Cancer Flashcards
- Name the three main types of skin cancer and the cells affected in each.
- Basal cell carcinoma (basal cells)
- Squamous cell carcinoma (squamous cells)
- Melanoma (melanocytes) is considered the most serious
Discuss the relationship between sun exposure and skin cancer
The suns ultraviolet radiation is the main cause of cancer. Increased exposure damages the DNA skin cells. Damage over time causes the cells to grow out of control (skin caner).
Describe the appearance of basal cell carcinoma, squamous cell carcinoma and melanoma
BCC- Basal cell carcinoma appears as a lump or dry scaly area, it can be red pale or pearly in colour. As it grows, it may ulcerate and appear to not to heal properly.
SCC- Squamous cell carcinoma appears to be a thickened red scaly spot that may bleed easily, crust or ulcerate.
MELANOMA- Melanoma appears as a raised lesion, often red or pink although some are brown or black in colour
Compare the treatments of basal cell carcinoma, squamous cell carcinoma and melanoma.
Basal cell carcinoma – treatment include procedures such as electrodesiccation and curettage (ED&C). the tumor is scraped down to its base followed by pulses of electrical energy.
Squamous cell carcinoma – treatment include mohsmicographic surgery. The goal is to revome skin cancer one layer at a time. After each layer is removed, it is sent for further examination to determine if more layers need removal.
Melanoma – early stage: a biopsy is taken, removal of tumour by removing it. A wide local excision may be required where the skin surrounding the melanoma is removed to reduce the risk of reoccurrence. Later stage: surgery is used to assess how far the cancer has spread. Invasive surgery to remove lymph nodes.
Discuss the terms angiogenesis and metastasis.
Metastasis: is the medical term for cancer that spreads to different parts of the body from where it started. When this happens, doctors say the cancer has ‘metastasized’. Other names for metastasis are ‘metastatic cancer’ and ‘stage 4 cancer’. Sometimes the term ‘advanced cancer’. In metastasis, cancer cells break away from where they first formed (primary cancer), travel through the blood or lymph system, and form new tumours (metastasis tumours) in other parts of the body. The metastatic tumour is the same type of cancer as the primary tumour.
Angiogenesis: literally means creation of new blood vessels. The word ‘angio’ means blood vessels while genesis means creation.
Compare benign with malignant tumors.
Benign: Grows slowly well-defined capsule not invasive well differentiated does not metastasis
Malignant: Grows rapidly not encapsulated invasive poorly differentiated Does metastasise
Identify why cancers are more prevalent in older people?
Due to accumulated exposure to carcinogens and age-related declines in the action of the immune system. Older adults are less likely to undergo cancer screening due to fear, depression, cognitive impairments, and poor access to healthcare and financial constraints. Some older adults my mistake cancer symptoms for normal age related changes.
Discuss the common bacterial and viral causes of cancer.
Viral causes of cancer- hepatitis B and C affects the liver and human papillomavirus (HPV) affects the cervix.
Bacterial causes of cancer- Helicobacter pylori (H. pylori) infects the lining of the stomach duodenum. Responsible for gastric carcinomas.
List and describe the common risk factors in the development of cancer.
Age – common cancer statistics are; breast cancer 61yrs, colorectal cancer 68yrs, lung cancer 70yrs, prostate cancer 66.
Tobacco – chemicals in the tobacco causes cancer of the lung, larynx, mouth, oesophagus, throat, bladder, kidney, liver, stomach, pancreas, colon, rectum and cervix.
Sunlight – U radiation causes early aging of the skin and skin damage.
Discuss how diet and physical activity may assist in the prevention of cancer.
Poor diet can lead to risk of developing cancer specifically those found in the digestive tract, eating foods such as fresh veg, fruit and legumes and by having a high fiber intake keeps food moving through the digestive tract, in a sense keeping it ‘clean’. Sugars and preservatives are stored as toxic fats which accumulates around the vital organs which increases the risk of developing cancers.
Little or no physical activity increases the risk of developing the following cancers, 14% colon, 11% breast. Regular exercise can reduce body weight which can contribute to the development of other factors that influence the risk of developing cancer.
Discuss the clinical manifestations of pain, fatigue and cachexia in relation to cancer development.
-PAIN:
little or none associated with early malignancy stages
-does occur in 60-80% of patients
-influenced by: fear, anxiety, sleep loss, fatigue, overall physical deterioration
FATIGUE:
- Sleep disturbance
- Biochemical changes from circulating cytokines
- Psychosocial factors
- Level of activity
- Nutritional status
- Environmental factors
CACHEXIA: most severe form of malnutrition present in 80% of cancer patients at death -Anorexia -Early satiety -Weight loss -Anemia -Asthenia -Taste alterations -Altered protein, lipid, & carbohydrate metabolism
Describe the three key events involved in the process of carcinogenesis.
