Neoplasia Flashcards
Cancer
disorder of altered cell differentiation and growth
Neoplasim
the new growth
Tumor
swelling that can be caused by a number of conditions, including inflammation and trauma
Polyp
growth that projects from a mucosal surface, such as the intestine
Carcinoma
term used for malignant tumors of epithelial in origin
(bronchogenic carcinoma, adenocarcinoma)
Sarcoma
term used for malignant tumors of mesenchymal/connective tissue in origin
(liposarcoma, angiosarcoma)
Benign tumors
usually end with the suffix “oma”,
except for lympfoma, hepatoblastoma, neuroblastoma, myeloma, melanoma.
Lymphomas
Cancers of the lymphatic tissue
leukemia
cancer of blood forming cells
Carcinoma in SITU
Pre-invasive epithelial malignant tumors of glandular or epithelial origin that has not broken through the basement membrane or invaded the surrounding stroma (cervix, skin, oral cavity, esophagus & bronchus)
Epithelial Benign Tumors
Papilloma
Adenoma
Epithelial Malignant Tumors
Squamous cell carcinoma
adenocarcinoma
Connective tissue benign tumors
fibroma
lipoma
chondroma
osteoma
hemangioma
lymphangioma
Conncective tissue malignant tumors
fibrosarcoma
liposarcoma
chondrosarcoma
osteosarcoma
hemangiosarcoma
lymphangiosarcoma
lymphosarcoma
Muscle benign tumors
leiomyoma
rhabdomyoma
Muscle malignant tumor
leiomyosarcoma
rhabdomyosarcoma
Neural Tissue benign tumor
Neuroma
glioma
neurilemmoma
meningioma
Neural tissue malignant tumor
neuroblastoma
glioblastoma
medulloblastoma
oligoendroglioma
neurilemmal sarcoma
meningeal sarcoma
Hematological malignant tumor
myelocytic leukemia
erythrocytic leukemia
mulitple myeloma
lymphocytic leukemia
lymphoma
monocytic leukemia
endothelial benign tumor
hemangioma
lymphangioma
endothelial malignant tumors
hemangiosarcoma
lymphangiosarcoma
a malfunction in any part of ________can lead to rapid proliferation of immature cells
the cell cycle
cell characteristic of benign tumors
- well differentiated
- resemble normal cells from which tumor originated
Mode of growth benign tumors
tumor grows by expansion and does not infiltrate surrounding tissues
usually encapsulated
benign tumor rate of growth
usually slow
malignant cell characteristics
undifferentiated
usually do not ressemble normal cells of tissue from which they arose
malignant tumor mode of growth
grows at periphery and send out processes that infiltrate and destroy surrounding tissue
Malignant rate of growth
variable and depends on level of differentiation
more anaplastic=faster growth
benign tumor metastasis
None- negative
malignant tumor metastasis
gains access to blood and lymph channels and metastasizes to toher areas of the body
benign tumore general effects
usually localized phenomenom
does not cause generalized effects unless localtion interfers with normal/vital function
malignant tumor general effects
anemia
weakness
weight loss
benign tumor destruction
does not cause destruction unless location interferes with blood flow
malignant tumor destruction
- often causes tissue damage as the tumor outgrows its blood supply or blocks blood flow to the area
- may also produce substances that cause cell damage
invasion and metastisis
- Cancer cell expresses surface adhesion molecules (capable of invasion)
- tumor adhesion molecules bind to underlying extracellular matrix
- tumor cells disrupt and invade extracellular matrix
Phagocytic enzymes-repeated disruption of extracellular matrix by binding=dissalution of matrix
- tumor cells metastasize by way of blood and lymph
Metastasis types
direct invasion
diffusion
lymphatic spread
hematologic spread
metastasis: lymphatic spread
Local or distant lymph nodes via lymphatic drainage
Migratory nature also be carried by lymphatic drainage to local or distant lymph nodes
metastasis: direct invasion
Nearby organ and tissue
Through a structure such as pelvis or abdomen
May cause skin changes and ulcerations of involved tissue
Not orderly spread
Surgical removal must include margins
metastasis diffusion
Serous cavities such as pelvis
metastasis: heamtological spread
Tumor cells are carried to distant sites through blood flow
Colon cancer commonly spreads to the liver
Normal circulation carries blood from the intestines to the liver through the hepatic portal vein.
