Lecture 17: Cancer Care Flashcards
how many canadians develop cancer
2/5!!!
What is the biological process of cancer
1.Defects in cellular proliferation
(cell divison of cancer cells)
2.Defects in cellular differentiation
(genes affected by mutation)
Origins of cancer…
1.Genetic
2.Chemical carcinogens
3.Radiation
4.Viral and bacterial carcinogens
5.Unknown causes
what are 4 stages of development of cancer….
1.Latent
2.initiation
3.Promotion
4.Progression
What is latent stage of cancer
1-40 years
-for disease to be clinically relevant, tumour must reach critical mass
What is initiation stage of cancer development…
-Mutation in cell genetic structure
Results from inherited mutation, error in DNA replication or exposure to carcinogens
What is promotion stage of cancer development…
-Reversible proliferation of altered cells
-Activities of promotions are reversible, obesity, smoking, alcohol, dietary fat
What is progression stage of cancer development…
-Increased tumour growth rate
-Increased invasiveness and spread
-Metastatic vibes
Normal cells vs cancer cells
Normal: “HEALTHY”
-Large cytoplasm
-single nucleus
-single nucleous
Cancer: “UNHEALTHY”
-Small cytoplasm
-multiple nuclei
-large nucleos
Benign vs Malignant
Benign: Tumour cells grow only locally not spreading/metastatic
Malignant: Cancer cells invade neighbouring tissues, enter blood vessels and metastasize to different sites!
Classifications of cancer…
-Carcinoma
-Sarcoma
-Blastoma
-Lymphomas
Oncologist… does what
Carcinoma is tissue in skin glands that lines organs
Sarcoma=muscle tissue
Blastoma=cancerous tumour in brain
Lymphomas and leukemias=blood cancer
Oncologist will stage cancer by symptoms and wheres its occuring
Histological analysis…
Grade 1= mild dysplasia
Grade 2= moderate dysplasia
Grade 3=Severe dysplasia
Grade 4= Anaplasia-cells immature an undifferentiated
Staging of cancer (0-4)
0- Non invasive cancer in situ
1-Limited to tissue of orgin, localized tumour growth
2-Limited local spread
3-Extensive local and regional spread
4-Metastasis
TNM classifiaction
T=tumour size
N=lymph nodes
M=Distant Metastasis
Risk factors %
60% of canadians with bad diet
54 % physical inactivity
15% obesity
-Tobacco use
-sun
-unhealthy eating/drinking
What gender is more at an unhealthy weight….. LOL
56% men
39% women
Prevention of cancer… What can we do?
-Reduce sun
-TOBBACO
-Diet
-Exercise
-Healthy weight
-limited alcohol
-cancer screening
-Warning signs
What is really bad thing that causes cancer warn your patients?
Tobbaco doesn’t just cause lungs cancer but also head,neck and bladder and kidney cancer
What are the 7 warning signs of cancer***
C-Change in bowel or bladder habits
A- A sore that dose not heal
U-Unusual bleeding or discharge from body
T-Thickening or lump in breast/anywhere
I-Indigestion or difficulty swallowing
O-Obvious change in mole or wart
N-nagging cough or hoarsness
What are 3 main collaborative care goals of cancer
1.Cure-surgery
2.Control-chemo
3.Palliation-Relief control, maintain quality of life
Factors that determine treatment modality?
-Cell type
-Location and size of tumour
-Extent of disease
-Physiological and psychological status
-Expressed needs and desires
what is the sequence of events to discover cancer and treat….
-Biopsy
-Staging/Grading
-Treatment:
-Prophlaxis
-Cure
-Control
-Palliation
What is the ideal cancer for surgical therapy
-Slow rate of cellular proliferation or replication is ideal for surgical interventions
-Margins of normal cell tissue surrounding tumour must be excised
What is chemotherapy?
-Use
-Goal
-Route of administration
-Use of chemical as systemic therapy for cancer like meds
-Goal is to reduce number of malignant cancer cells in tumour site
-Used for solid tumors and hematological cancers
-All route but MOSTLY IV
What is most common route for chemotherapy
IV (central line preferred)
3 types of chemo
1.Primary: expected to cure or control
2.Adjunct: complements another therapy like radiation
3.Palliative: slow tumor growth for pain control
What should we think about when handling chemotherapeutic agents
- CYTOTOXIC
-Drugs can be absorbed through skin
or inhaled during preparation, transport and administration
-Need training
Cytotoxic 1 and 2 (things….)
1- Cytotoxic agents are primarily eliminated from the patient by renal or hepatic
2-Tablets must be handled in matter in which avoids skin contact and liberation of powdered agents into air
What are some adverse effects of chemo administration…
1.Vesicants
2.Extravasation
3.Flare
4.Infiltration
5.effects on normal tissues
6.Nephrotoxicity
What’s vesicants
Result in tissue necrosis or formation of blisters when accidentally infused
What’s Extravasation
Delivery of a vesicant an agent which can erode or cause permanent damage to tissues
what’s a flare
Localized allergic reaction to chemo