Exam 2 Flashcards
Stages of Cancer progression: Initiation
Cancer cells arise from normal cells because of changes in genes. Involves a mutation in the cell’s genetic structure. A mutation is any change in the usual DNA sequence.
Stages of Cancer progression: Promotion
Single alteration of the genetic structure of the cell is not enough to cause cancer.
Reversible proliferation of altered cells. An increase in the altered cell population further increase the likelihood of more mutations.
Stages of Cancer: Progression
Progression is the last stage in the natural history of a cancer. Characterized by increased growth rate of tumor, increased invasiveness and metastasis (spread of the cancer to a distant site).
Tumor angiogenesis
In multistep metastasis, the tumor grows, it forms blood vessels within the tumor.
Hematogenous metastasis
primary tumor cells penetrating blood vessels of distant organs.
Most do not survive
Cancer treatment
Treatment differs according to cancer being treated.
Cancer treatment types
May involve local therapies (surgery/radiation) alone or combo with or w/out periods of adjunctive systemic therapy (chemo)
Goal for chronic cancers?
Control is the goal of treatment for cancers that cant be completely eradicated.
Responsive to anticancer therapies, controlled for long periods w/ therapy.
Cancer - Maintenance therapy
ongoing therapy for a cancer that is administered after the acute phase of treatment has been completed.
Cancer - Goals for maintenance therapy
Pts monitored closely for early s/s of disease recurrence/progression which calls for new therapy
Cancer - Palliative care
relief or control of symptoms maintaining sustaining quality of life. Treat & palliative care may be concurrent
Cancer - Palliative care example
goal includes radiation therapy to reduce tumor size and relieve subsequent symptoms, like pain of bone metastasis
Cancer - Personal treatment
genetic info of pt to guide treatments of prevention, treatment, diagnosis of cancer.
Expensive, time-consuming and insurance does not cover.
Cancer - targeted therapy
targets cancer’s specific genes or proteins that contribute to cancer growth/survival.
Testing biopsy sample.
Chemo complications
Many chemo drugs are irritants (discomfort or pain along internal lumen of vein) or vesicants (cause blistering, tissue slough, or necrosis when it escapes into surrounding tissue)
Chemo complications interventions
Important to monitor, take action, minimize discomfort, emotional distress and risks of infect. and infiltration.
Chemo treatment - pathway
Usually given in central venous access device (CVAD) to surpass venipunctures
Chemo treatment side effects
destruction of normal cells (esp rapidly proliferating). Bone marrow, lining of GI system, and integument (skin, hair and nails)
Acute toxicity
occurs during or after drug admin.
Anaphylactic, hypersensitivity reactions, extravasation/flare reaction, anticipatory N/V and dysrhythmias
Delayed side effects of chemo
delayed N/V/D, constipation, mucositis, alopecia, skin rashes, bone marrow suppression and variety of cumulative neurotoxicities.
Diagnostic testing for cancer
Cytology study, tissue biopsy, chest x-ray, CBC, radiographic studies, PET scan
Blood products - assessment
complete baseline physical assessment of pt to assess changes during and after transfusion
Blood products assess..
patent IV line (approp. needle)
