Cancer 2 Flashcards
How are benign tumors named?
Tissue origin + oma
Maglingnat tumor nomenclature
Carcinoma= epithelial origin Sarcoma= Connective tissue origin Lymphoma= lymphatic tissue origin Leukemia= blood forming cell origin (emia= decline or elevation of something )
Benign qualities
- Growth rate?
- Capsule?
- Invasive?
- Differentiated?
- Mitotic index?
- Metastasize?
Slow growth Has capsule Not invasive into surrounding tissues Well differentiated- looks like tissue from where it originated Low mitotic index Does not metastasize
Malignant qualities
- Growth rate?
- Capsule?
- Invasive?
- Differentiated?
- Mitotic index?
- Metastasize?
- Growth rate? fast
- Capsule? No
- Invasive? Yes. breaks through BM
- Differentiated? Poorly differentiated. Anaplastic. Cannot tell which tissue it originated from.
- Mitotic index? High
- Metastasize? Yes, can spread distantly *** hallmark of malignant tumors
Hallmark of malignant tumors
Can spread far- metastasis
TNM cancer staging system
T= tumor N= nodes M= metastases
Predicts behavior and outcome of tumor. Helps patient understand how serious it is, treatment options and survival rate.
High value= not good
Want low value. 0= no tumor.
Tumor grading
Assess cellular differentiation and nuclear size/shape/% of tumor cells divide.
As grade increases, malignancy increasing. Evaluating aggressiveness.
GX: Undetermined G1: Well differentiated (good, low grade) G2: Moderately differentiated G3: Poorly differentiated G4: Undifferentiated
Tumor doubling time
How fast tumor doubles in size.
1 malignant cell to form takes a long time
Less time for tumor to grow and be detectable
Even less time for it to cause death
Local spread of tumor
Is through BM to nearby organs.
How does local spread occur
Increase growth rate, decrease apoptosis Decrease cell-cell adhesion Increase motility Release of lytic enzymes Mechanical pressure
Pre-invasive tumor (in situ)
Still has intact BM. As soon as BM breaks, it is considered invasive.
Distant metastases often occurs in the ____
First capillary bed encountered.
Colon –> liver
Liver –> lung
Lung –> brain
Metastatic process
Direct or continuous extension
Penetration into vessels or body cavities
Transport into lymph or blood
Entry and growth in secondary sites
Angiogenesis occurs in what stage of tumor growth
Late.
How is angiogenesis imitated?
secretion of angiogenic factors. Will release VEGF, which causes production of new blood vessels. Leaky, hemorrhage.
This deprives neighboring tissues of oxygen and nutrients.
Why it is hard to kill stem cells involved with cancer?
The stem cells may give rise to most or all cancers, but the stem cells make up a very small portion of the cancer cells.
If the stem cells are killed, they may regenerate the cancer even tho the tumor may initially get smaller.
Parenoplastic syndroms
Indirect cancer related effects to sires of the body distant from the primary tumor.
Triggered by altered immune response in response to neoplasm.
Symptoms are indirectly related with the tumor.
Usually a result of tumor producing hormones and may be the first sign of malignancy.
Parenoplastic syndroms manifestations
Mental aberration Neurologic disease Hypercalcemia Gynecomastia (increased estrogen levels) Cushings disease Electrolyte imabalnce
Symptoms associated may lead to cancer dx
Pain throughout the cancer process
In early stages, there is little to no pain
Pressure
obstruction occur (blood or urinary flow)
Invasion of sensitive structures: bone, brain, bowel
Tissue destruction
Inflammation
Main symptom of cancer
Fatigue
Causes of fatigue in cancer
Sleep distrubance, biochemical changes from disease and tx, stress, level of activity, nutrion
Cachexia
Form of malnutrition
Result of tumor and worsens by Tx (chemo)
Muscles metabolized for energy
Altered protein, lipid, and carbohydrate metabolism due to cytokines produced by tumor
What is present in 80% of cancer patients at death and causes 20% of patient death
Cachexia.
most severe form of malnutrition
Cachexia
Clinical manifestations of cancer
Anemia
Leukopenia (deficiencies in circulating RBC)
Thrombocytopenia (Deficiecies in circulating platelets)
Most common cause of death in cancer patients
Infection
Why is there an increased risk of infection in cancer patients?
Low neutrophil and lymphocyte count
Disrupted epithelial barriers
Surgery
Nosocomial infections (disease originating in hospital)
Current cancer treatment
Prevention when possible
Chemo
Drug
Surgery - solid tumors with no metastasis.
Radiation- shrink tumor and kill cells.
Emerging cancer tx
Immunotherapy, targeted molecular therapies using interferons, interleukins, and mAbs, stem cell transplantation.
Cure
No traces of cancer. Will never come back
Remission
Can be partial or complete
Complete: all signs have disappeared
5+ years of remission= cure
GI side effects of cancer tx
Mucositis- inflammation of mucus. Common cause of cancer pain and anorexia. Due to chemo.
Malabsorption
Nausea
Diarrhea
Hair and skin side effects of cancer tx
Alopecia- loss of hair
Thinned and dry skin
Ocular side effects of cancer tx
Conjunctivitis Dry eye Epiphora- watering Photophobia Corneal deposits Cataracts Pigmentary retinopathy Macular edema Retinal ischemia Optic Neuritis
