ANSWERS IN MODULE 1 CELLULAR ABERRATION

Gabrielle A. Magdaraog
BSN-III Heliodor

Course Pretest

I would explain to Mrs. Chiu that cigarette smoke is carcinogenic which means
that since her husband has been a cigarette smoker for 40 years, she is continuously
exposed to the carcinogen in her household even without experiencing first hand
smoking, and this is the reason why she developed adenocarcinoma of the lung. I
would also inform her that second hand smoke is much more dangerous than first
hand smoke or the smoke being inhaled by the smoker himself. In addition to this,
third hand smoke, which is the chemicals that has been absorbed by furniture,
clothing and linens stays for a long time. Thus, this explains her query about the
development of her adenocarcinoma in the lungs.

Part I: Evaluation

1. B
2. C
3. C
4. A
5. B
6. D
7. B
8. Rapid growth of the primary tumor
9. B
10. B
Part II: Essay

1. Before a metastasis of a cancer cell happens, it must first undergo

several delopmental stages. The first stage is rapid growth of the primary tumor;
when there is a rapid growth of a malignant tumor in a person’s body, this
indicates that the cancer progress quickly and eventually become more severe. A
malignant primary tumor growth takes up to approximately 2 months to double its
size and up to 10 years to reach a 1 cm length. In addition to this, as the
malignant tumor grows and double its size, because of altered differentiation it
looses its normal function, appears cytologically disorganized and becomes more
aggressive.

The second phase is angiogenesis at the site of the primary tumor. This
is when the tumir cells releases angiogenic factors that stimulates formation of
blood vessels. This is a very important phase in tumor growth because this helps
the tumor to grow more rapidly since it can now receive oxygen and nutrients
from the body. In addition, the vasculature developed by the tumor aids in the
spread of the cancer cells. With angiogenesis, tumor growth can exceed more
than 1 mm.
The third phase is local invasion. This is the phase where a tumor can
be able to pass through it’s basement membrane and invade the nearest blood
vessel or part of the hosts lymphatic system.

The fourth phase is detachment and embolization. Once the tumor is

able to reach the underlying blood vessels from a tissue of origin, it is now
considered as an invasive tumor. The tumor releases or sheds millions of cells
into the blood circulation but because of the hosts immune system that fights of
invading tumor cells, only 0.01% survives in the circulation. The tumor cells
protects itself by forming an emboli with the hosts platelets, this prevents them
from being destroyed by the immune system defenses and enables them to
successfully metastasize and adhere to the capillary walls of the target organ.

The fifth phase is arrest in distant capillary beds. This is when the tumor
cells are able to attach to adjacent capillary bed or lymphatic tissues from the
organ of origin. This happens because with the help of the circulation and
movement of the tumor emboli with a platelet, they can move adjacently to
tissues or organs.

The sixth phase is extravasation. This phase is when the tumor cell
uses the same process when it first invades the vascular system of the host, it
penetrates the vessel wall of the target organ by firmly attaching to the
endothelial cells. When the tumor cells successfully extravasate the organ, the
tumor cells escape through the vessel wall, thus, causing another tumor growth in
the extravascular tissue.

The seventh and final phase is termed as proliferation. This is when the
newly grown tumor in the extravascular tissue is able to gain and form new blood
supply in order for the tumor to continuously grow. Since the tumor is growing in
a new environment, adaptation in that environment is important. A more poorly
differentiated tumor cell is easier to adapt to the new environment of the
extravascular organ. This is the reason why poorly differentiated malignant
tumors are much more dangerous and invasive.

2. Normal cells and cancer cells differ in so many characteristics. Normal

cells have a uniformly shaped nuclei and a relatively large cytoplasmic volume
whereas cancer cells have a large variable shaped nuclei and a relatively small
cytoplasmic volume. Normal cells have conformity in cell size and shape and are
able to arrange into discrete tissues whereas cancer cells has a variation in cell
size and shape and has a disorganized arrangement of cells. Normal cells
possess differentiated cell structures and has a normal presentation in cell
surface markers whereas cancer cells has loss of normal specialized cell features
and elevated expression of certain cell markers. Normal cells have lower levels of
dividing cells and cell tissues are clearly demarcated whereas cancer cells has a
large number of dividing cells and has a poorly defined tumor boundaries.