| Term | Definition |
|---|---|
Neoplasm | A tumor or abnormal mass |
Benign | Tissue that is not malignant |
Malignant | Cancerous tissue that can invade nearby organs and circulate to other body parts |
Metastasis | Ability of cells to break away from the original mass and spread through blood to nearby or distant sites |
Carcinoma | Malignant tumor of epithelial lining/origin; ~80% of cancers |
Leukemia | Cancer of the blood |
Lymphoma | Cancer of lymphoid tissues |
Sarcoma | Malignant tumor of bone, soft tissue, muscle, or fat |
Adenoma | Benign tumor arising from a gland |
Adenocarcinoma | Malignant glandular tumor |
Neuroblastoma | Nervous-system tumor; more common in children |
Environmental cancer factors | Asbestos, lead, benzene, tobacco, UV radiation, radon, and alcohol |
Asbestos | Associated with mesothelioma |
Lead | Associated with lung cancer |
Benzene | Associated with leukemia |
Tobacco | Associated with lung cancer |
UV radiation | Associated with skin cancer |
Radon | Associated with skin cancer/lung cancer in the notes |
Alcohol | Associated with liver cancer |
Genetic cancer factors | Genetic mutations can increase cancer susceptibility |
BRCA-1 | Genetic factor associated with susceptibility to breast cancer |
Proto-oncogenes | Genes that promote cell growth and proliferation |
HER-2 | Proto-oncogene; overexpression is associated with breast cancer |
Tumor suppressor genes | Genes that downregulate/stop cell growth |
BRCA-1 and BRCA-2 | Tumor suppressor genes; mutations remove growth-control functions |
Immunosurveillance | How the immune system defends against cancer |
T cells in immunosurveillance | CD8+ T cells can destroy cancer cells |
NK cells in immunosurveillance | Destroy abnormal cells without requiring MHC recognition |
Macrophages in immunosurveillance | Release enzymes/cytokines such as TNF-α and IL-2 to kill cancer cells |
Monocytes in immunosurveillance | Participate in immune-mediated destruction of cancer cells |
Immunoediting | Genetic changes allow tumor cells to avoid immune detection |
Elimination phase | Cancer cells are identified and eliminated by the immune system |
Equilibrium phase | Immune system controls tumor cells, but some remain dormant/slow-growing |
Escape phase | Cancer cells escape immune response and continue growing |
Cancer escape: lack of antigenicity | Tumor cells have too little antigenicity to stimulate an immune response |
Cancer escape: lack of MHC | Lack of MHC prevents recognition by T cells |
Cancer escape: antigen variation | Tumor antigens may not be present on all tumor cells |
Cancer escape: rapid growth | Tumor growth can outpace the immune response |
Cancer escape: blocking factors | Tumors produce factors that suppress/block immune responses |
PD-L1 | Blocking factor that prevents T-cell recognition/activation |
Cancer escape: self-antigens | Tumor cells may express self-antigens, reducing immune attack |
Tumor-specific antigens | Antigens recognized as foreign and associated specifically with tumor cells |
Neoantigens | New antigens produced by mutations |
Neoantigen mutations | Can result from mutations in proto-oncogenes or tumor suppressor genes |
Oncogenic-virus antigens | Antigens produced by cancer-causing viruses |
Endogenous retroviral elements (ERVs) | Foreign retroviral DNA integrated into the host genome |
ERVs and tumors | Integrated viral DNA can produce tumor-specific antigens |
Epstein-Barr virus (EBV) | B-cell lymphoma and nasopharyngeal cancer |
Human papillomavirus (HPV) | Cervical cancer |
Herpes simplex virus type 2 (HSV-2) | Associated with cervical cancer, Kaposi's sarcoma, and non-Hodgkin's lymphoma in the notes |
Human immunodeficiency virus (HIV) | Associated with Kaposi's sarcoma and lymphoma |
Hepatitis B and C viruses | Associated with hepatocellular carcinoma |
Tumor-associated antigens | Antigens that are also found on normal cells |
Overexpressed tumor-associated antigens | Antigens present at higher levels on cancer cells |
Cancer/testis antigens | Antigens associated with cancer and normally expressed in testicular tissue |
Differentiation antigens | Antigens associated with a particular differentiated cell/tissue type |
Tumor markers | Substances that indicate the presence of cancer |
Source of tumor markers | Produced by tumors or tumor cells |
Tumor marker characteristics | Produced by tumor, detectable in body fluid, correlated with tumor load, elevated when disease is treatable, highly sensitive, and highly specific |
Tumor markers and body fluids | Tumor markers can be detected in body fluids such as serum |
Tumor marker and tumor load | Marker levels can correlate with the amount of tumor present |
Highly sensitive tumor marker | Should detect disease when it is present; few false negatives |
Highly specific tumor marker | Should indicate disease when it is present; few false positives |
Clinical application: screening | Used for early detection of cancer |
Clinical application: diagnosis | Used to help diagnose cancer |
Clinical application: prognosis | Used to predict disease course/outcome |
Clinical application: predicting | Can help predict treatment response |
Clinical application: monitoring | Used to monitor treatment and recurrence |
Alpha-fetoprotein (AFP) | Marker associated with hepatocellular carcinoma |
AFP and hepatocellular carcinoma | AFP can be elevated in primary hepatocellular carcinoma |
AFP and germ-cell tumors | AFP can be elevated in non-seminomatous germ-cell tumors |
AFP sample | Detected in serum/body fluid |
hCG | Marker used with AFP in non-seminomatous testicular cancer |
AFP + hCG | Used in evaluation of non-seminomatous testicular cancer |
LDH with AFP/hCG | LDH can be added to help make the diagnosis |
Serial hCG testing | Used to monitor hCG over time |
Cancer antigen 125 (CA-125) | Marker associated with ovarian cancer |
CA-125 and ovarian cancer | Used for ovarian cancer evaluation |
CA-125 screening | Can be used for screening women with a family history |
CA-125 prognosis | Can help assess prognosis and recurrence |
CA-125 limitations | Can also be elevated in endometriosis, PID, and pregnancy |
HE4 | Human epididymis protein 4; another ovarian-cancer-related marker |
OVA1 | Panel of biomarkers used in ovarian-cancer evaluation |
CA 19-9 | Marker associated with pancreatic cancer |
CA 19-9 use | Used to monitor pancreatic-cancer treatment |
CA 19-9 limitation | Not specific for pancreatic cancer |
CA 19-9 other elevations | Can be elevated with pancreatitis and cystic fibrosis |
Pancreatic cancer survival | Notes list a 5% survival rate at 5 years after diagnosis |
Pancreatic cancer diagnosis | Often diagnosed at a late stage |
Pancreatic cancer and DNA sequencing | DNA sequencing can identify important genetic defects |
Pancreatic cancer genes | KRAS, CDKN2A, SMAD4, and TP53 |
Daraxonrasib | A RAS(on) inhibitor noted as slowing cancer growth |
Pancreatic cancer treatment and sequencing | Genetic sequencing can help guide treatment decisions, especially with treatment resistance |
CA 15-3 | Breast-cancer-associated tumor marker |
CA 27-29 | Breast-cancer-associated tumor marker |
CA 15-3 and CA 27-29 | Both recognize two epitopes of the same antigen |
CA 15-3/CA 27-29 use | Used to monitor breast-cancer therapy |
CA 15-3/CA 27-29 limitation | Not specific |
CA 15-3/CA 27-29 other elevations | Can be elevated with pancreatic and liver cancers |
Carcinoembryonic antigen (CEA) | Marker associated with colorectal cancer |