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lewis ch 15 (cancer) Flashcards

1
Q

what are the 2 major dysfunctions present in the process of cancer development

A

proliferation

differentiation

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2
Q

what rate do cancer cells multiply at

A

the same as the rate of the location they originated from

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3
Q

sometimes cancer cells produce more than 2 cells

through mitosis. 1 x 2 x 4 x 8 x 16

A

pyramid effect

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4
Q

which are more malignant: undifferentiated cancer cells or differentiated cancer cells

A

undifferentiated cancer cells

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5
Q

alterations in these tumor suppressor genes cause increased incidence in breast & ovarian cancers

A

BRCA 1 and 2

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6
Q

what is the process of the development of cancer

A
  • -initiation–
    1) carcinogen invades target cell
    2) altered cell: dysfunction in differentiation and proliferation
    3) cancer cell
  • -promotion–
    4) proliferation
  • -progression–
    5) evidence of clinical disease
    6) evidence of regional spread and metastasis
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7
Q

Cancer-causing agents capable of producing

cell alterations

A

carcinogens

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8
Q

examples of carcinogens (5)

A
  • poor diet
  • radiation
  • environmental toxins
  • viruses, bacteria, parasites
  • chemicals in tobacco goods
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9
Q

first stage of development of cancer, mutation of cell’s genetic structure

A

initiation

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10
Q

second stage of development of cancer, characterized by reversible proliferation of altered cells

A

promotion

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11
Q

what are some examples of reversible proliferation activities

A
  • obesity
  • smoking
  • alcohol use
  • dietary fat
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12
Q

the amount of time in the
initiation and promotion stage. The cancer is
not yet clinically evident.

A

latent period

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13
Q

third stage of development of cancer, characterized by increased growth of tumor, invasiveness, and metastasis

A

progression

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14
Q

what are the main sites of metastasis (6)

A
  • brain
  • CSF
  • bones
  • lung
  • liver
  • adrenals
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15
Q

what is it called when the primary tumor develops its own blood supply

A

tumor angiogenesis

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16
Q

what is the role of lymphocytes in response to tumor associated antigens

A

check cell surface
antigens and detect and
destroy abnormal cells

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17
Q

what is the role of cytotoxic T cells in response to tumor associated antigens

A

Kill tumor cells directly, Produce cytokines

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18
Q

what is the role of NK cells and macrophages in response to tumor associated antigens

A

lyse tumor cells

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19
Q

what is the role of B cells in response to tumor associated antigens

A

make antibodies that bind to tumor cells

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20
Q

what are some characteristics of benign tumors

A
  • encapsulated
  • differentiated
  • normal cell characteristics
  • slight vascularity
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21
Q

what are some characteristics of malignant tumors

A
  • not encapsulated
  • poorly differentiated
  • abnormal cells
  • moderate to marked vascularity
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22
Q

what are four things tumors can be classified by

A
  • anatomic site
  • anatomic extent (TNM classification)
  • histology
  • extent of disease
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23
Q

3 anatomic sites tumors can be classified by

A
  • carcinoma: skin and glands, mucous membranes
  • sarcoma: CT, bone, muscle, fat
  • lymphoma and leukemia: blood
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24
Q

what are the three parameters that classify anatomic extent (TNM classification)

