Module 1: Chapter 19 Cancer Developement Flashcards
1What is cancer?
2also called malignancy , is a type of abnormal cell growth in
which cellular regulation is lost, resulting in new tissues that serve no
useful function, are harmful to the function of normal cells and organs,
and can lead to death if left untreated.
How does risk for cancers differs for each adult?
differs by genetic, immunologic, and environmental factors.
What is Celluar Regualtion ?
Cellular regulation
is the genetic and physiologic processes that control cellular growth,
replication, differentiation, and function to maintain homeostasis. All steps
in the processes of cellular regulation are the result of gene interactions
What tissue continues to grow in the body?
Tissues that continue to grow by undergoing mitosis in adulthood include
cells of the skin, hair, mucous membranes, bone marrow, and linings of
organs such as the lungs, stomach, intestines, bladder, breast ducts, and
uterus. These tissues are located in areas in which constant damage or
wear is likely and continued cell growth is needed to replace dead tissues.
What is Neoplasia?
Any new or continued cell growth not needed for normal development
or replacement of dead and damaged tissues is called neoplasia. This cell
growth is abnormal even if it causes no harm (is benign).
Biology of Normal Cells?
Specific morphology is the feature in which each normal cell type has a
distinct and recognizable appearance, size, and shape
Differentiated Function of a normal cells
Differentiated function means that every normal cell has at least one
function it performs to contribute to whole-body function. For example,
skin cells make keratin, liver cells make bile, cardiac muscle cells contract,
and red blood cells make hemoglobin
What is tight adherence?
Tight adherence occurs because normal cells make sticky cell adhesion
molecules (CAMs) that protrude from the membranes, allowing cells to
bind closely and tightly together.
Do RBC produce tight adherence ?
Red blood cells and white blood cells produce no
CAMs and do not usually adhere together.
Nonmigratory on normal cells
Nonmigratory means that normal cells do not wander throughout the
body (except for blood cells). Normal cells are nonmigratory because they
are tightly bound together with CAMs, which prevents cells from
wandering from one tissue into the next.
What are important features of normal cells?
- Orderly and well-regulated growth by cellular regulation is a very important feature of normal cells.
- They divide (undergo mitosis) for only
two reasons: (1) to develop normal tissue or (2) to replace lost, damaged,
or aged normal tissue.
Why are cells termed the name G, 0 ?
-Living cells not actively reproducing are in reproductive resting state.
-During G, 0 period, cells actively carry out their functions but do not divide.
- Normal cells spend most of their lives in the G, O state rather than the reproductive state.
What is contact inhibition ?
Contact inhibition is the part of cellular regulation that stops further
rounds of cell division when the dividing cell is completely surrounded
and touched (contacted) by other cells.
What is Apoptosis ?
Apoptosis is programmed cell death.
What is Euploidy ?
Euploidy, having a complete set of chromosomes, is a feature of most
normal human cells.
What is the correct number of chromosomes for humans ?
23 pairs of chromosomes
Characteristics of a Normal Cell
-Cell division: none or slow
-Appearance : Specific morphologic feature
-Small nuclear to cytoplasmic ratio
-many differentiated cell function
-tight adherence
-no migratory
-well-regulated growth
Diploid ( euploid) chromosome
-low index mitotic index
Characteristics of Benign Tumor Cell
- Continuous or innappropriate cell division
-Specific morphologic features - Smaller nuclear to cytoplasmic ratio
- Many different function
- tight adherence
- no migratory
- Expansion growth
-Diploid ( Euloid) - Low mitotic index
Characteristics of Malignant Cell
Rapid and continious
-Anaplastic appearance
-Larger ratio
-some or none diff funct
-loose adherence
-yes migratory
- invasion growth
-Aneuploid chromosomes
- High mitotic index
What alters body cells?
Body cells are exposed to a variety of conditions that can alter how cells
grow or function. When either cell growth or cell function is changed, the
cells are considered abnormal.
What are Benign Tumor Cells
Benign tumor cells are normal cells growing in the wrong place or at the wrong time as a result of a problem with cellular regulation.
- Examples include moles, uterine fibroid tumors, skin tags, endometriosis, and nasal polyps. Benign tumor cells have these characteristics:
Feature of Benign Tumor
Specific morphology occurs with benign tumors. They look like the
tissues they come from, retaining the specific morphology of
parent cells.