Major Metastatic sites
lung
brain
liver
bone
breast cancer common metastasis sites
lung
bone
colorectal cancer common metastasis sites
liver
prostate cancer common metastasis sites
bone
spine
legs
lung cancer common metastasis sites
brain
brain tumors common metastasis site
CNS
cancer risk factors
smoker
obesity
nutrition
alcohol
some chemical/drugs
some viruses/bacteria
radiation
Nonmodifiable: age, immune condition, hormones, heredity
Alcohol increase the risk of cancer in
mouth, pharynx, larynx, esophagus, liver, colorectum, and breast
Warning signs of cancer
- Change in bowel or bladder habits
- Any sore that does not heal
- Unusual bleeding or discharge
- Thickening lump in breast or anywhere
- Indigestion
- Obvious change of wart or mole
- Nagging cough or hearseness
Cancer early detection screenings
mammogram
PAP smear
stools for occult blood
sigmoidoscopy
colonoscopy ( polyps=5 years, no polyps=10 years)
breast self exam
testicular self exam
skin inspection
What are Tumor Markers??
Tumor cell markers (biological markers) are substances produced by cancer cells or that are found on tumor plasma cell membranes, in the blood, SF, or urine
Hormones
Enzymes
Genes
Antigens
Antibodies
How are tumor markers used?
Tumor markers are used to:
Screen and identify individuals at high risk for cancer
Diagnose specific types of tumors
Observe clinical course of cancer
What are the three steps in carcinogenesis
Initiation
promotion
progression
Explain Carcinogenesis Initiation Step
Carcinogens such as chemicals, physical factors, and biologic agents escape normal enzymatic mechanisms and alter the genetic structure of the cellular DNA
- DNA DAMAGE
- CELL MUTATION
Explain Carcinogenesis Promotion step
Repeated exposure to promoting agents causes the expression of abnormal or mutant genetics information
-activation of oncogenes by promoter agent
Explain Carcinogenesis Progression step
The altered cells exhibit increased malignant behavior; they now have the propensity for invasion and metastasis
=malignant tumor!!
Will every dna damage to a cell lead to mutation?
NO
Malignant Grading definiton
According to the histologic or cellular characteristics of the tumor
Degree to which the tumor cells retain the functional and structural characteristics of the tissue of origin
Malignant staging definition
According to the clinical stage of the disease, including tumor size and spread or metastasis to distant sites
TNM Classification: Tumor
Tx - Primary tumor cannot be assessed
T0 - No evidence of primary tumor
Tis - Carcinoma in situ; intraepithelial or invasion of lamina propria
T1 - Tumor invades submucosa
T2 - Tumor invades muscularis propria
T3 - Tumor invades through muscularis propria into subserosa or into non-peritonealized pericolic or perirectal tissues.
T4 - Tumor directly invades other organs or structures and/or perforate visceral peritoneum
Primary tumor cannot be assessed is what on TNM classification?
Tx
No evidence of primary tumor is what on TNM classification
T0
Carcinoma in Situ is what on the TNM classification?
Tis
intraepithelial or invasion of lamina propria
A tumor that invades submucosa would be classified as what on the TNM
T1
A tumor that invades muscularis propria would be classified as what on the TNM scale?
T2
A tumor that invades musularis propria into the subserosa or into non-peritonealized perocolic or perirectal tissues would be classified as what on the TNM scale?
T3
A tumor that directly invades other organs or structures and/or perforate visceral peritoneum would be classififed as what on the TNM
T4
Regional Lymph Nodes TNM classification
Nx - Regional lymph nodes cannot be assessed
N0 - No regional lymph node metastasis
N1 - Metastasis in 1 to 3 regional lymph nodes
N2 - Metastasis in 4 or more regional lymph nodes
what is the TNM classification when regional lymph nodes cannot be assesed
Nx
What is the TNM classification when there is no regional lymph node involvement?
N0
What is the TNM classification when there is metastasis in 1-3 lymph nodes?
N1
What is the TNM classification when there is metastasis in 4 or more regional lymph nodes?
N2
TNM- distant metastasis
Mx - Distant metastasis cannot be assessed
M0 - No distant metastasis
M1 - Distant metastasis
What is the TNM classification if distant metastasis cannot be assessed?
