Neoplasms Flashcards
Plasm
Growth
Neo
New
Neoplasm
Overgrowth of cells that serves no useful purpose. Cells enlarge & divide more rapidly
Cancer is most common :
In older adults
In men
Rare in kids but still common
2nd only to cardiovascular disease
Hyperplasia
Exaggerated response to stimuli
Increase in cell numbers (not size)
Tumor
Originally swelling or mass
Now it’s the same as a neoplasm
Benign neoplasm
Cells masses that remain localized at origin site
& limited in growth.
Some can cause serious disease
Malignant neoplasm
Tumor that tends to grow, invade, & metastasize
Usually irregular shape & is made of poorly differentiated cells
Cancer
Large group of malignant neoplasticism diseases characterized by presence of malignant cells
Oma
Suffix added after tissue in which neoplasm exists
Usually benign
Carcinoma
Malignant neoplasm of epithelium
Sarcoma
Malignant neoplasm of non-epithelial tissue
Adenoma
Malignant neoplasm of epithelial & glandular tissue
Lymphoma
Malignant neoplasm of lymph node cells. No benign counterpart
Melanoma
Malignant neoplasm of melanocytes
Nevus birthmark is benign counterpart
Glioma
Neoplasms of supporting cells (glial cells) of brain
Benign in that they don’t spread, malignant in that they usually kill the pt
Myeloma
Neoplasms of plasma cells (malignant???)
Neoplasms that don’t form rumors
Leukemia- neoplasm of lymphocytes
Erythroleukemia- neoplasms of RBCs
Invasion
Direct ext. of neoplastic cells into surrounding tissue without regard to tissue boundaries
Metastasis
Transportation of cells to a new site (thru vascular or lymphatic channels, accidental surgical transplantation or by local extension)
Seeding
Invasion of natural body cavity
Factors causing initiation of cancer
Radiation-UV, x-ray, gamma
Oncogenic viruses- Epstein Barr (mono) is linked to lymphomas
Herpes is linked to cancer of cervix and nasopharynx
Asbestos (6 naturally occurring silicate minerals) causes
Mesothelioma of lung or peritoneum
Vinyl chloride (used to make PVC) causes
Angiosarcoma of lived
Aromatic hydrocarbons and benzopyrene from polluted air causes…
Lung cancer
Alkylating agents interfere with cell division by. Reacting with DNA and cause…
Leukemia
Tobacco causes
Lung, oral cavity, upper airways, esophagus, pancreas, kidneys, and bladder
Diet that can cause cancer
High protein
Additives
Hormones that can cause cancer
Still controversial
Estrogen and synthetic estrogen
Immunologic factors that can cause cancer
Theory that cancer cells are always developing but the immune system recognizes and destroys. So if immune system is disrupted=cancer
Most common cancer
Skin
Local Manifestations of cancer
Mass- may be 1st discovered manifestation
Pain- produced by localized destruction of tissue. Causes inflammation.
Obstruction- passageways can be blocked depending on where its involved
Hemorrhage- may ulcerate & bleed leading to blood loss
Pathological fracture- primary bone or metastatic cancer can invade and destroy bone…BREAST, LUNG & PROSTATE likely metastasize to bone.
Systemic manifestations of cancer
INFECTION by microorganisms
Leukopenia- decrease in WBC
Inadequate nutrition
ANEMIA- bone marrow replaced by neoplastic cells. Blood loss.
CACHEXIA- generalized wasting. Loss of fat, body mass, with weakness, anorexia, and anemia.
Paraneoplastic syndrome
Tumor immune response that attacks normal tissue
Diagnosis based on screening or symptoms
X-ray, endoscopy, isotope scan, CT scan,
Biopsy is most important: curettage, fluid aspiration, needle aspiration biopsy, dermal punch
Surgical excision
Staging
Classifies tumor based on 3 factors & is adjustable as disease progresses
Is of greater clinical value than grading
Not applicable to cancers of brain, spinal cord, blood, or bone marrow
Tumor size staging
TX: primary tumor can’t be evaluated
T0: no evidence of primary tumor
Tis: carcinoma in situ ( early cancer hasn’t spread)
T1-T4: size/extent of primary tumor
Nodal involvement staging
NX: regional lymph nodes can’t be involved
N0: no regional lymph node involvement
N1-N3: involvement of regional lymph nodes and extent of spread
Metastatic involvement staging
MX: distant metastasis can’t be evaluated
M0: no distant metastasis
M1: distant metastasis
Grading
Considers resemblance of tumor tissue to normal cells, estimated growth rate, names lesion according to corresponding normal cells
The higher the the grade the higher the rate of growth and spread :(
Different grades
GX: grade cannot be assessed G1: well differentiated (low grade) G2: moderately differentiated (intermediate grade) G3: poorly differentiated (high grade) G4: undifferentiated (high grade)
Criteria for grades varies with each neoplasm
Treatment of neoplasm depends on
Type Stage Localization Response Clinical status
Surgery for neoplasm.
