Oncology notes
THE NATURE OF CANCER
Incidence the number of new cases within a certain period
Prevalence all persons who somewhere in time have been diagnosed with cancer and are still living at a
certain date
Mortality number of patients who died as a result of cancer within a certain period
Survival percentage of patients still living at a certain period after diagnosis
Cancer
A group of diseases
Uncontrolled cell growth
Invasive and forming metastases
Clonal
Disease of the genome
o Cancer is not inheritable because almost all mutations happen in somatic cells
o You can inherit germlines that increase the chance of getting cancer
Tumor
A heterogenous mass of cells
Not all are invasive and metastasising
Benign tumors not a cancer
Malignant tumors cancer
o Life threatening because:
Disturb organ function
Cancer cells compete with normal cells for O2 and nutrients
Growing tumors cause obstructions
Types of cancers
Carcinomas arise from epithelia (~85% of all cancers)
o Most exposed to carcinogens as they align inside and outside of the body
Adenocarcinomas arise from glandular tissues (e.g breast)
Sarcomas arise from mesodermal tissues (e.g. bone, muscle)
Lymphomas arise from (progenitors of) white blood cells
Carcinogen
An agent causing cancer
Causes alterations in the DNA of a cell
Cancer cells contain many alterations in the DNA
The accumulation of mutations in the DNA of a cell causes stepwise development of cancer
1
,Main characteristics of cancer
Have a different morphology
Can grow at low serum concentration
Show no/decreased contact inhibition
Can grow without substrate for attachment
10 Hallmarks: every hallmark is a potential target for selective therapy
Transformation can be used to distinguish cancer cell from non cancer cell in the lab
o The cell grows unattached to the surface
Treatment of cancer
2
, Surgery
Radiotherapy
Chemotherapy
Prevention of cell division cytostatic effect
Killing of cancer cells cytotoxic effect
Therapeutic window difference between max tolerated
dose (MTD) and the min dose needed to exert anti-cancer
activity
CANCER GENOME: MUTATIONS VS REPAIR
DNA
Sugar + phosphate group + base
Base
o Pyrimidine: thymine, cytosine
o Purine: adenine, guanine
o 3 bases = 1 codon = 1 amino acid
Thymine becomes Uracil in the transcription process
Large DNA changes
Aneuplopidy: whole chromosome gain or loss
Deletions
Chromosome rearrangements translocations
Gene amplifications
Cancer can result from (epi)genetic alteration in human cancer genes
Stability genes (e.g. repair) inactivation
Oncogenes (e.g. growth factors) activation
3
THE NATURE OF CANCER
Incidence the number of new cases within a certain period
Prevalence all persons who somewhere in time have been diagnosed with cancer and are still living at a
certain date
Mortality number of patients who died as a result of cancer within a certain period
Survival percentage of patients still living at a certain period after diagnosis
Cancer
A group of diseases
Uncontrolled cell growth
Invasive and forming metastases
Clonal
Disease of the genome
o Cancer is not inheritable because almost all mutations happen in somatic cells
o You can inherit germlines that increase the chance of getting cancer
Tumor
A heterogenous mass of cells
Not all are invasive and metastasising
Benign tumors not a cancer
Malignant tumors cancer
o Life threatening because:
Disturb organ function
Cancer cells compete with normal cells for O2 and nutrients
Growing tumors cause obstructions
Types of cancers
Carcinomas arise from epithelia (~85% of all cancers)
o Most exposed to carcinogens as they align inside and outside of the body
Adenocarcinomas arise from glandular tissues (e.g breast)
Sarcomas arise from mesodermal tissues (e.g. bone, muscle)
Lymphomas arise from (progenitors of) white blood cells
Carcinogen
An agent causing cancer
Causes alterations in the DNA of a cell
Cancer cells contain many alterations in the DNA
The accumulation of mutations in the DNA of a cell causes stepwise development of cancer
1
,Main characteristics of cancer
Have a different morphology
Can grow at low serum concentration
Show no/decreased contact inhibition
Can grow without substrate for attachment
10 Hallmarks: every hallmark is a potential target for selective therapy
Transformation can be used to distinguish cancer cell from non cancer cell in the lab
o The cell grows unattached to the surface
Treatment of cancer
2
, Surgery
Radiotherapy
Chemotherapy
Prevention of cell division cytostatic effect
Killing of cancer cells cytotoxic effect
Therapeutic window difference between max tolerated
dose (MTD) and the min dose needed to exert anti-cancer
activity
CANCER GENOME: MUTATIONS VS REPAIR
DNA
Sugar + phosphate group + base
Base
o Pyrimidine: thymine, cytosine
o Purine: adenine, guanine
o 3 bases = 1 codon = 1 amino acid
Thymine becomes Uracil in the transcription process
Large DNA changes
Aneuplopidy: whole chromosome gain or loss
Deletions
Chromosome rearrangements translocations
Gene amplifications
Cancer can result from (epi)genetic alteration in human cancer genes
Stability genes (e.g. repair) inactivation
Oncogenes (e.g. growth factors) activation
3