Neoplasia Flashcards
What is cancer?
Group of diseases characterized by uncontrolled and unregulated growth of cells
●Occurs in people of all ages
○ Majority of cases are diagnosed in those over age 55 becuase they have been more exposed to carcinogens throughout life and their immune system is worse
Both the incidence and mortality rate of cancer has been declining
○ Incidences of lung, colorectal (colon), breast and oral cancer have ↓
○ Other cancers have ↑ skin, kidney, and thyroid. The number tends to go up based on the years. now it’s 1.8 million.
- Higher in men than women
- Secondmostcommoncauseofdeath
in the United States after heart disease - Leadingcauseofdeathinpeople 40-79 years of age
What is cancer 2.0 continues.
> 16.9 million Americans are alive today who have a history of cancer
* Disease free
* In remission
* Under treatment
- 78% of all CA diagnosed at age 55 or older
- Incidence highest in individuals 60-69 yrs of age
- Most common type of CA: Skin Cancer
- Highest Mortality Rate: Lung CA
Check slide 4 and 6 watch lecture.
Cancer cells have a worse shape and go passed thier boundaries becoming bigger
Normal Cellular Differentiation
* Orderly process progressing from a state of immaturity to a state of maturity
* Stable and will not change
Orderly process progressing from a state of immaturity to a state of maturity
* Stable and will not change. Check slide 5
Pathophysiology of cancer cells irreversible cell growth?
Irreversible cell growth is when you have anaplasia; (the loss of the mature or specialized features of a cell) They become like zombies
- Loss of differentiation between cells
- Lack of normal cellular characteristics
and are nearly always malignant
Defect in Cellular Differentiation
Two types of genes that can be affected by mutation:
1 Proto-oncogenes are a group of genes that cause normal cells to become cancerous meaning oncogenes)
2 Tumor suppressor genes
Protooncogenes
Regulate normal cellular processes such as promoting growth
Genetic locks that keep cells functioning normally
Mutations that alter their expression can activate them to function as oncogenes (changed) form of a type of gene called a proto-oncogene) causing unrestrained growth
Tumor suppressor genes stop tumors;
Exist in normal cells and function to control cell growth (suppress growth)
May also play role in carcinogenesis
When these genes mutate, normal constraints on cell growth are removed so cancer cells appear.
Tumor Immunology
Surveillance Network in cells;
- Destroys cells before growing into detectable masses
- Tumor antigens assist in the recognition process
Carcinogenesis?
Carcinogens: substances or agents that damage genetic material
Carcinogenesis
External factors?
External Risk Factors
Chemicals such as nicotine, asbestos, sunlight
Radiation
Chronic Irritation: pollution, alcohol, acid reflux, cigarette smoking
Dietary Influences: red meat in excess, bbq, burned food, processed meat
Viral carcinogens.
Epstein Barr virus: Burkitt’s lymphoma
HIV: Kaposi sarcoma
Hepatitis B virus: Hepatocellular carcinoma
Human papillomavirus: squamous cell carcinoma
Internal Risk Factors Carcinogenesis meaning that are not external to the body
Immune Function
* Immunosuppressed = increased risk
-Surveillance Failure
-Genetic Predisposition
*Has influence on the efficiency of the carcinogenic process
Breast CA, Colorectal CA
slides 13 14 and 15 16 17 starting min 19 all covered on this slide no worries!
The initiation phase of cancer by carcinogens is stoppable by killing the infected cell That damages the DNA of the cell . If that cell is not killed and it multiplies it goes to a phase called promotion where it replicates itself. (Excess Fat, protein, calories are promotors) This can be reversible except with cigarettes because they have both the promoting factor and the initiating factor.
The progression stage is when you have evidence of cells having a cluster meaning. The size of a marble of cells is a billion cells.
Malignant tumor: more dangerous, it has metastasized meaning that it travels to another area.
Beginning tumor: does not metastasize, they are generally encapsulated. It can be deadly as well depending on size and location example impeding a vital vessel.
Most tumors are capable of developing their circulatory pathways. It’s called angiogenesis. Once they do that they can invade other areas and develop a whole new system. If a cancer metastasizes from bone to brain it’s still gonna be called bone cancer.
Prevention of cancer Smoking?
Smoking Cessation
-The deadliest form of cancer can be prevented by smoking cessation
- Also attributed to other cancers like: Mouth, esophageal, bladder
Protection from cancer ?
Nutrition
- Five servings of fruit and vegetables q day
- Limit red meats, processed high fat meats
- Whole grains
Protection from cancer Nutrition?
Nutrition
- Five servings of fruit and vegetables q day
- Limit red meats, processed high-fat meats
- Whole grains
-The best is the Mediterranean diet. omega 3, olive oil
Prevention Alcohol?
Limit Alcohol Consumption
- No more than 2 drinks/day for men
- No more than 1 drink/ day for women
- Even a few drinks q week assoc with breast CA
Prevention sun?
Sun Protection
- Many of more than one million skin cancers could be prevented
- Avoid exposure during peak periods
- Wear protective clothing, hats
- Wear sun protection
- Inspect for new skin lesions when performing a skin assessment
Prevention exercise?
Physical Activity
- Engage in at least 150 minutes of moderate-intensity or 75 min of vigorous-intensity physical activity each week, or an equivalent combination
- Children engage in 60 min moderate-vigorous activity each day with vigorous activity at least 3x week. People used to walk to school now they don’t.
Prevention from cancer behavior?
Behavioral Modification
- Certain CA related to infectious exposures including Hep B, HIV, HPV, and others could be prevented through behavioral changes, vaccines
Prevention screening?
Regular screening and self examinations could increase 5 yr survival rate to 82%
If all Ca dx at localized stage through regular screening, 5 yr survival rate could increase to 95%
Screening Guidelines?
Breast
Uterus/cervical
Colon/rectal
Lung Ca
Prostate/testicular
(Refer to link on Canvas)
Seven Warning Signs of Cancer? Caution
Caution Mnemonic Device!
-Change in bladder or bowel habits
-A sore throat that does not heal
-Unusual bleeding or discharge
-Thickening or lump
-Indigestion or difficulty swallowing
-Obvious change in wart or mole
-Nagging cough or hoarseness
Tests?
Complete history
Physical Exam
Labs CBC
chest x-ray
Chest CT to detect size and location of the mass, as well as the enlargement of lymph nodes
PET(positron emission tomography) scan to look for lymph nodes and spread to other parts of the body
Brain MRI (magnetic resonance imaging)
Excisional Biopsy
chest x-ray?
YOu can see a tumor
