Ch. 6 Neoplasias Flashcards
Neoplasia
new growth
Stem cells
reserve cells that remain quiescent until there is a need for cell replenishment. when a stem cell divides, one retains stem cell characteristics, and the other becomes a progenitor that proceeds through to terminal differentiation
Benign Neoplasias
well differentiated cells that resemble the cells of the tissue of origin
slow forming and some can regress
inability to metastasize
grow by expansion, fibrous capsule and do not cause death unless their location is such that it interrupts vital body functions
Malignant Neoplasms
grow rapidly and spread widely
have potential to kill
tend to compress by and out outgrow their supply, causing ischemia and tissue necrosis
rob normal tissues of nutrients
liberate enzymes and toxins that destroy tumor tissue
solid tumors and hematologic cancers
-solid; initially confined to a specific tissue or organ. as the growth progresses, cells detach and invade surrounding tissue and enter blood and lymph, and metastasize
Carcinoma in situ
localized pre-invasive lesion
Anaplasia
loss of cell differentiation in cancerous tissue
Pleomorphism
undifferentiated cancer cells are marked by a number of morphologic changes, including variations in size and shape.
How cancer spreads
- direct invasion and extension
- seeding of cancer cells in body cavities
- metastatic spread through vascular or lymphatic pathways
Invasion and metastasis
development of a second tumor in a different location.
Sentinel node biopsy
piece of cancer to diagnose. dye into area to see the tumor, and using the snetinel node to discover where the invasion starts and stops in the lymph
Factors affecting tumor growth
the number of cells that are actively dividing or moving through the cell cycle. duration of cell cycle. number of cells lost compared to new produce. Growth fraction: ratio of dividing cells to resting cells in a tissue mass
Doubling time: length of time it takes for the total mass of cells in a tumor to double
Host and Environmental Factors leadng to cancer
heredity hormones carcinogens oncogenic viruses immunologic mechnaisms
Cancer Cachexia
weight loss and wasting of body fat and muscle tissue, profound weakness, anorexia and anemia
Paraneoplastic Syndrome
inappropriate hormone release, ciruculating hematopoietic, neurological and dermatological factors
Classification and Staging TMN
Primary Tumor (T)
TX – primary tumor cannot be evaluated
T0- no evidence of primary tumor
T1s- carcinoma in situ, has not spread
T1,2,3,4,- size and/or extent of the primary tumor
Regional Lymph Nodes (N)
NX- regional lymph nodes cannot be evaluated
N0- no regional lymph node involvement
N1,2,3, - involvement of regional lymph nodes (number and/or extend of spread)
Distant Metastasis (M)
MX- distant metastasis cannot be evaluated
M0 – no distant metastasis
M1- distant metastisis (cancer has spread)
In order to understand a cancer, you need to understand its TNM
This is the classification system of the disease
Cancer treatment modalities
surgery: debulking
radiation
hormonal therapy
targeted therapy: drugs that selectively attack
biotherapy: immunotherapy and biological response modifiers to change the persons own immune response to cancer (T cells)
chemotherapy
How does chemotherapy work?
Direct DNA interacting: these disrupt the cell cycle with alkaline.
Indirect DNA interacting- antimetabolites andmitotic spindle inhibitors
Cell cycle specific- specific part of cell cycle
Cell cycle non sprecific: all phases of cell life
Stem Cell Transplantation
bone marrow transplantation (BMT)
Peripheral blood stem cell transplantation (PBSCT)
Radiation Benefits
external beam or teletherapy (beams generated at a distance and aimed at tumor)
brachytherapy (sealed radioactive source is placed close or directly in tumor)
Systemic therapy: radioisotopes are given orally or injected into the tumro site
uses high energy particles or waves to destroy or damage cancer cells
Radiation Adverse effects
negatively affects normal tissue
tissue within field is freq affeted: skin, mucosal lining of GI and bone marrow
Oncologic Emergencies
SADH
Syndrome of inappropriate antidiuretic hormone
SIADH causes body to retain water
Dilution of normal electrolytes
Lung and brain cancers
Post neurosurgical (brain) surgery
Monitor for low sodium (sx include nausea vomiting, lethargy and seizures)
Oncologic Emergencies: Hypercalcemia
Complication of breast, lung, head and neck cancers; leukemia; multiple myeloma
and bony metastasis of any cancer
sx include anorexia, nausea, vomiting, and changes in mental status
Oncologic Emergencies: Superior Vena Cava Syndrome
results from obstruction (metastases from breast or lung cancers) of venous return and engorgement of the vessels from the head and upper body
Periorbital and facial edema, dyspnea, and neck pain
Oncologic Emergencies: Tumor Lysis Syndrome
occurs when tumors are rapidly destroyed, releasing intracellular contents into the bloodstream faster than the body can process them. This release causes hyperkalemia, hyperphosphatemia, and hyperuricemia. Can lead to acute kidney injury and change in cardiac function.