Can be total or partial removal, even if just a small portion for biopsy.
Surgery is now often combined with other treatments to discourage proliferation of cells
Benefits of surgery
Relieve pain
Correct obstruction
Alleviate pressure
Goal of radiation
Destroy rapidly dividing cancer cells while preserving normal cells as little as possible.
Targets cellular DNA
Treatment approaches for radiation
External beam radiation
Intracavitary & interstitial implants
(Brachytherapy-small implant, radiation source placed close To tumor)
What tumors respond better to radiation
Those with rapidly dividing cells
Uses for radiation
Tx of localized masses not surgically accessible When surgery would cause damage After surgery to treat residual neoplasm Before surgery to shrink tumor To treat lymph nodes
Radiation can help relieve
Pain Obstruction Malignant effusions (fluid between tissues) Cough Dyspnea Ulcerative lesions Hemorrhage
Systemic side effects of radiation
Weakness Fatigue Anorexia Nausea Vomiting Anemia Diarrhea
Side effects are particular to area treated
Radiation requires what special skin care and…
Frequent blood counts with emphasis on WBCs and platelets
Chemotherapy
Includes anticancer drugs and hormone therapy
Hormone therapy (form of chemo)
Some rumors require hormones for growth and will regress temporarily if deprived of their hormone
Prostate tumors require testosterone so take out testes or add estrogen
Some breast cancers can be temporarily controlled by removing ovaries
Corticosteroids
Can inhibit growth of many rumors by inhibiting protein synthesis which suppresses growth & division of tumor cells
Side effects of corticosteroids
Hot flashes Sweating Impotence Decreased libido Nausea and vomiting Blood dyscrasias (abnormal elements in blood)
Anti cancer drugs
Alkylating agents
Antimetabolites
Anti tumor antibodies
Plant alkaloids
Alkylating agents
React with DNA and inhibit cell division by binding DNA strands together.
Antimetabolites
Resemble essential compounds required for cell growth but cannot be utilized by the cell so
Metabolic process is disrupted
Anti tumor antibodies
Bind with DNA and interfere with DNA dependent RNA synthesis
Plant alkaloids
Disrupt mitosis
Anti cancer drugs are used to
Induce regression of tumor and its metastasis Adjunct to surgery or radiation Control residual disease Relieve pain Relieve other symptoms
Side effects of other cancer drugs
Can cause change in normal tissue
Depress bone marrow: anemia, leukopenia, thrombocytopenia (abnormally low blood clotting platelets)
Irritate GI epithelial cells: ulceration, bleeding, vomiting, diarrhea
Destroy cell of hair follicles and skin: alone is
Pain during administration
Venous sclerosis
Immunotherapy
AKA bio therapy
Used in combo with chemo or radiation and is most effective in early stages
Still experimental
Stimulates bodies immune system
Nonspecific immunostimulation biotherapy
Uses bacterial agents or chemicals that nonspecifically stimulate immune system
Intralesional stimulation biotherapy
Uses injection of biological agent directly into the tumor to initiate specific and nonspecific responses.
Active specific immunostimulation biotherapy
Uses specific tumor antigen vaccines to stimulate the immune system
(Pts DNA or a donors)
Adoptive transfer of immunity biotherapy
Uses transfer of immunologically active cells from donor with established immunity to stimulate pts immune system
Interferon
Once used for antiviral applications only
Now used to stimulate antibody production and cell mediated immunity
Bone marrow transplantation biotherapy
Restores hematologic and immunologic function to some types of cancers
Monoclonal antibodies (specific type of antibody) biotherapy
Attach to tumor cells and when linked with toxins destroy specific cancer cells without disturbing surrounding healthy cells
Still investigational
Colony biotherapy
Stimulating factors
Don’t treat cancer directly but help support pt with low blood counts
Genetic or DNA testing of cancer cells biotherapy
Give info on persons outlook and what type of treatments might be best
Pain from neoplasm may result from
Inflammation
Pressure
Tumor infiltration of nerves and blood vessels
Metastatic extension to bone
Method of pain relief
Narcotics & nonnarcotics Relaxation Biofeedback Distraction Surgical excision of tumor Meds to reduce inflammation Radiation therapy Anesthetics
PT Tx for cancer
Strength and cardio system to overcome weakness
No aerobic exercise if
Ambulated <50% of the time
Confined to bed
Fatigue with mild exertion
If fatigue persists more than 60 min after exercise decrease intensity
Hemodynamics contraindicated for exercise
Platelet <500/ml
Modalities contraindicated because increasing circulation may increase rate of growth.
