pt with cancer Flashcards
what is cancer
complex of diseases which occurs when normal cells mutate into abnormal cells that take over normal tissue
when does cancer mostly occur
in pts >65 yrs old d/t the natural decline in the immune system
what is the highest cancer in men?
women?
men- prostate
women- breast
what are non diagnositic screening tools for cancer
-assessing skin- color texture, denting, discharge, redness, bumps, lumps
mucous membrane
breast exam
testicular exam
what are causes for differences in survival for pts with cancer
- poverty
- access to healthcare
- poor quality healthcare
- comorbid conditions
- differences in tumor biology
what are the 3 major dysfunctions of cancer
- cell proliferation is continuous
- cell differentiation is poor, may not resemble the normal cell
- contact inhibition- no regard for cell boundaries- how the cancer becomes metastatic
what can mutated cells do
- die r/t damage or programmed suicide
- repair themselves
- survive and pass on the mutation
characteristics of benign tumors
well-differentiated encapsulated no metastasis rarely reoccur no vasculature fairly normal cells/similar to parent cell cause tissue damage by pressure usually doesn't cause death
how fast do cancer cells proliferate
at the same rate as normal cells
however
they sometimes produce more than 2 cells at a time during mitoses therefore it seems like they are growing faster
most common cancer associated death
lung
what conditions can you avoid to prevent cancer
HPV hep b & c HIV Obesity poor nutrition
what are the 2 most common cancers that cause death in children
leukemia
brain/nervous system
what are characteristics of cancer cells
poorly differentiated rarely encapsulated ability to invade and metastasize possible recurrence vasculature cells are abnormal and become more unlike parent cells cause tissue damage and encroaches on blood supply causes death unless growth is controlled
what are the stages of cancer
initiation
promotion
progression
what occurs in the initiation stage of cancer
there is a mutation in the sells genetic structure (alteration in the DNA sequence) and cancer cells arise
this can happen via inheritance or acquired via exposure
the mutated cells may die or they may replicate daughter cells with the same genetic mutation
what causes mutations in the cells genetic structure
carcinogens chemicals radiation hormones viruses
what occurs in the promotion phase of cancer
the cells will continue to proliferate and the chances of cancer development are increased with the presence of “promoting” agents– (cancer causing substances)
thus the removal of the cancer causing substances will reduce the risk of cancer development
this stage includes reversible proliferation of cells.
what is the latent period
the promotion phase-
ranges from 1-40 years before cancer is detected (depending on the type)
by the time the cancer is detected the cells have reached a critical mass size
what occurs in the progression phase of cancer
it is the final stage and has increased growth rate of the tumor
increased invasiveness and
metastatis occurs
how does metastasis occur
the primary tumor rapidly grows
this causes the development of its own blood supply (angiogenesis) which is critical for its growth and survival
the tumor cells are able to detach from the tumor and invade the surrounding tissue and thus penetrate the lymph or vascular vessels and travel to another site in the body.
what is immunologic surveillance
the process in which lymphocytes continuously check cell surface antigens and detect and destroy cells with abnormal or altered antigenic determinants.
cancer cells can develop abnormal cell surface antigens known as tumor associated antigens (TAAs)
what is the immune response to malignant cells
Cytotoxic T cells resist tumor growth and kill tumor cells- also secrete cytokines that stimulate T cells NK cells B cells and macrophages
NK cells- directly lyse tumor cells without prior sensitization (these cells are stimulated by the cytokines that cytotoxic T cells release)
macrophages– lyse tumor cells, secrete cytokines, tumor necrosis factor and colony stimulating factor
B cells– produce specific antibodies that bind to tumor cells and destroy them
what does tumor necrosis factor do
causes hemorrhagic necrosis of tumors and exerts cytocidal or cytostatic actions against tumor cells.
what is immunologic escape
the process by which cancer cells evade the immune system.
- they suppress the factors that stimulate T cells to react
- weak surface antigens allowing cancer cells to “sneak by”
- develope tolerance of the immune system
- secrete products that suppress the immune system
- induction of suppressor T cells by the tumor itself
- block antibodies that bind to TAAs preventing recognition
what is CA 125
CA19-9
PSA
CA 15-3,27,29
tumor associated antigens
CA 125- associated with ovarian cancer
CA19-9– gallbladder and pancreatic cancer
PSA- prostate specific antigen- prostate cancer
CA 15-3,27,29- breast cancer
what are ways to prevent cancer
reduce exposure to carcinogens no smoking reducing amount of UV exposure reduce alcohol consumption avoid chemical exposure get regular physical exams have a healthy diet and exercise maintain healthy weight reduce stress/coping strategies for stress adequate rest(6-8hrs /night) monthly self breast/testicular exams know they 7 warning signs and seek medical care
what are the 7 warning signs
CAUTION C-change in bowel or bladder habits A- a sore throat that does not heal U- unusual bleeding or discharge T- thickening or lump in breast/elsewhere I- indigestion or difficulty swallowing O- obvious change in wart or mole N- nagging cough or hoarsness
what types of screening exams should be done and at what age
skin-should start at a young age
breast- clinical and self around age 20
(mammo- annually age 50)
colorectal- age 50 Q10yrs (colonoscopy)
testicular- clinical and self, age 15-40
prostate- obtain PSA and digital exam age 50
cervix/uterus- sexually active or age 21 w/ PAP, annually age 30
what are the histologic classifications of cancer (appearance of cells)
Stage 1- cells differ slightly from normal cells
Stage 2- more abnormal cells
Stage 3- very abnormal
Sage 4- immature and primitive cells, undifferentiated do not resemble parent cells
what are the stages of cancer
Stage 0- carcinoma in situ- cells are localized and show no tendency to invade or metastasize to other tissues.
Stage I- tumor limited to the tissue of origin- localized growth
Stage II- limited local spread
Stage III- extensive local and regional spread
Stage IV- metastasis
what is the TNM classifications
THM is used to determine the anatomic extent of the disease involving:
tumor size and invasiveness
presence or absence of spread to lymph nodes
metastasis to distant organs
