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52 Cards in this Set
- Front
- Back
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What are the four types of cells of the immune surveillance system? |
1. Natural killer cells (NK) 2. Cytotoxic T-Cells 3. Cell-mediated T-cells (effector T-Cells) 4. B-Cells |
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What do Natural Killer cells do? |
They directly kill tumor cells (helped by cytokines: interferon IFN, and interleukon 2, IL-2) |
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What are cytokines? |
Molecules used for communication between cells to trigger that protective defenses of the immune system that eradicate pathogens. |
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What does cytotoxic mean? |
Toxic to living cells |
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What are cytotoxic t-cells? |
They directly kill tumor cells. |
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What are cell-mediated T-cells? (effector T-cells) |
They produce lymphokines ( a type of cytokine that directs immune system response through signalling between cells). this activates macrophages and Natural Killers and produces a tumor necrosis factor. |
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What are B-cells? |
B-cells develop antibodies to tumor antigens. They bind together on the tumor cell, working through cytotoxic t-Cells and sensitized T-cells to kill the tumor and activate macrophages. |
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Tumor Escape Strategies
What two things can a tumor due to disguise or show less of itself? |
1. It lowers its histocompatibility molecules on its surface so the immune system's cytotoxic lymphocytes can't recognize it.
2.Some can stop producing their antigens. |
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What chemical can it produce to reduce the efficiency of the immune system? |
It can produce immunosuppressive factors. |
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How can tumors get the immune system used to them and to disregard them as threats? |
Tumor antigens can induce immunologic tolerance. (Hey, it's OK, no problem) |
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What is the result of tumors blocking t-cell receptors? |
The immune system is prevented from recognizing and attacking tumor cells. |
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How can tumor antigens be masked? |
Antigens on the surface of tumors may be masked by sugar (mucopolysaccharides) |
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What are tumor markers? |
Biological substances synthesized and released by cancer cells - or by the host in response to the presence of tumors. (Can be detected through lab tests for screening, early detection, diagnosis, and monitoring) |
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What is the most common non-skin cancer in men? And the second most common cause of cancer death in men? |
Prostate Cancer |
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What is adenocarcinoma? |
A type of cancer that forms in glands thorough-out the body, such as the lungs, prostate gland, colon. It is a malignancy of the epithelial tissue. 95% of prostate cancers are adenocarcinoma. |
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What zones of the prostate gland can be impacted by prostate cancer? |
The Peripheral zone (PZ) - Outer portion where 70% grow The Transitional Zone (TZ) - 20% grow |
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Which are more aggressive - the Peripheral zone or the Transitional zone? |
The peripheral zone |
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What are the early signs of prostate cancer? |
In the earliest stages, there are no signs. |
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What are locally advanced signs of prostatepathophysiology? |
-Obstructive urination -Growth into the urethra or bladder neck -Hematuria (blood in urine) |
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What are advanced signs of prostate cancer? |
-Spread to the pelvic lymph nodes -Edema of the leg - lymphatic obstruction -Pelvic discomfot |
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What is the most common type of cancer in women in the US (outside of skin) and the second most frequent cause of death from cancer? |
Breast cancer (Dong Lee reports 227,000 new cases in USA in 2012) |
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What are breast lobules and ducts? |
A network of lobes in the fatty tissue made of tiny, tube-like structures called lobules. The lobules contain milk glands. The lobules are linked by thin tubes called ducts.
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What are the major types of breast cancer? (from Dong Lee's slide) |
Ductal carcinoma (70%) - originate in breast duct Lobular carcinoma - 10% - originate in breast lobule Other: mixture of ductal and lobular |
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Why can cancer spread easily from the breast ? |
Blood and lymph vessels run throughout the breast |
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What steps can women take for early detection? |
-Yearly mammograms (after age 40)
-Regular clinical and self-examinations |
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What are the symptoms of breast cancer? |
-New lumps or thickening in the breast -Nipple tenderness, discharge, or physical changes -Warm, red, swollen breasts with a rash resembling the skin of an orange -Sometimes there are no visible or obvious symptoms |
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What are etiological factors in the development of breast cancer? (From Dong Lim's presentation) |
-Age and gender -Family history -Genes (BRCA1 and BRCA2) -Early menstruation or delayed menopause -Alcohol use |
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What are breast cancer risk factors? (From Dong Lim's slide) |
-Alcohol use -Childbirth (after age 30) -DES to prevent miscarriage -Hormone therapy -Obesity -Radiation |
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(From Dong Lim's slide) What can the pathology report tell a woman about her cancer? (Three types) |
The lab tests will show:
1) If the tumor is hormone-dependent. If the tumor is receptive to estrogen or progesterone, two female hormones, the treatment may include hormonal treatments.
