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NURS 220 > LEC 10: Cancer Care > Flashcards

LEC 10: Cancer Care Flashcards

1
Q

Cancer

A

Uncontrolled and unregulated growth of cells

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2
Q

Risk Factors for Cancer

A
  • Obesity, inactivity, unhealthy eating, excessive sun exposure, smoking
  • Chemical, radiation, viruses, genetic susceptibility
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3
Q

What are types of occupations that are risk factors for cancer?

A
  • Pilots
  • X-ray technicians
  • Working in nuclear plants
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4
Q

What viruses are risk factors for cancer?

A
  • HPV
  • HIV
  • Hepatitis B and C
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5
Q

What are the two major process that contribute to cancer cells?

A
  1. Cell proliferation

2. Cell differentiation

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6
Q

Normal Cell Growth

A
  • Cell growth
  • Normal cell growth = Cells stay in a state of equilibrium during cell growth
  • Normal cells respect boundaries of other cells
  • Immature cells become mature cells
  • Normally, the differentiated cell is stable and does not differentiate
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7
Q

Defects in Cell Proliferation

A
  • Cancer cells do not respect boundaries of other cells
  • Cancer cells are generated at the same rate as the cells of the tissue from which they arise
  • Cancer cell division is haphazard
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8
Q

Defects in Cell Differentiation

A
  • Cancer cells do not look and behave like mature cells
  • Cancer cells revert to an immature cell and can look abnormal
  • Proto-oncogens become oncogenes and tumour suppressor genes become inactive
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9
Q

Proto-Oncogenes

A

Promote cell growth and keep cell in the locked in mature state

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10
Q

Tumor Suppressor Genes

A

Inhibit cancer cell growth

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11
Q

Health Bodies

A
  1. In healthy bodies, we want proto-oncogenes and tumour suppressor genes BUT when there is a glitch in our systems simething triggers proto-oncogenes into oncogenes which let cells to differentiate (become immature)
    - Oncogenes are bad
  2. When there is a glitch in our systems, tumour suppressor genes become inactive and are not able to prevent cancer cells from growing
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12
Q

What are the 3 stages to cancer cell development?

A
  1. Initiation
    - Mutation on cell’s genetic structure
  2. Promotion
    - Reversible growth of altered cells
  3. Progression
    - Increased growth, invasion, and metastasis of the cancer
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13
Q

What are the 3 things than can happen in the initiation phase?

A
  1. A cell can die if it is altered
  2. A cell can try and repair itself
  3. A cell can replicate as an altered cell
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14
Q

How big dose a cancer cell need to be in order to be directed by an MRI?

A

The growth or mass needs to be 0.5cm

- 1cm tumour = to 1 billion cancer cells

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15
Q

What is the role of the immune system in cancer cell recognition and destruction?

A
  • Immune system distinguished between normal and abnormal cells
  • Cancer cells can be perceived as abnormal (non-self) cells and destroyed OR
  • Because cancer cells are mutated from normal cells- they can be perceived as ‘self-cells’ and response by immune system can be inadequate
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16
Q

Benign Tumour

A

Cells grow only locally and cannot spread by invasion or metastasis
-Not cancer

17
Q

Malignant Cells

A

Invade neighbouring tissues, enter blood vessels, and metastasize to different sites
- Cancer

18
Q

Metastasis

A

Movement of the cancer to another location

- There is different affinities depending on the cancers

19
Q

Diagnostic Tests

A
  • Cytology studies
  • Blood-work
  • Colonoscopy studies
  • Radioisotope scans
  • Assays for oncofetal antigens or genetic markers
  • Bone marrow examiantion
  • Biopsy
20
Q

What are the 3 ways tumours are classified?

A
  1. Anatomical site (location)
  2. Histological analysis (grading)
  3. Extent of disease (staging)
21
Q

What are the 4 anatomical sites that cancers can be described as?

A
  1. Carcinomas
  2. Sarcomas
  3. Lymphomas
  4. Leukemias
22
Q

Carcinomas

A

Cancer of external or internal body surfaces

- Lungs, brast, colon

23
Q

Sarcomas

A

Cancer of supporting tissues

- Bone, cartilage, fat, muscle

24
Q

Lymphomas

A

Cancer of the lymph nodes

25
Q

Leukemias

A

Cancer within the bone marrow and blood stream

26
Q

Histological Analysis (Grading)

A

How abnormal the cell looks under a microscope and how quickly the tumour is likely to grow and spread

Grade I

  • Cells differ slightly than normal cells
  • Well differentiated

Grade II

  • Cells more abnormal
  • Moderately differentiated

Grade III

  • Cells very abnormal
  • Poorly differentiated

Grade IV

  • Cells immature an dprimitive
  • Undifferentiated
27
Q

Extent of Disease (Staging)

A

Description of the extent of disease rather than on cell appearance

Stage 0: Cancer is instu
Stage I: Tumour limited to the tissue origin
Stage II: Limited local spread
Stage III: Extensive local and regional spread
Stage IV: Metastasis: has spread to the rest of the body

28
Q

TNM Classification

A

Primary Tumour Size (T)

  • T0: No evidence of primary tumour
  • TIS: Carcinoma instu
  • T 1-4: Ascending degrees of increase in tumour size and involvement

Involvement of Regional Lymph Nodes (N)

  • N0: No evidence of primary tumour
  • N 1-4: Ascending degrees of lymph node involvement
  • Nx: Regional lymph nodes unable to be assessed clinically

Distant Metastases (M)

  • M0: No evidence of distant metastases
  • M1-4: Ascending degrees of metastatic involvement including distant nodes
29
Q

Tumor Makers

A
  • Substances produced by tumour cells, or other cells of the body, in response to cancer
  • Can be found in the blood, urine, tumour tissue, or other tissues
  • Different tumour markers are found in different types of cancers
  • May be measured before treatment to help physicians plan appropriate therapy
30
Q

What are the goals of care for cancer patients?

A
  • Cure: eradicate the cancer
  • Control: Can’t be completely removed, but are responsive cancer therapies
  • Palliation: Relief or control of symptoms and optimization of quality of life
31
Q

What are the 2 treatment options?

A
  1. Surgical therapy
    - Cure and control; supportive and palliative procedures; rehabilitation
  2. Chemotherapy
    - Drug therapy
    - Cure, control, and palliation
  3. Radiation therapy
    - High dose of radiation
    - Cure, control, and palliation

*Can be used singularly or on combination; usually used in combination

32
Q

Pain in the Patient with Cancer

A
  1. Causes of pain
    - Tumours, medical procedures, treatments
  2. Types of pain
    - Based on the part of the body affected
  3. Treating pain
    - Non-opioids, adjuvants, opioids
33
Q

Cancer Pain Relief Ladder

A

a. Non-opioids and/or adjuvant
- Pain persisting or increasing; move up
- Acetaminophen, NSAIDs, acetylsalicylic acid

b. Opioids for mild to moderate pain and/or non-opioids, adjuvant
- Pain persisting or increasing; move up
- Codeine, morphine

c. Opioids for moderate to severe pain and/or non-opioids, adjuvant
- Freedom from pain
- Morphine, hydromorphone, fentanyl

34
Q

Psychosocial Care

A
  • Establish therapeutic relationship
  • Assess patient and family needs for counselling and referrals
  • Actively listen to patient and family
  • Offer strategies to enhance coping
  • Provide information and answer questions
  • Collaborate with patient and family to establish goals
  • Maintain hope
  • Consider spiritual aspects of care
  • Encourage patent and family participation in care

NURS 220 (41 decks)

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