Intro to Cancer Flashcards
1
Q
Mitosis
A
cell splits into 2 genetically identical daughter cells
2
Q
Meiosis
A
- cell splits but keeps only half the genetic chromosomes (23 vs. 46)
- Only occurs in sex cells of testes and ovaries
3
Q
Differentiation
A
normal process where cells change in order to specialize for certain body functions
4
Q
Hyperplasia
A
increase in number or density of normal cells
5
Q
Metaplasia
A
Change in the normal pattern of cell differentiation (cells aint where they are supposed to be)
6
Q
Dysplasia
A
cells differentiate in abnormal ways
7
Q
Anaplasia
A
Immature or undifferentiated cell reproduction
8
Q
What is cancer?
A
- classification of many diseases
- can affect many different types of cells or body systems
- can affect anyone though there are risk factors
- marked by uncontrolled growth and spread of abnormal cells
9
Q
Tumor
A
aka neoplasm
- can be either benign or malignant
- mass of new tissue which grows independently from surrounding tissues and has no function
- cells grow at rates which are uncoordinated
- share properties of parents but altered shape/size
- provide no benefit and may be harmful
- still require blood, oxygen, nutrients
10
Q
Benign tumors
A
- localized growths
- solid, well defined borders
- stop growing when they reach the border of other tissues (inhibition)
- grow slowly and remain stable in size
- usually easily removed and don’t recur
- can still cause problems (crowding, obstructions, etc..)
11
Q
Malignant tumors
A
- primarily what we think of when we refer to cancer
- grow aggressively
- irregular in shape, no defined borders
- cut through other tissues causing injury
- varying degrees of differentiation from parent cells
- altered cell structure
- simple metabolic activity, only care about mitosis
- progressive mutations leads to greater deviation and sometimes immortality
- promotes own survival, create vascular and support structures for own use
NO INHIBITION
12
Q
Transplantability
A
- able to break away and grow elsewhere
- associated with malignant tumors
13
Q
Angiogensis
A
- formation of new blood vessels from old
- normal body function
- integral in wound healing
- formation of granulation tissue (connective tissue)
- key step that separates benign from malignant tumors
14
Q
“in situ”
A
pre-cancer
15
Q
Invasion
A
-as cancer cells grow they invade surrounding tissue
- cause pressure atrophy
- degrade barriers between tissues
- cancer cells easily separate
- chemotaxis
16
Q
Chemotaxis
A
cells breakdown drawing phagocytes to clean up; this attracts cancer cells too
-as body starts to attack cancer, actually release some cellular mediators, spurs growth of more cells
17
Q
Metastasis
A
process where cancer cells spread from their primary site to distant organs and tissues
- As malignant cells spread they access vascular and lymphatic systems (even possibly creating their own) allowing for spread to distant parts of the body
- The majority of cancers have already metastasized by the time they are discovered or diagnosed
18
Q
Etiology
A
- several theories to origins of cancer
- 2 primary factors central to all: Carcinogens and immune impairment
19
Q
Carcinogens
A
substances which can cause genetic mutation in cells through exposure
- external (chemicals, substances, viruses, etc.)
- internal (inherited mutations, hormones, etc.)
- everyone is exposed to these on some level and at some point
- other factors like genetics, immune response, exposure to viruses, etc. all contribute to carcinogenises
20
Q
immune impairment
A
lessens bodies’ ability to fight and control abnormal cell growth
21
Q
General Risk factors
A
- heredity
- age
- gender
- poverty
- stress
- diet
- occupation
- infections
- tobacco
- alcohol
- recreational drug use
- obesity
- sun exposure
22
Q
Initiation
A
- cancer cells arise from “normal” cells due to a change in the cells’ genetic structure
- mutation occurs in the cells’ DNA
- These mutations can be inherited via a generic link fro parents or acquired during life due to exposure to carcinogens
23
Q
Promotion
A
- a single genetic alteration is not enough to cause cancer
- exposure to promoting agents (carcinogens) causes mutations to express themselves and/or mutated cells to proliferate
some carcinogens function as both indicators AND promoters
24
Q
Progression
A
- cancer cells increase in proliferation rate
- formation of a tumor
- spread of cancer cells outside of tumor-metastasis, angiogenises
25
Summary of Initiation, Promotion, and Progression
Initiation: initiators cause cellular mutation
Promotion: carcinogen exposure causes expression of mutant genetics
Progression: increasing malignant behavior and spread
26
Prevention
- avoid exposure to carcinogens/reducing risk factors
- follow workplace safety guidelines
- general lifestyle changes (quit smoking, limit drinking, eat healthy, wear sunscreen/limit sun exposure, exercise, stress reduction)
27
Diagosing
- Imaging
- Cytology
- Tumor markers
- Visualization
- Lab tests
28
Tumor markers
biochemical indicators of tumors which can be found in ALL body tissue when tumors are present
29
Cytological examination
will reveal differences in tumor cell from normal to parent cells
30
Grading
level of differentiation from parent cell
Grades 1 to 4
4 is the least
31
Each cancer has...