* A smaller nuclear-to-cytoplasmic ratio is a feature of benign tumors
just like completely normal cells.
* Specific differentiated functions continue to be performed by benign
tumors. For example, in endometriosis, a type of benign tumor, the
normal lining of the uterus (endometrium) grows in an abnormal
place (e.g., on an ovary or elsewhere in the abdominal or even the
chest cavity). This displaced endometrium acts just like normal
endometrium by changing each month under the influence of
estrogen. When the hormone level drops and the normal
endometrium sheds from the uterus, the displaced endometrium,
wherever it is, also sheds.
Benign Tumor Cells Features
Tight adherence of benign tumor cells to one another occurs because
they continue to make cell adhesion molecules.
* No migration or wandering of benign tissues occurs because they
remain tightly bound and do not invade other body tissues.
* Orderly growth with normal growth paerns occurs in benign
tumor cells even though their growth is not needed. The fact that
growth continues beyond an appropriate time or occurs in the
wrong place indicates some problem with cellular regulation , but
the rate of growth is normal. The benign tumor grows by
expansion. It does not invade.
* Euploidy (normal chromosomes) are usually found in benign tumor
cells, with a few exceptions. Most of these cells have 23 pairs of
chromosomes, the correct number for humans.
Features of Cancer Cells
Cancer (malignant) cells are abnormal, serve no useful function, and are harmful to normal body tissues
Cancer Cell Features
Anaplasia is the cancer cells’ loss of the specific appearance of their
parent cells. As a cancer cell becomes more malignant, it becomes
smaller and rounded. Thus many different types of cancer cells
look alike under the microscope, rather than looking like their
parent cells.
* A larger nuclear-cytoplasmic ratio occurs because the cancer cell
nucleus is larger than that of a normal cell and the cancer cell is
smaller than a normal cell. The nucleus occupies much of the space
within the cancer cell, especially during mitosis, creating a large
nuclear-to-cytoplasmic ratio.
Cancer Cell Features
- Specific functions are lost partially or completely in cancer cells.
Cancer cells serve no useful purpose. - Loose adherence is typical for cancer cells because they do not make
cell adhesion molecules. As a result, cancer cells easily break off
from the main tumor. - Migration occurs because cancer cells do not bind tightly together and have many enzymes on their cell surfaces. These features allow the cells to slip through blood vessel walls and between tissues, spreading from the main tumor site to many other body sites. The ability to spread by undergoing metastasis is unique to
cancer cells and is a major cause of death. Cancer cells invade other tissues, both close by and more remote from the original tumor. Invasion and persistent growth make untreated cancer deadly.
Terms used to for cancer development
-Carcinogenesis, oncogenesis, and malignant transformation are different terms for cancer development, which is the process of changing a normal cell into a cancer cell.
-This process occurs through loss of cellular regulation
leading to the steps of initiation, promotion, progression, and metastasis.
First step in cancer developement
Initiation is the first step in carcinogenesis. Normal cells can become cancer cells if they lose cellular regulation by having their genes promoting cell division (proto-oncogenes) turn on excessively (are overexpressed), becoming oncogenes, and produce more cyclins.
What happens after a cell becomes intiated
After initiation a cell can become a cancer cell if the cellular regulation loss that occurred during initiation continues.
What are carcinogens?
Substances that change the activity of a cell’s genes so the cell becomes a cancer cell are carcinogens. Carcinogens may be chemicals, physical agents,
or viruses. More than 62 agents, substances, mixtures, and exposures are known to cause cancer in humans, and about another 186 are suspected to
be carcinogens
What is the 2nd process in cancer development?
Promotion . Promotion is the enhanced growth of an initiated cell by substances known as promoters.
-. Once a normal cell has been initiated by a carcinogen
and is a cancer cell, it can become a tumor if its growth is enhanced. Many normal hormones and body proteins, such as insulin and estrogen, can act as promoters and make cells divide more frequently. The time between a
cell’s initiation and the development of an overt tumor is called the latency period, which can range from months to years. Exposure to promoters can shorten the latency period.
What is latency period ?
The time between a cell’s initiation and the development of an overt tumor is called the latency
period, can last for months to years.
What is the 3 process in cancer development?
Progression
Progression is the continued change of a cancer, making it more malignant over time. After cancer cells have grown to the point that a detectable tumor is formed (a 1-cm tumor has at least 1 billion cells in it), other events must occur for this tumor to become a health problem. – First the tumor must develop its own blood supply. The tumor makes vascular endothelial growth factor (VEGF) that triggers nearby capillaries to grow new branches into the tumor, ensuring the tumor’s continued nourishment and growth.