A

T: tumor size and invasiveness
N: spread to lymph nodes
M: metastasis

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25
what does T^0 mean
no evidence of primary tumor
26
what does T^is mean
carcinoma in situ
27
what does T^1-4 mean
ascending degrees of increase in tumor size and involvement
28
what does T^x mean
tumor cannot be found or measured
29
what does N^0 mean
no evidence of disease in lymph nodes
30
what does N^1-4 mean
ascending degrees of nodal involvement
31
what does N^x mean
regional lymph nodes unable to be assessed
32
what does M^0 mean
no evidence of distant metastases
33
what does M^1-4 mean
ascending degrees of metastatic involvement including distant nodes
34
what does M^x mean
cannot be determined
35
staging done at completion of diagnostic workup to | guide effective treatment selection (Bone and liver scans, ultrasonography, CT, MRI, PET scans)
clinical staging
36
staging determined by surgical excision, exploration, | and/or lymph node sampling
surgical staging
37
what does clinical stage 0 mean
Cancer in situ (localized cancer cells that show no tendency to invade or metastasize)
38
what does clinical stage 1 mean
Tumor limited to tissue of origin; | localized tumor growth
39
what does clinical stage 2 mean
Limited local spread
40
what does clinical stage 3 mean
Extensive local and regional | spread
41
what does clinical stage 4 mean
metastasis
42
7 warning signs of cancer (CAUTION)
``` C: change in bladder/bowel habits A: a sore that won't heal U: unusual bleeding or discharge T: thickening or lump I: indigestion or trouble swallowing O: obvious change in wart or mole N: nagging cough or hoarseness ```
43
3 goals of cancer treatment
- cure - control - palliative
44
Study of genomic variation associated | with drug responses
pharmacogenomics
45
Use of chemicals given as a systemic | therapy for cancer, used for solid tumors and hematologic cancers
antineoplastic therapy (chemo)
46
methods of admin for chemo (3)
- oral - IM - IV (most common)
47
type of chemo: Delivery of drug directly into tumor site, higher concentrations of drug can be delivered with less systemic toxicity
regional chemo
48
what normal cells are most affected by chemotherapy
- bone marrow stem cells - epithelial cells in GI tract - hair - neutrophils - ova/testes
49
One of the oldest nonsurgical methods of cancer treatment, emission of energy from a source and travels through space or some material
radiation
50
Implantation or insertion of radioactive | materials into or close to tumor, minimal exposure to healthy tissue
internal radiation
51
common side effects of radiation therapy (6)
- bone marrow suppression - fatigue - GI problems - integumentary and mucosal reactions - pulmonary effects - reproductive effects
52
type of cancer treatment: Boost or manipulate the immune system and create an environment not conducive for cancer cells to grow, attacks cancer cells directly
immunotherapy
53
type of cancer treatment: Interferes with cancer growth by targeting specific cell receptors and pathways that are important in tumor growth, does less damage to normal cells
targeted therapy
54
side effects with immunotherapy and targeted therapy (8)
- flulike symptoms (pretreat with acetaminophen) - anorexia/weight loss - fatigue, weakness - nausea/vomiting - photosensitivity - hepatotoxicity - tachycardia - orthostatic hypotension
55
two examples of hormone therapy used to treat cancer
- sex hormones | - corticosteroids
56
supportive med for cancer treatment for anemia
erythropoietin (epoetin alfa)
57
supportive med for cancer treatment for neutropenia
granulocyte colony-stimulating factor (filgrastim)
58
supportive med for cancer treatment for myeloid cell recovery after bone marrow transplant
Granulocyte-macrophage colony-stimulating factor | sargramostim
59
supportive med for cancer treatment for thrombocytopenia
interleukin 11 platelet growth factor (oprelvekin)
60
allogeneic donor
matched donor
61
syngeneic donor
identical twin
62
autologous donor
patients own stem cells
63
problems associated with cancer and chemotherapy
- nutritional (malnutrition, altered taste sensation, cancer cachexia) - infection - oncologic emergency - cancer pain
64
oncologic emergency: obstructive: -Intense, localized, and persistent back pain with vertebral tenderness. * Motor weakness, sensory paresthesia and loss. * Autonomic dysfunction (e.g., change in bowel or bladder function).
spinal cord compression
65
oncologic emergency: obstructive: • Facial edema, periorbital edema. * Distention of veins of head, neck, and chest. * Headache, seizures. * Mediastinal mass on chest x-ray.
superior vena cava syndrome
66
oncologic emergency: obstructive: | • Signs of hypovolemia: hypotension, tachycardia, low central venous pressure, decreased urine output.
third space syndrome
67
oncologic emergency: metabolic: • Serum calcium higher than 12 mg/dL (3 mmol/L) often produces symptoms. * Apathy, depression, fatigue, muscle weakness, ECG changes, polyuria and nocturia, anorexia, nausea, vomiting. * High calcium elevations can be life threatening. * Chronic hypercalcemia can result in nephrocalcinosis and irreversible renal failure.
hypercalcemia
68
oncologic emergency: metabolic: • Water retention and hyponatremia (hypotonic hyponatremia) . • Weight gain without edema, weakness, anorexia, nausea, vomiting, personality changes, seizures, oliguria, decrease in reflexes, coma.
syndrome of inappropriate antidiuretic hormone
69
oncologic emergency: metabolic: • Hallmark signs: hyperuricemia, hyperphosphatemia, hyperkalemia, hypocalcemia. * Weakness, muscle cramps, diarrhea, nausea, vomiting. * Occurs within 24–48 hr after starting chemotherapy. * May last 5–7 days. * Metabolic abnormalities and concentrated uric acid (which crystallizes in distal tubules of kidneys) can lead to acute kidney injury.
tumor lysis syndrome
70
oncologic emergency: infiltrative: • Heavy feeling over chest, shortness of breath, tachycardia, cough, dysphagia, hiccups, hoarseness. * Nausea, vomiting, excessive perspiration. * Decreased level of consciousness, distant or muted heart sounds. * Extreme anxiety.
cardiac tamponade
71
oncologic emergency: infiltrative: | • Bleeding: ranges from minor oozing to spurting of blood in the case of a “blowout” of artery.
carotid artery rupture

PathoPharm (42 decks)

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