their own classification system
32
Staging
Size of tumor, and spread (TNM)
T: (tumor) size of tumor
N: (nodes) # of lymph nodes involved
M: (metastasis) spread to other areas
33
Differentiation
is a good thing
- acting like they should
- if not differentiated, "came from liver, but now not acting like one"
34
Medical Treatments
- Surgery
- Pharmacological
- Radiation
Often times, 2 or more treatments used in conjunctions
35
Post surgery nursing care
- general post op care
- pain control
- TCDB
- Monitor for bleeding (BRB immediate post op)
- Infection control (first dose of broad spectrum antibiotic before surgery, 2 more doses after)
36
Meds during chemo
- Antineoplastic meds
- Hormones
- Antianemics
37
Antineoplastic meds
inhibit DNA and/or RNA production or replication
1. Alkylating
2. Antibiotics
3. Antimetabolites
38
Busulfan and Cyclophosphamide
alkylating antineoplastic agents
39
Bleomycin and Dactinomycin
antibiotic agents
40
Fluorouracil and Methotrexate
antimetabolites agents
41
Hormones in chemotherapy
block hormones used for cancer cell growth
42
Antianemtics in chemotherapy
help support RBCs, correct anemia
43
Design of Chemo Drugs
By design, they target quickly replicating cells because thats what cancer cells are
-they do not specifically target cancer cells
"shotgun"
44
General Chemo Side Effects
- GI upset (N/V, nutritional imbalance)
- Alopecia
- Fatigue
- Anemia, neutropenia, thrombocytopenia
- dry mouth
- wasting
- dehydration
45
Nursing care for chemo
- infection control/neutropenic precautions
- immunocompromised
- promote fluid intake and nutrition
- monitor kidney, liver function especially with antineoplastic meds
- activity intolerance
- be careful handling/administering chemo drugs
- educate on side effects/changes (urine color changes)
- psychosocial, sexual, spiritual health
- avoid favorite foods until not nauseous, bland foods immediately after dose
- small frequent meals
46
Radiation
1. EBR
| 2. Bracytherapy
47
EBR Nursing care
External beam radiation
- monitor site
- educate patient on cleaning (mild soaps, pat dry, don't soak, ask about creams and lotions)
- protect yourself
48
Brachytherapy Nursing care
radioactive pellets
- minimize time in rooms/maintain distance
- don't dislodge pellet
- keep lead container and tongs in room
- immobile, skin tears, hazards of immobility
- focused on protecting the nurse, the patient is radioactive
- end of hall
- rotate nurses
- not a lot of visitors
49
Clinical Manifestations of Cancer
- change in normal body functions
- hematological changes
- infection
- Cachexia
- Paraneoplastic syndromes
- pain
- psychological stress
50
Cachexia
wasting/rapid weight loss caused by metabolic demands of cancer
-can also be caused/exacerbated by chemo/radiation
51
Paraneoplastic syndromes
caused by production of biological chemicals (ex. hormones) at sites other than where cancer is
52
Emergency situations related to cancer
- Anemia
- Thrombocytopenia
- Compression/occlusionof spine, brain, etc...
- Tumor Lysis Syndrome
53
Tumor Lysis Syndrome
breakdown of cancer cells= increase in intracellular contents(electrolytes) in circulation
-hyperkalemia, hypercalcemia, hyperphosphatemia, acute kidney injury
54
What are our priorities of care for our patients with cancer?
-pt comfort
55
What assessment data is important?
-assess pain
56
What interventions do we expect to implement?
- antiemetic (preemptively)
- meds as ordered
- positioning
- bland diet
- keep hydrated
