WEEK 1 Oncology Nursing Flashcards
Define Cancer
A class of diseases characterised by uncontrolled cell division
Identify the two forms of growth within cancer
Direct growth into adjacent tissue (invasion) OR migration of cells to distant sites (metastasis)
Why are cancer cells referred to as “rapidly dividing”
They do not rest and they do not die
Define Carcinogenesis
Normal healthy cells transform into cancer cells as they have had a change in programming and have made it through checkpoints where abnormalities would normally be picked up
Define Carcinogen
A cancer causing agent e.g. Cigarette smoking, UV exposure, Alcohol
Define Well Differentiated tumour cells
Tumour cells reproduce these features well e.g. Breast cells (Clear to tell what the cell is)
Define Poorly Differentiated tumour cells
Tumour cells reproduce these features poorly e.g. Difficult to tell the cell of origin (Where it has come from)
Define Undifferentiated tumour cells
Cannot tell where the cell has come from (No maturation)
What are Proto-oncogenes
Normal growth promoting genes e.g. Growth factors, Cell cycle controlling genes
What are Oncogenes
Mutated form of Proto-oncogenes. Body cells are exposed to personal/environmental conditions that can mutate the genes and alter how the cells function and grow
Describe the process of tumour growth
- Cells normally only divide when needed to replace dying/damaged cells
- Cells are programmed so that they die when no longer needed (Apoptosis)
- With good communication, cells proliferate when required/stop dividing when required
- In cancer cells, something is wrong (genetic code mix up = Cancer cell born)
- Cancer cell divides to produce daughter cells which also divide = Uncontrolled growth and spread
Describe cancer cells “loss of cellular surface contact inhibition”
Normal tissues have balance between cell birth and cell death, tumour cells have an inability to proceed to the resting phase, causing cell birth>cell death = TUMOUR
Define tumour suppressor genes
Function by encoding proteins that block growth promoting proteins “Off switch”. Mutation occurs = No off switch
Identify and describe a common tumour supressor gene mutation
p53 gene “Gate keeper”. Prevents cells that should not be dividing from entering the cell cycle (e.g. those with damaged DNA). When mutated, cells are able to replicate = uncontrolled abnormal cell growth
Define growth fraction
Ratio of the total number of cells to the number of dividing cells. The higher the growth fraction, the more rapidly a tumour mass increases
Define doubling time
Time taken for tumour to double in volume (Average time 2-3 months)
When are tumours usually clinically detectable?
Usually not clinically detectable until they have doubled around 30 times
Describe the Gompertzian Tumour Growth Curve
Describes the decrease in cells doubling time as tumour progression occurs
Describe the Metastatic Cascade
- Growth and progression of primary tumour
- Cells detach and motile cancer cells invade and enter the bloodstream/lymphatic vessels
- If successful, blood/lymph transports them to distant sites where they extravasate and lodge in bones/lungs/liver
- Angiogenesis occurs
- Blood supply to tumour established = Further aggressive growth
Identify the 8 stages of the Metastatic Cascade
- Tumour initiation
- Progression
- Proliferation
- Angiogenesis
- Invasion/Intravasation
- Extravasation
- Colony Formation
- Evasion of host defences
Define intravasation/extravasation
Transport of cancer cells into/out of a blood/lymphatic vessel
Define Prevelance
Measurement of all cancer cases
No. of people with cancer / Total no. of people
Define Incidence
Number of newly diagnosed cases in specified period of time
No. of people developing cancer in period of time/Total population
Define Mortality
Number of deaths attributed to cancer in period of time in a defined population
No. of people dying of cancer in period of time/Total population
What 6 aspects does staging include
- Location of tumour
- Type of cells
- Tumour grade (How abnormal cells look)
- Measurement of tumour size
- Lymph-node spread of tumour cells
- Metastatic spread of cancer cells
Identify the most common staging system
TNM System:
T (Tumour): Size and Extent of primary tumour
N (Nodes): No. of nearby lymph-nodes that contain cancer/cells
M (Metastasis): Spread to other sites/organs
Define Screening
Performance of tests on apparently well people to detect a medical condition that would otherwise be detected at a later stage
Define Neoplastic disease
Malignant and Benign Growths
Define Benign Growths
Generally slow growing, where the tumour is localised to one area of the body e.g. Fibroids in uterus
Define Malignant Growths
Tumour is consistently growing, made up of poorly differentiated tissue and has the potential to involve other areas of body e.g. Breast, Prostate, Ovarian Cancers
Identify 3 aspects of the emotional response to a cancer diagnosis
Shock, Anger, Depression
Identify 3 aspects of the physical response to cancer diagnosis
Sleep disturbance, Appetite changes, Altered sexual interest
Clinical Distress may be related to?
Disease Status, Treatment tolerance, Symptom intensity/frequency
Identify 3 psychosocial issues associated with cancer
Adjustment disorders to illness/changes in care, Feelings of isolation and Decreased quality of life
Identify 3 treatments of psychosocial issues associated with cancer
Education, Support groups, Psychotherapy/Relaxation/medication
Identify 3 practical issues associated with cancer
Transportation issues, Financial issues, Occupational problems
Identify 3 treatments of with practical issues associated with cancer
Education, Support from community agencies, Referrals
Define supportive care
Embraces the full range of issues that emerge for an individual within a cancer diagnosis
Define sensitive care
Required to help the individual cope with what is happening and maintain or improve the persons quality of life
What are some risk factors which increase the likelihood of heightened emotional distress/recovery adjustment
Being very old/very young, female, single, poor marital functioning, socially isolated people
What are 3 key principles of supportive care
Person centred, System wide and team approach and focus on quality of care
Identify 3 barriers to the delivery of psychosocial care
No access (Geographically)
Don’t ask for help due to stigma
Lack of provider familiarity within community resources
Identify 2 sexual and 2 cultural issues related to a cancer diagnosis
- Lack of sexual interest/Intimacy = Impacting on relationship
- Fertility issues
- Provider miscommunication = Impact on understanding/education
- Lack of cultural awareness/sensitivity by HCP
