Exam 3: Chapter 15 - Management of Patients With Oncologic Disorders Flashcards
Cancer is
a disease process that begins when an abnormal cell is transformed by the genetic mutation of cellular DNA
Cancer: Abnormal cells have
invasive characteristics and infiltrate other tissues. This phenomena is metastasis
What is Metastasis?
Spread of cancer from the primary tumor to distant sites
What is Anaplasia?
Pattern of growth in which cells lack normal characteristics and differ in shape and organiztion with respect to their cells or origin
Benign Cell Characteristics
Well-differentiated cells resemble normal cells of the tissue from which the tumor originated
Benign Mode of Growth
Tumor grows by expansion and does not infilitrate the surrounding tissues; usually encapsulated
Benign Rate of Growth
Rate of growth is usually slow
Benign Metastasis
Does not spread by metastasis
Benign General Effects
Is usually localizeed phenomenon that does not cause generalized effects unless its location interferes with vital functions
Benign Tissue Destruction
Does not usually cause tissue damage unless its location interfers with blood flow
Benign Ability To Cause Death
Does not usually cause death unless its location interfers with vital function
Malignant Cell
Cells are undifferentiated and may bear little resemblance to normal cells of the tissue from which they arose
Malignant Mode of Growth
Grows at the periphery and overocmes contact inhibition to invade and infilitrate surrounding tissues
Malignant Rate of Growth
Rate of growht is variable and depends on level of differentation; the moe anaplastic the tumor, the faster its growth
Malignant Metastasis
Gains access to the blood and lymphatic channels and metastasizes to other areas pf the body or grows across body cavities
Malignant General Effects
Often causes generalized effects, such as anemia, weakness, systemic inflammation, weight loss, and CACS
Malignant Tissue Desruction
Often causes extensive tisue damage as the tumor outgrows its blood supply or encroaches on blood flow to the area; may also produce substances that cause cell damage
Malignant Ability to cause death
Eventually causes death unless growth can be controlled
What is Carcinogenesis
Process of transforming normal cells into malignant cells
Three steps in malignant transformation?
Initiation
Promotion
Progression
What are Carcinogens?
Agents that initiate or promote malignant transformation
What do Carcinogens do during Initation?
Carcinogens such as chemicals, physical factors, or biologic agents, cause mutations in the cellular DNA. During here, Apoptosis does not occur
What occurs during Promotion?
Repeated exposure to promoting agents cause proliferation adn expansion of initiated cells with increased expression or manifesations of abnormal gene informaiton
Promotion phase generally leads to
the formaiton of a preneoplastic or benign lesion
What occurs during progression?
The altered cells exhibit increasingly malignant behavior. These cells acquire the ability to stimulate angiogenesis
What is Angiogenesis?
Growth of new blood vessels that allow cancer cells to grow
Cell Proliferation
Uncontrolled growth, with the ability to metastaize and destroy tissue and cause death
What is the Cell Characteristics in the Malignant process?
Presence of tumor-specific antigens, altered shape, structure, and metabolism
How does Metastasis occur?
Lymphatic Spread
Hematogenous Spread
Angiogenesis
Carcinogenic Agents and Factors: Viruses: Afer infecting individuals, DNA viruses..
insert part of their own DNA near the infected cell genes causing cell division
Carcinogenic Agents and Factors: Examples of Viruses?
HPV, Hepatitis B, and Epstein-Barr Virus
Carcinogenic Agents and Factors: Physical Factors associated with carcinogenesis include
exposure to sunlight, radiation, chronic irritation or inflammation, tobacco, industrial chemics
Carcinogenic Agents and Factors: What chemical agents should I look out for
Tobaco, Asbestos
Carcinogenic Agents and Factors: Cancers with underlying genetic abnormalities include
chronic leukemia meningiomas Acute leukemia retinoblastomas Wilms tumor
Carcinogenic Agents and Factors: What cancers have enabled families to take extra precautions in order to identify them?
Hereditary Breast and Ovarian Cancer Syndrome and Multiple Endocrine NEoplasia Syndrome
Carcinogenic Agents and Factors: Dietary substances that appear to increase the risk of cancer includes
fats, alcohol, salt-cured or smoked meats, nitrate and nitrite containing foods and red and processed meats
Carcinogenic Agents and Factors: Heavy alcohol use increases the risk of
cancers of the mouth, pharynx, larynx, esophagus, liver, colon, rectum, and breast
Carcinogenic Agents and Factors: Poor diet and obesity have been identified as contributing factors to the develpoment of cancers of the
breast, colon, endometrium esophagus, and kidney
Carcinogenic Agents and Factors: Obesity is assocated with increased risk for
pancreas, gallbladder, thyroid, ovary, and cervix cancer
Carcinogenic Agents and Factors: Women taking what substance increases teh risk of breast cancer?
Estrogen
What is found on the membranes of many cancer cells?
Tumor-AssociatedAntigens (TAAs)
TAAs are processed
by antigen-presenting cells (APCs) and are presented to T lymphocytes that recognize the antigen-bearing cells as foriegn
What is included in APCs?
MAcrophages and Dentritic Cells
In response to recognizing TAAs as foreigh, T-Cell lymphocytes release
several cytokines that elicit various immune system action including 1. proliferation of cytotoxic T cell 2. Induction of cancer cell apoptosis and 3. recruitment of additional immune system cells
What is a PD-1 Ligand?
Can bind to PD-1 Proteins on T Cells and either block the killing of the tumor or induce cell death in the lymphocyte
Cancer cells have also been found to release..
cytokines that inhibit APCs as well as other cells of the immune system
Primary prevention is about
reducing the risks of disease through health promotion and risk reduction strategies
Example of primary prevention is
the use of immunization to reduce the risk of cancer through prevention of infections associated with cancer
Primary prevention is concerned with
reducing cancer risk in healthy people
SEcondary prevention involves
detection and screening to achieve early diagnosis and intervention
Secondary Prevention: Many screening and detection programs target people who do not
regularly practice health-promoting behaviors or lack acess to health care
Examples of SEcondary Prevention:
Mammograms, Colonoscopy
Tertiary Prevention: Efforts focus on
monitoring for and peventing recurrence of the primary cancer as well as screening for the development of second malignancies in cancer survivors
