Cancer and oncology nursing Flashcards
prevalence
all cancer cases at a designated point in time
incidence
newly diagnosed cases of cancer during a specific period
- in a defined population
- expressed as a rate per 100,000 persons
- allows for comparison of populations
when looking at the statistics for cancer deaths, why does the number of deaths go up, but the percentage goes down?
we are seeing more and more cases of cancer every year, but percentage of ppl dying from it is going down because we are becoming more preventative and catching it early.
what is cancer?
-group of many different diseases
-abnormal cellular structure
-loss of normal controls on cell growth/death
-spread of malignant cells to parts of body beyond site of origin (metastasis)
Cancer overrides everything, apoptosis, etc
cancer growth patterns
Non-neoplastic growth patterns: hypertrophy, hyperplasia, metaplasia, dysplasia, anaplasia.
Neoplastic: neoplasm, benign or malignant
- Metaplasia:
- Dysplasia:
- Anaplasia: new cells completely different from parent cell. This change has been happening over long time. Late in staging.
-Neoplasm: new growth that may be benign or malignant
hypertrophy
cells enlarge
hyperplasia
more cells develop
metaplasia
may or may not lead to cancer. transposition of cells. Abnormal cell structure. Can have transposition/oddness of cells without cancer.
dysplasia, plus example
precancerous cells. Cells are altered in such a way that they are precancerous. If a patient has dysplasia of cells, and are easy to remove, they are removed (ie in cervix which is common) because they may turn into cancer. However, if deep inside the kidney or something, it’d be diff
anaplasia
new cells completely different from parent cell. This change has been happening over long time. Late in staging.
neoplasm
new growth. can be benign or malignant
normal cells vs cancer cells:
normal:
limited cell division, apoptosis, specific morphology, have a small nuclear-cytoplasmic ratio, perform specific differentiated functions, adhere tightly together, nonmigratory, grow in orderly/regulated manner (contact inhibition), euploid with 23 pairs of chromosomes
cancer:
rapid or continuous cell division, do not respond to signals for apoptosis, show anaplastic morphology (loss of normal arrangement of cells), have a large nuclear-cytoplasmic ratio, lose some or all differentiated functions, adhere loosely together (adherence is important for metastasis), able to migrate thru embryonic cells, grow by invasion, aneuploid
carcinogenesis, what is it, whats the theory, whatre the steps
Process of tumor development. Multistep process with multiple influences.
2 step theory: : cancer causing thing (ie smoking, sun exposure) PLUS the body’s inability to respond enough (immune system) –> permanent/ irreversible change to cell DNA
1. initiation 2. promotion 3. progression
carcinogen
Carcinogen: initiating agent. Starts the cancer process and then if immune system can’t stop it THEN u get cancer
-chemical, biological, physical, hormonal
cocarcinogen
promote/assist carcinogenesis
when do we want to be able to find the cancer?
Want to find it at initiation when it’s only changed a few cells. 2 hit theory is very important for understanding that immune system doesn’t only work for communicable diseases but also for cancer. HIV/aids pt have high rate of cancer because their immunocompromised
benign tumors
Show normal cell growth patterns, but the new tissue is not needed. (Can also show abnormal cell growth tho). They don’t respond to apoptosis, contact inhibition, any signals. But key thing is that they’re not harmful, don’t metastasize, are well encaspulated
examples of benign tumors
fibromas (anywhere in body in the connective tissue)
lipomas (in fat)
leiomyomas (fibroids in the uterus)
malignant tumors
Faster growing than benign, more likely to spread. These are true cancer in healthcare (laymen call everything cancer).
Differentiate benign and malignant by using word tumor.
Malignant cells divide almost continuously and gradually lose appearance of cells from which they arose
as malignant tumors become worse…
Further stage they become less and less like the original normal cell.
examples of malignant tumors
carcinoma in situ (hasn’t spread yet: stage 0).
malignant fibrosarcomas
bronchogenic carcinomas (lung type of cancer, specifically in wall of bronchus)
tumor nomenclature
- differentiated
- undifferentiated
- cell classification: cell type, originating tissue, malignant/benign, site, function
differentiated vs undifferentiated tumor cells
- differentiated (more like parent cell)
- undifferentiated (Looks a lot less like parent cell. More undiff it is, the less it acts and looks like parent cell. See cells like this on biopsy, signals that the cancer has been growing for a while.)
cancer grading
microscopic examination of biopsy of differentiation and number of mitoses of the cells.
GX: grade can not be assessed
G1: well differentiated (resembles parent cell)
G2: moderately differentiated
G3: poorly differentiated
G4 undifferentiated (does not look like parent cell
cancer staging
clinical, radiographic, surgical examination of extent/spread –> treatment, prognosis
More detailed than grading. Get stage from cat scans, x rays, etc. Tells us more than just what the cells look like.
grading v staging
grading on basis of cell appearance/activity compared with parent cell
staging classifies it on clinical aspects of the cancer and determines exact location and degree of metastasis at diagnosis
cancer staging systems
TNM, AJC
TNM
T1-4 = tumor size N0-3 = lymph node involvement M0-1 = metastasis
AJC
stages 0-IV = size of primary lesion and presence of nodal spread and metastasis
where does metastasis from blood cancer tend to go to
liver cause of blood flow.
where does mets from prostate/pancreas cancer tend to go to
bones because its prostate/pancreas are nearby legs, spine, etc.
patient has prostate cancer staged as T3, N2, M1. what does this mean?
tumor extends thru prostate capsule.
mets in single or multiple lymph nodes (2-4 cm).
distant metastasis
how does cancer compromise function?
Malignant cells do not perform intended tasks
Crowd out functioning cells
Form tumors that cause pressure on adjacent structures
Obstruct vessels
Impinge on nerves
Angiogenesis
common sites of mets, s/s
Brain (headaches, seizures, vertigo) Respiratory (cough, hemoptysis, dyspnea) Lymph nodes Liver (hepatomegaly, jaundice) Skeletal (pain, fractures, spinal cord compression)
angiogenesis: what is it, side effect?
development of new blood vessels within a tumor. easy and abundant access to blood and other nutrients necessary for growth. small localized tumor that gets angiogenesis can grow and spread.
happens when cancer sends out signaling molecule to surrounding tissue: seeding. this signals angiogenesis.
se: Anemia can be a side effect of the process of feeding tumor more than feeding tissue around it after angiogenesis.
metastasis, common sites/why
spread of cancerous cells from origin to a distant site.
-extension into surrounding tissues
-release of tumor cells
-local seeding
-bloodborne metastasis
-lymphatic spread
Liver/lung are both common sites for metastasis because tumor cells break off.
disease-related consequences of cancer
(These are not consequences of tx; consequences of cancer itself.)
- Impaired immune and hematopoietic function: Body can’t keep up with its hematopoietic fx, can’t make the RBCs fast enough.
- Altered GI structure and function: because GI is pliable tube, tumor can grow into it and block it
- Motor and sensory deficits: Could be impingement on nerves or eff on muscles but mostly neural thing
- Decreased resp function
- Pain and discomfort (psychological and physical): Big one. Acute/chronic/cancer pain. Has its own category because it has not only pain/discomfort of cancer in body, but also emotional and mental pain, treatment pain. Most cancer pts have pain, and its very hard to treat and has a large psych portion to it. There’s something we talk about in pain and talk about in cancer: that means its probs a test question cause its 2 topics in one.