Mx
What is the TNM classification if there is no distant metastasis
M0
What is the TNM classification is there is distant metastasis
M1
what influences pain in malignancy
fear, anxiety, sleep loss, fatigue, and overall physical deterioration
what are the mecahnisms of pain in malignancy?
Pressure,
obstruction,
invasion of sensitive structures,
stretching of visceral surfaces,
tissue destruction,
inflammation
what are some clinical manifestations of malignancy
pain
fatigue
cachexia
anemia
leukopenia
thrombocytopenia
infection
what are components of fatigue in malignancy
psychogenic cultural and physiologic comnponents.
what are suggested causes of fatigue in malignancy
Sleep disturbance
biochemical changes from circulating cytokines
secondary to disease and treatment
psychosocial factors
level of activity
nutritional status
environmental factors
what is cachexia syndrome?
severe form of malnutrition
What are the compnents of cachexia syndrome?
Anorexia
early satiety
weight loss
anemia
asthenia
taste alterations
altered protein, lipid, and carbohydrate metabolism
what are the mechanisms of anemia in malignancy
Chronic bleeding resulting in iron deficiency
severe malnutrition
medical therapies
malignancy in blood-forming organs
what are mechanisms of leukopenia and thrombocytopenia in malignancy
Direct tumor invasion to the bone marrow causes both leukopenia and thrombocytopenia
Chemotherapy drugs are toxic to the bone marrow
when does infection risk increase?
Risk increases when the absolute neutrophil and lymphocyte counts fall
what are the 3 treatment modalities for oncology?
chemo
radiation
surgery
what are the purposes of surgery in the oncologic patient?
diagnose, stage and treat cancer
what are the types of surgery in the oncologic patient
Prophylactic surgery
Curative surgery
Control (cytoreductive) surgery
Palliative surgery
Reconstructive or rehabilitative surgery
what are the side effects of surgery?
Loss or loss of function of a specific body part
Reduced function as a result of organ loss
Scarring or disfigurement
Grieving about altered body image or imposed change in lifestyle
what does chemotherapy do?
Kills or inhibits the reproduction of neoplastic cells
Does Chemotherapy effect healthy cells or malignant cells?
BOTH
The effects are systemic and affect both healthy cells and cancerous cells
What are the normal healthy cells mostly effected by chemotherapy treatment?
the skin,
hair,
lining of the GI tract,
spermatocytes
hematopoietic cells
What are chemotherapy side effects
alopecia
nausea and vomiting
mucositis
skin changes
immunosuppression
anemia and thrombocytopenia
what are the two most common typers of radiation therapy?
teletherapy
brachytherapy
Does radiation therapy effect both healthy and cancer cells?
Destroys cancer cells with minimal exposure of normal cells to the damaging effects of radiation; the cells damaged either die or become unable to divide
Effective on tissues directly within the path of the radiation beam
Does the patient remit radiation when getting teletherapy?
The client does not emit radiation and does not pose a hazard to anyone else
What is beam radiation?
AKA teletherapy
radiation source is external
patient does not emit radiation
Teletherapy education
Wear soft clothing over the area avoiding belts, buckles, straps, or any clothing that binds or rubs the skin
Avoid sun and heat exposure
Monitor for moist desquamation (weeping of the skin)
If moist desquamation occurs, cleanse the area with warm water and pat dry, apply antibiotic ointment or corticosteroid cream as prescribed, and expose the site to air
Wash area with water or mild soap and water using the hand rather than a washcloth; rinse the soap thoroughly, and pat dry using a soft towel or cloth
Do not remove the radiation markings from the skin
Use no powders, ointments, lotions, or creams on the area unless prescribed
DO clients receiving brachytherapy emit radiation
YES
The radiation source is within the client; for a period of time, the client emits radiation and can pose a hazard to others
brachytherapy unsealed sources
Administered via the oral or IV routes, or as an instillation into body cavities
The source is not completely confined to one body area, and it enters body fluids and is eventually eliminated via various excreta, which is radioactive and harmful to others
Most of the source is eliminated from the body within 48 hours; then the client nor the excreta are radioactive or harmful
Sealed Brachytherapy
SEALED RADIATION SOURCES
A sealed, temporary or permanent radiation source (solid implant) placed within the tumor target tissues
The client emits radiation while the implant is in place, but the excreta is not radioactive
what is sealed brachytherapy usually used for
cervical/prostate cancer
