PATHO Ch. 9 Biological & Clinical Manifestations of Cancer

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Cancer epidemiology

Environmental Risk Factors

Sexual Reproductive Behavior

Radiation

Alcohol Consumption

Obesity & Physical Activity

Diet

Xenobiotics

Foods that increase your risk versus those that decrease your risk

May account for 30% of the overall risk factors for cancer

Certain chemicals that can act like mutagens

Tobacco

Cigar & pipe smokers also at risk

Secondhand smoke (EST) contains many toxic chemicals

Increases risknfor multiple cancers

Multipotent carcinigenic mixture

Genes, Environmental/Lifestyle Factors & Cancer Risk

Two thirds of all cancers are caused by environmental/lifestyle factors & occupational exposure interacting with cell & its DNA

Biology & Clinical Manifestations of Cancer

Clinical Manifestations

Hair & skin

Hair loss

GI Tract

Infection

Immune system suppression

Anemia

Related to blood loss, malnutrition, or cancer in blood forming organs

Leukopenia & thrombocytopenia

Chemotherapy drugs are toxic to bone marrow

Direct tumor invasion to the bone marrow causes leukopenia & thrombocytopenia

Cachexia

Cancer cells stealing nutrition from normal cells

Results in wasting, emaciation, & decreased quality of life

Most severe form of malnutrition

Pain

Influenced by fear, anxiety, sleep loss, fatigue, & overall physical deterioration

Occurs in 60-80% of terminally ill cancer patients

Little to no pain associated with early stages of malignancy

General Treatment Options

Metastisis

Lymphatic system

Venous system

Seeding

D: spread of cancer from a primary site of origin to a distant site

Characteristic sign of cancer

Cancer needs...

Will grow in any environment (including high acid or hypoxic states), & will steal what they need from healthy cells

No need for external growth factors

Subtopic

Blood supply

Angiogenesis

Growth of new blood vessels

Biology of cancer

Normal cells

Anchorage dependent

Must be anchored to something to grow

Have contact inhibition

Cells stop growing when they come into contact with each other

Cancer cells

Immortal

Will live forever, until host dies

Anchorage independence

Dont need to be anchored to something to grow

Lack contact inhibition

Dont stop growing when come into contact with one another - pile up

Classification

Carcinoma in situ (CIS)

Pic: basement membrane

Could...

3. Disappear entirely

2. Progress

1. Remain stable

Has properties of malignant tumors, but is not consideed cancer because it has not invaded basement memberane

Area of abnormal cell growth in epithelial tissue that hasn't invaded the basement membrane

Mitotic index

How many cells are currently reproducing

Benign vs. Malignant

Malignant

Can spread distantly (metastasis)

High mitotic index

Poorly differentiated

Invasive

Not encapsulated

Benign

Do not metastasize

Low mitotic index

Not invasive

Well-defined

Grow slowly

Malignant tumors

Named according to tissue from which it arises

Sarcomas

Connective, muscle, & bone tissue

Lymphomas

Lymphatic tissue

Carcinomas

Epithelial tissue

Metastasis

Ability of a malignant tumor to spread to other parts of the body

Pleomorphic: different size & shape from which they arise

Anaplasia: loss of differentiation

Disorganized & lose normal tissue structure

Grow rapidly

Benign Tumor

Named according to the tissues from which they arise

Well organized stroma (surrounding capsule)

Well differentiated

Diagnostics

Staging

Blood studies

Biopsies

Screening

Viruses, Bacteria, & Cancer

Heliobacter pylori

Mucosa-associated lymphoid tissue lymphomas

Stomach carcinoma

Pepetic ulcer disease

Chronic infections associated with

About 15%nof cancers are viral related

Human papilloma virus

Kaposi sarcoma herpes virus

Epsein-Barr virus (EBV)

Hepatitis B & C viruses

Inflammation & Cancer

Damaged or suppressed immune system

In both cancer & inflammation, the site will be invaded by cells to stimulate cell & vessel growth

Cancer cells like to use immune cells (neutrophils, lymphocytes, and macrophages) to help the cancer grow

Consequently, those with autoimmune diseases are at higher risk of developing cancer

Cancer-Causing Mutations

Mutations & future generations

Offsring may be effected by DNA damage of parents

Cancer is also a disease of aging

Cell damage accumulation

Changes in the DNA & chromosomes of the cell are what cause cancer to occur

Tumor Markers

Used to....

Problem: false positives/negatives

Observe clinical course of cancer

Diagnose specific types of tumors

Screen & identify individuals at high risk for cancer

D: substances produced by cancer cells or that are found on plasma cell membranes inbthe blood, CSF, or urine

5. Genes

4. Enzymes

3. Hormones

2. Antibodies

1. Antigens

Cancer

Cancer: only refers to malignant tumors

Tumor/Neoplasm: new growth