2. HER2 results. HER2 is a gene that can play a role in development of breast cancer. Targeted medication therapies can be used with HER2-positive tumors.
3. If the cancer is triple-negative. This means there are: -No estrogen receptors -No progesterone receptors -No high levels of HER-2/ |
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(All the following breast cancer slides are also from Dong Lim's slide)
What types of staging test show if the cancer has spread? |
-Lymph node biopsy -CT scan -MRI -Bone scan -PET scan |
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What does TNM system mean? |
TNM is a breast cancer staging system based on: -The size of the Tumor -Whether cancer has spread to nearby lymph Nodes -whether the cancer has Metastasized |
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How many stages of breast cancer are there? |
Stage 0 Stage 1 Stage 2 Stage 3 Stage 4 |
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Has the tumor metastasized in Stage 0? |
No, it is "in situ." The cancer has not spread from the duct, lobule, or nipple. |
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What happens in Stage 1A and 1B? |
IA - The tumor is up to 2 centimeters, but has not spread from the breast or into the lymph nodes.
1B - Small group of cancer cells are in the lymph nodes, with or without a breast tumor of up to 2 centimeters. |
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Stages 2 A? |
The cancer is invasive. The size is increasing and it may have spread to the lymph nodes.3 conditions: Size: Larger than 2 millimeters and found in 1-3 axillarylymph nodes OR 2 cm or smaller and has spread to the axillary lymph nodes OR 2-5 cm and has NOT spread to the axillary lymph nodes. |
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Stage 2B? |
The tumor is larger and may have invade lymph nodes: -tageS2-5 cm, small group of breast cancer cells are in the lymph nodes; -Larger than 5 cm but not in the axillary lymph nodes. |
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Stage 3a? |
The lymph nodes are definitely involved now 1.There may be no tumor and 4-9 axillary lymph nodes or in the lymph nodes near the breastbone; 2)or a tumor larger than 5 cm, small groups of breast cells in the lymph nodes, 3)or the tumor is larger than 5 cm with cancer having spread to 1-3 axillary lymph nodes or to the lymph nodes near the breastbone. |
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Stage 3b? |
Tumor size increases, signs of inflammation, and lymph node involvement.
The tumor may be any size and has spread to the chest wall and//or skin of the breast and caused swelling or an ulcer (sign of inflammation). It also has spread up to 9 axillary lymph nodes or to lymph nodes near the breastbone. |
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Stage 3c? |
-The tumor may have spread to the chest AND has spread to the lymph nodes in one of these ways: -10 or more axillary lymph nodes -Lymph nodes above or below the collarbone -Axillary lymph nodes or t lymph nodes near the breastbone. |
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Stage 4? |
Invasive breast cancer that has spread beyond the breast and nearby lymph nodes to other organs of the body, such as the lungs, distant lymph nodes, skin, bones, liver, or brain. |
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What are treatment options? |
Treatment depends upon the stage of cancer, known mutations, menopausal status, the patient' ages and general health. Possibilities: -Surgery -Adjuvant Therapy -Radiation Therapy -Hormone Therapy -Chemotherapy -Targeted therapy |
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What is adjuvant therapy? |
Treatment given in addition to surgery to reduce the risk of recurrence (biologic therapy, hormone therapy, vitamin therapy) |
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What is neoadjuvant chemo? |
Neoadjuvant chemo is given before surgery to shrink a large tumor. |
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What is adjuvant chemo? |
Adjuvant chemo is given after surgery to reduce the risk of recurrence. |
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What is targeted therapy? |
Treatment that targets cancer cells while minimizing damage to health cells. |
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What is a clinical trial and its phases? |
A clinical trial is a planned experiment that involves volunteers.
Investigational medication must go through different phases of clinical trials before FDA approval: Laboratory studies first, then animal studies, then human studies. |
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What is the preclinical phase? |
Non-human studies (In vitro or with animals)
Absorption, Distribution, Metabolism, Excretion (ADME) |
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What is a Phase I clinical trial? |
-Testing dosage (safety and toxicity) in humans -Require small numbers of volunteers, closely monitored -Are of short duration
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What is a Phase II clinical trial? |
-Continue to evaluate drug safety -The dose that works the best with the least side effects -Involve a larger number of volunteers |
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What is a Phase III clinical trial? |
-Continue to evaluate drug safety -Compare investigational drugs with current standard treatment -Monitor long-term effectiveness -Larger number of volunteers |
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What is a Phase IV clinical trial? |
-Post-marketing surveillance -Long-term safety and efficacy |
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Also, remember to review your 5 homework assignments! |
GOOD LUCK! |
