

What is the ONLY reason we give adjuvant chemo?

Back 26

TO IMPROVE SURVIVAL! (after radiation or surgery)

Front 27

What pallative cancer treatment relieves Pain, Dyspnea, and improves performance Status?

Back 27

chemo

Front 28

What are the classes of chemo drugs:

Back 28

1. Alkylators
2. Anti-metabolites
3. Topoisomerase Inhibitors
4. Microtubule Binding Drugs
5. antibodies
6. tk inhibitors
7. pt
8. hormmonal therapies

Front 29

What are the alkylators?

Back 29

Cyclophosphamide, Nitrogen Mustard

Front 30

What are the anti-metabolites:

Back 30

1.Fluorouracil (Capecitabine), 2.Cytarabine
3.Gemcitabin
4.Methotrexate
5.Fludarabine

Front 31

What are the Topoisomerase Inhibitors:

Back 31

1.Doxorubicin
2. Etoposide
3. Irinotecan

Front 32

What are the Microtubule Binding Drugs:

Back 32

1.Vincas
2.Taxanes

Front 33

What are the Antibodies:

Back 33

Trastuzumab, Cetuximab, Rituximab

Front 34

What are the TK inhibitors:

Back 34

Erlotinib, Sunitinib, Lapatinib

Front 35

What are the Platinum Compounds:

Back 35

Cisplatin, Carboplatin, Oxaliplatin

Front 36

What are the hormonal agents:

Back 36

1.Tamoxifen
2. Aromatase Inhibitors (Anastrazole),
3. LHRH Agonists

Front 37

What are the four ways that chemo drugs are metabolized?

Back 37

1. Renal
2. Hepatic
3. Intracellular
4. Prodrugs

Front 38

What drugs are primarily renal?

Back 38

Platinum Analogues, Methotrexate, Bleomycin

Front 39

What drugs are primarily hepatic?

Back 39

Taxanes, Vincas, Anthracyclines, Camptothecins, TKIs

Front 40

What drugs are primarily intracellularly metabolized?

Back 40

5-FU, Gemcitabine, Cytarabine, Fludarabine

Front 41

What are the prodrugs?

Back 41

Cyclophosphamide, Capecitabine, Irinotecan, Tamoxifen

Front 42

What is the most common toxic effect of chemo drugs and which drugs are exceptions:

Back 42

Myelosuppression –
Exceptions: Vincristine, Bleomycin, TKIs, Antibodies, Cisplatin

Front 43

What drugs cause nausea?

Back 43

Cisplatin, Nitrogen Mustard, Doxorubicin, Nitrosureas

Front 44

What causes renal side effects:

Back 44

Cisplatin

Front 45

What drugs cause neurological problems?

Back 45

Vincristine, Taxanes, Cis-/Oxalo-platin

Front 46

What drugs cause cardiac problems?

Back 46

Doxrubicin, Trastuzumab

Front 47

What do you FOCUS on in Palliative care? Focus on the P

Back 47

Focus on patient goals and prognosis (PP)

Front 48

What interventions work to prevent cancer?

Back 48

1. tobacco cessation
2. diet
3.surgery (in heritable cancers)
4. Drugs to Prevent Cancer
5. Vaccines to Prevent Cancer

Front 49

What are the drugs to prevent cancer:

Back 49

Finasteride: Prostate Cancer
Tamoxifen, Raloxifene: Breast Cancer

Front 50

What are vaccines to prevent cancer:

Back 50

Hepatitis B: Hepatocellular Cancer
Papilloma Viruses: Cervical, Head and Neck Cancers

Front 51

What are 3 definitely effective screens for cancer:

Back 51

Mammogram, PAP, colonoscopy

Front 52

Name to maybe useful screens:

Back 52

Chest CT in Smokers for Lung Cancer
–
Liver Scan/AFP in HB/CV(+) for Hepatoma

Front 53

What is the definition of a positive screen:

Back 53

Reduces Morbidity and Mortality of Screened Cancer, NOT Just Able to Find the Cancer at an Early Stage

Front 54

Staging vs Grading systems:

Back 54

Staging -TNM
Grading - morphological guidelines

Front 55

Does Staging or grading have strong prognostic value?