What is a primary tumor?
The original group of cancer cells or tumor caused by carcinogenesis is called the primary tumor . It is usually identified by the tissue from which it arose (parent tissue) such as in breast cancer or lung cancer. When
primary tumors are located in vital organs such as the brain or lungs, they can grow and either lethally damage the vital organ or interfere with thatorgan’s ability to perform its vital function.
What is the last process in cancer development?
metastasis. Metastasis occurs when cancer cells move from the primary location by breaking off from the original group and establishing remote colonies.
-These additional tumors are called metastatic tumors or secondary tumors. Even though the tumor is now in another organ, it is still a cancer from the original altered tissue. For example, when breast cancer spreads to the lung and the bone, it is still breast cancer in the lung and bone—not lung cancer and not bone cancer.
Ways a tumor can spread
-Tumors first extend into surrounding tissues by secreting enzymes that open up areas of surrounding tissue. Pressure, created as the tumor increases in size, forces tumor cells to invade new territory.
-Spread to distant organs and tissues requires cancer cells to penetrate blood vessels. Bloodborne metastasis (tumor cell release into the blood) is a common cause of cancer spread.
-Enzymes secreted by tumor cells also make large pores in the patient’s blood vessels, allowing tumor cells to
enter the blood and circulate. Because tumor cells are loosely held together, clumps of cells break off from the primary tumor into blood vessels for transport.
Another way tumor can spread…
-Another way cancers metastasize is by lymphatic spread. Lymphatic spread is related to the number, structure, and location of lymph nodes and vessels. Primary sites that are rich in lymphatics have earlier metastatic spread than areas with few lymphatics.
NCLEX Practice Question 19.1
A client asks the nurse why his colorectal cancer is being tested for genetic
mutations even though no one else in the family has ever had cancer.
What is the nurse’s best response?
A. “Colorectal cancer is rare and most cases are caused by a genetic
mutation.”
B. “The results of this testing will indicate what caused your cancer so
you can avoid further exposure.”
C. “Many tumors have one or more genetic differences that can help
determine the most effective treatment options.”
D. “Genetic testing of tumor cells can help determine the stage of your
cancer and whether it has spread to other organs.”
How is cancer classified?
- Cancers are classified according to the type of tissue from which they arise (e.g., glandular, connective) (McCance et al., 2019), as described in Table
19.3. Other ways to classify cancer include biologic behavior, anatomic site, and degree of differentiation. - Cancers are either solid or hematologic. Solid tumors develop from specific tissues (e.g., breast cancer and lung cancer). Hematologic cancers arise from blood
cell–forming tissues (e.g., leukemias and lymphomas).
Why have cancer grading been developed ?
Systems of grading and staging have been developed to help standardize cancer diagnosis, prognosis, and treatment.
What is grading relating to cancer?
Grading of a tumor classifies cellular aspects of the cancer.
What is Ploidy relating to cancer grading?
Ploidy classifies the number and structure of
tumor chromosomes as normal or abnormal.
What is Staging relating to cancer grading ?
Staging classifies clinical aspects of the cancer.
-Staging determines the exact location of the cancer and whether metastasis has occurred.
- Cancer stage influences selection of therapy.
Staging is done by clinical staging, surgical staging, and pathologic staging. Clinical staging assesses the patient’s symptoms and evaluates tumor size and possible spread.
-Surgical staging assesses the tumor size, number, sites, and spread by inspection at surgery.
-Pathologic staging is the most definitive type, determining the tumor size, number, sites, and
spread by pathologic examination of tissues obtained at surgery.
What is Ploidy ?
Ploidy is the description of cancer cells by chromosome number and appearance. Normal human cells have 46 chromosomes (23 pairs), the normal diploid number (euploidy).
Common sites of Metastasis for Breast Cancer
-Bone
-Lung
-Liver
-Brain
Lung cancer metastasis
-Brain
-Bone
-Liver
-Lymph Nodes
-Pancreas
Prostate Cancer Metastasis
-Bone ( especially spine and legs)
-Pelvic nodes
Melanoma Metastasis
- GI tract
-Lymph nodes
-Lung
-Brain
Primary Brain Cancer Metastasis
Central Nervous System
What is benign?
Abnormal cell growth