Initiation – the initial event when the cell is exposed to an initiating factor (carcinogen)
Promotion – a secondary event when the cell is exposed to additional factors (co-carcinogens) that promote growth of the transformed cells
Progression – third stage when the cellular changes are irreversible and express malignant characteristics
What is the term used to describe the self-destruct mechanism cells have when growth is excessive, and why is it necessary?
The self-destruct mechanism is called apoptosis and ensures that abnormal cells are destroyed to preserve the health of the body.
Identify three common sites of metastasis
Bone, liver, lung
What is a cytokine?
Are chemical signals that are released by immune cells to signal between immune system processes
Identify two cytokines associated with the body’s response to cancer
Interleukin-1 (IL-1) from macrophages to induce the inflammatory response
Interleukin-2 (IL-2) from helper T-lymphocytes to increase the function of natural killer cells.
Discuss the information included in most cancer staging systems and the purpose this serves in relation to treatment.
- where the tumour is located in the body
- the cell type (adenocarcinoma or squamous cell carcinoma)
- size of the tumour
- if the cancer has spread to nearby lymph nodes
- whether the cancer has spread to a different part of the body
- tumour grade, how the abnormal cancer cells look and how likely the tumour is to grow/spread.
Using breast cancer as an example, what are other important factors that need to be considered in determining cancer treatment?
- Prognosis
- Side effect
- risks – infections
- psychological impacts / body image / support / palliative care
- education / understanding
- pain management / medications / side effects
The TNM system assists clinicians to describe cancer in detail. For many cancers however, the TNM combinations are often grouped into five less-detailed stages.
Define the elements of the TNM acronym and describe the five, less detailed categories used to assign an overall stage of cancer.
T – tumour size (original /primary tumour)
N – involvement of lymphatic nodes
M – degree of metastasis
Stage 0 – (not applicable to all forms of cancer) Abnormal cells are detected within the top layer of cells within the affected body region.
Stage 1 – when abnormal cells clump together and penetrate beneath top layer of cells within the organ of origin.
Stage 2 – cancerous cells begin to grow into a small tumour within the organ of origin
Stage 3 – as the cancerous tumour grows, it can spread into lymph nodes and surrounding tissues.
Stage 4 – when cancer cells spread from their point of origin to another organ (metastatic).
Another stage 5 system –
In situ – abnormal cells are present but have not spread to nearby tissue
Localized – cancer in limited to the place where is started, with no sign that it has spread.
Regional – cancer has spread to nearby lymph nodes, tissues or organs
Distant – cancer has spread to distant parts of the body
Unknown – there is not enough information to figure out the stage
Brain cancer Signs and Symptoms
Headaches, seizures, nausea/vomiting, fatigue, dysphasia
Disturbed vision, hearing. Paralysis in part of the body, loss of balance, loss of memory
Leukaemia Signs and Symptoms
Bruising, fatigue, infections
Breast cancer Signs and Symptoms
A lump, rash, discharge from nipple, pain
Prostate cancer Signs and Symptoms
Difficulty passing urine, frequent urination, incontinence, blood in urine, painful urination
lung cancer Signs and Symptoms
SOB, chest pain, coughing blood, fatigue, recurring infections
Discuss the mechanisms that may cause pain in the cancer patient.
Pressure, obstruction, stretching, tissue destruction and inflammation. The pain can be related directly to the malignancy or infection. Bone metastasis causes pain that is referred away from the involved bone and manifests as back pain. Tumours can obstruct and distend the bowel causing pain.
Which cancers have the highest incidence rate in Australia?
Prostate cancer, breast cancer, colorectal cancer, melanoma and lung cancer
Identify the five factors that predispose individuals with cancer to infection. Include a rationale for each factor in your answer.
Age – immunological functions decline with age, immobility predisposes to infection, elderly predisposed to nutritional inadequacies
Tumour – favourable to grown of microorganisms, cellular immune defects may be caused, metastasis to bone marrow may cause leukopenia or other defects in immunity.
Leukaemia’s – bleeding and breaks in skin integrity, chronic lung disease can develop later during therapy, inadequate granulocyte production
Lymphomas – cellular immune defects, splenectomy in children increases susceptibility to infection
Treatment surgery – invasive procedure interrupts first lines of defence, long postoperative stay in a hospital, patients may be older and at poor risk
Discuss the factors that contribute to the development of anaemia in patients with cancer.
Cancer can cause thrombocytolic, which causes haemorrahage and in return cause iron deficiancy leading to anemia.
Iron malobsorbtion can also cause iron deficiancy
Inaffective erythroprotin