Back 55

STAGING - STRONG

some - prognostic value, but little theraptutic value

Front 56

Give me the real general stages for cancer:

Back 56

Stage I –Small Tumor, Negative Nodes
Stage II –Larger Tumor or Tumor Invades Deeper Structures, Negative Nodes or Only Immediate Nodal Group
Stage III –Larger Tumor or Positive Nodes
Stage IV –Distant Metastatic Disease

Front 57

Ped oncology has more of what kind of tumors that adult oncology and less of what?

Back 57

More Leukemias, less carcinomas

Front 58

Prediliction for Cancer in Children occur when?

Back 58

Growth spurts

Front 59

Do kids or adult cancers more associated with the enviroment?

Back 59

Kids are not associated with enviroment!

Front 60

How important is staging in pediatric cancers?

Back 60

NOT important!

Front 61

Is cancer more common in kids or adults?

Back 61

adults

Front 62

What long term health issues might survivors of cancer have to deal with?

Back 62

1. Increased risk of second cancers.
2. Long term side effects

Front 63

What are the long term side effects of chemo:

Back 63

Heart Failure, Leukemia, Sensory Neuropathy, Renal Insufficiency, Sterility, Pulmonary Fibrosis, etc.

Front 64

What are the long term side effects of radiation:

Back 64

Dementia, Sarcomas, Leukemia, Growth Retardation, Dry Mouth, Strictures, etc.

Front 65

What are the long term side effects of surgery:

Back 65

Lymphedema, Malabsorption, Maintenance of Stomas, Dyspnea, etc.

Front 66

How can you explain differences in the incidence of cancer around the world?

Back 66

1. Differences in enviroment
2. Access to health care

Front 67

Betel nuts cause cancer where?

Back 67

Asia, east Africa, tropical pacific

Front 68

Where is the Esophageal Cancer Belt?

Back 68

Caspian Sea to China

Front 69

Infections in two regions cause what kind of cancer via what assault?

Back 69

1. HepB, Hepatoma in Asia
2. EBV, Burkitt’s Lymphoma in Africa

Front 70

Where is cervical cancer really problematic?

Back 70

Third world

Front 71

What pathologic changes do cells undergo as they transform from normal to cancer?

Back 71

Normal → Hyperplasia → Dysplasia → CIS → Invasion

Front 72

What does pleomorphic mean?

Back 72

change in size, and shape of cell

Front 73

Name 4 TS genes:

Back 73

TP53, APC, RB, BRAC1

Front 74

Name some oncogenes:

Back 74

sis–B Chain of PDGF
erb-2–HER2
EGFR
KRAS, abl, src
MYC, HOX

Front 75

what are some of the normal functions of protooncogenes?

Back 75

Receptors, growth factors, intracellular signal transduction, nuclear TF

Front 76

sis–B Chain of PDGF is a ____ and what subtype?

Back 76

sis–B Chain of PDGF -
oncogene - Growth factor

Front 77

How does HER2 and egfr work?

Back 77

obvi

Front 78

KRAS is an oncogene invovled in ____ and it does what?

Back 78

GTP ase

Front 79

Neoplasia means ___ and does not neccessarily refer to?

Back 79

new growth and does Not Necessarily Refer to Benign or Malignant

Front 80

what's the difference between carcinoma in situ and invasive cancer?

Back 80

spread

Front 81

Increase in Number of Cells is called?

Back 81

hyperplasia

Front 82

Transformation of One Cell Type Into Another is called?

Back 82

metaplasia

Front 83

Abnormal Development of Cells is called?

Back 83

dsyplasia