Oncology
Lecture Prep and Study Guide
Topics that will be covered in class today:
Biology of Cancer
Required preparation before class
See Class Calendar
Study Guide/Objectives for after class
Oncology
Explain how cancer cells differ from normal cell characteristics.
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
Cancer cells are constantly moving through the cell cycle stages and have no
checkpoints. This leads to DNA errors being unrecognized and no apoptosis.
The disregard growth inhibitors and proliferate, eventually outgrowing their
environment or even traveling to distant body sites.
Distinguish between cell proliferation and differentiation.

Proliferation: Is the accumulation of cancer cells as they grow on top, around,
and besides each other due to the disregard of normal growth inhibitors
 Differentiation: Refers to the extent that neoplastic (cancer) cells resemble
normal cells in structure and function.
o Complete structural and functional dysfunction is called anaplasia
Relate the properties of cell differentiation to the development of a cancer cell line.
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Discuss how cancer cells break cell rules.
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Cancer cells fail to hold normal; Contact inhibition, Cohesion, Proliferation
control & rate, and HLA antigens that recognize self and stop auto-cellular
destruction due to “Nonself” markers.
Explain the ways in which benign and malignant neoplasms differ.
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
Benign tumors: Slow growth, well demarcated tumor with cohesive capsule of
cells, well differential (resembling tissue of origin), and do not metastasis and
have no necrosis.
 Tumors remain clustered and can be removed
Malignant Tumors: Erratic growth that is invasive with frequent metastasis
and necrotic core. They are also poorly differentiated leading to anaplastic
structure.
 Tumors often metastasize (breakaway and form more tumors)
Identify the stage of cancer when given a client description (using both the staging system
and TNM systems)

Stage Scale:
o Stage 1: Confined to organ of origin
o Stage 2: Locally invasive
o Stage 3: Regionally spread
o Stage 4: Spread to distant sites
 Grading Scale
o Grade I: cells are well-differentiated
o Grade 2: cells are moderately differentiated
o Grade 3: poorly differentiated or anaplastic cells
 TNM
o Tumor size, location, and involvement
 T0: no evidence of tumor
 TIS: Tumor in situ (growing in tissue but not going deeper)
 T1-4: progressive increase in tumor size or involvement
o Node involvement
 N0: no spread to regional lymph nodes
 N1: spread to closest or smaller number of lymph node
 N2: Spread to most distant or numerous lymph nodes
o Metastasis to distant organs
 M0: None
 M1: Yes
Discuss the concept of metastasis.
Describe genetic mechanisms of cancer risk.

Gene mutations, either hereditary or acquired, can cause an increase risk of
cancer. These mutations are often:
o Inactivated tumor suppressor gene
 P53 (tumor suppressor gene that controls apoptosis, natural cell
death)
o Mutated proto-oncogene
 Proto-oncogenes control a cell’s transition through the cell cycle,
when mutated causes constant and unrelenting cellular proliferation
and cycling.
o Growth signal permanently switched on
Discuss the differences and similarities between carcinogens and promoters.
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Carcinogens are substances that cause the development of cancer due to
cumulative damage resulting in alternation of the cell’s DNA
Promotors are agents that support the development of cancer such as diet,
alcohol, tobacco, and hormones
Both Carcinogens and Promotors lead to the development of cancers but
promotors don
Trace the pathway for cancer spread: seeding, implantation and metastasis (vascular and
lymphatic spread).
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Slide 32
Describe common locations for secondary tumors.
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
Lungs, Bone, Liver, and Brain
Secondary tumors require nutrients and O2 so they need access to blood. To
gain access to blood they undergo angiogenesis which is the construction of
new blood vessels due to excreted endothelial growth factor for neoplastic
cells.
State how lifestyle can contribute to the cancer risk through increased exposure to
carcinogenic agents.


Lifestyle can contribute to cancer risk through an increased exposure of
carcinogens leading to accumulation of damage to the cells and increased risk
of cellular mutations. Lifestyle choice can also lead to cancer promotion like
obesity, smoking, alcohol, hormone
s which support cancer development.
Discuss the modifiable and non-modifiable risk factors of the selected types of cancer (lung,
breast, cervical, and colorectal).

Modifiable risk factors for:
o Lung:

Primary/Secondary Smoke, Asbestos, Arsenic, Radon, COPD
o Breast:
 prolonged reproductive life, no pregnancies, late childbirth,
hormone replacement therapy, obesity due to estrogen storage in
fat.
o Cervical:
 Smoking, HPV infection, Two or more lifetime sexual partners,
immunosuppression
 Condylomata (genital warts) does not cause cervical cancer
but all Cervi cancer patients should test for HPV/
o Colorectal:
 Not getting screened at 45 and every 10 years after, tobacco useage,
physical inactivity, low fiber diet, high amount of animal fat, Low
vitamin A,C, and E, and heavy alcohol usage
 Non-modifiable risk factors for:
o Lung:
 Genetics
o Breast:

Age > 50, family Hx, Jewish, BRCA1 and BRCA2 mutations
o Cervical:
 Genetics, Hx of sexually transmitted
o Colorectal:
 Insulin resistance
 Ulcerative colitis
Describe signs and symptoms of lung, breast, cervical, and colorectal cancers.
o Lung:

Hemoptysis (blood in sputum), Abnormal lung sounds, Dyspnea,
Excessive fatigue, weakness, cough, accumulation of secretions, often
asymptomatic, paraneoplastic syndrome is often the first sign of lung
cancer
 Production of ACTH from lung tumor leading to a tanned
appearance
o Breast:
 Non-tender, firm tumor in breast with irregular borders often found
in the upper outer quadrant of the breast. Swelling in one breast,
nipple discharge, nipple/skin retraction
 Peau d’orange: a thickening of the skin that resembles an
orange peel
 Pagets disease: redness, crusting, pruritus, and tenderness of
the nipple
o Cervical:
 Long asymptomatic period before disease becomes clinically evident
 Most often caught via an abnormal pap test
o Colorectal:
 Most often begins as polyps in the lumen
 Fatigue, weakness, weight loss, iron deficiency anemia, changes in
bowel habits, Melena (blood in the stool), Diarrhea, Constipation,
rectal bleeding
Normal A & P Review (Study questions for exam)
Give a basic definition of the cell cycle and describe its purpose.
Differentiate between G0 and the cell cycle.
Discuss how the rate of cell division differs between different types of cells.
Describe the basic differences between stem cells, parent cells, and well-differentiated cells.
Describe the 3 basic rules of cell proliferation.
Define cell differentiation.