Questions to prepare for classes and examination
• Definition of neoplasms. Principles of classification of neoplasms.
• Forms of neoplastic cell abnormality.
• Characteristic features of benign and malignant tumors.
• Genetic hypothesis of cancer; classes of genes that incur mutations during neoplastic transformation of a cell.
• The concept of oncogenes.
• Mechanisms of transformation of protooncogene to oncogene.
• Role of antioncogenes in carcinogenesis.
• Role of genes that regulate DNA repair in carcinogenesis.
• Chemical carcinogenesis: types of carcinogens; initiation and promotion.
• Radiation carcinogenesis.
• Viral carcinogenesis.
• The concept of tumor progression. Antineoplastic mechanisms. Principles of prevention and treatment of neoplastic diseases.
N 62
A 48-year-old patient N. who has been smoking for 25 years works at the chemical plant where he deals with dyes and organic solvents. He visited his primary care physician with complaints of malaise, weakness, decreased appetite, and persistent cough without secretions. During the previous three weeks he noted the presence of blood in the urine, burning sensation in the lower abdomen aggravated by urination. The results of computer tomography scanning, X-ray, and ultrasonography attest against renal or ureter pathology in the patient. Cystoscopy shows proliferation of the bladder's mucosa with erosion of its surface. Biopsy of the lesion in the bladder shows the presence of malignant cells.
Questions
• What factors could be a potential cause of cancer of the bladder mucosa in this case? Substantiate your answer.
• What mechanisms of the anticancer defence system could have been deficient in this patient and failed to prevent the development of tumor?
• Characterize stages of carcinogenesis after the first contact of the bladder mucosa with carcinogen and up to the emergence of the tumor cells.
• Can you exclude the possibility of metastases of the lung cancer in the bladder? Substantiate your opinion.