Week 4 (ch. 20) Flashcards
Describe neoplasm cell growth
no longer responds to normal body controls
- continue to reproduce even though no need for them
- deprives surrounding cells of nutrients
- expanding mass create pressure on surrounding structures
neoplasms consist of what kind of cells
atypical or immature
characteristics of neoplasms depend on what
cell type
tumors are names according to what
system its in
benign tumor names vs malignant tumor names
benign: have tissue name plus the suffix -oma (adenoma)
malignant tumors (cancers) have the tissue name plus the suffix -carcinoma (adenocarcinoma)
characteristics of benign tumors
differentiated cells
reproduce higher than normal rate
encapsulated (expand but does not spread)
freely moveable on palpation
damage of benign tumors is from what
compression of adjacent structures
characteristics of malignant tumors
Undifferentiated cells, nonfunctional cells
Reproduce rapidly
Infiltrate or spread into surrounding tissues
Metastasize
Maligant tumors are composed of what cells
dysplastic cells
- absent of normal cell function
- surface antigens altered
malignant tumors compress nearby blood vessels, which causes what
necrosis and inflammation, increase pressure on surrounding structures
Do maligant cells adhere to each other
no - break lose from the mass, infiltrating into surrounding tissue
malignant tumors secrete enzymes, which do what
add to destruction and facilitate spread
Malignant tumors cause inflammation and loss of normal cell, which does what
progressively reduce the organ function
What happens as a malignant tumor enlarged
inner cells are frequently deprived of blood and nutrients (they die)
which leads to more inflammation
Some malignant tumors secrete growth factors, which does what
stimulates angiogenesis (development of new capillaries in the tumor) - promotes tumor development
Malignant tumors “trap” nutrients depriving normal cells, which does what
prevents tissue regeneration
Malignant tumors “in situ” =
preinvasive stage
- months or years
- offers early diagnosis for cervical or oral cancers
Warning signs of cancer
- bleeding / discharge at site
- change in BM or Bladder habits
- change in wart or mole
- sore that does not heal
- weight loss
- anemia / low hemoglobin
- fatigue
- cough or horseness without reason
- lump, painless, in breast, testes or anywhere in body
Local effects of cancer: pain
May be absent until well advanced
Severity depends on the type and location
Local effects of cancer: obstruction
Occurs when tumor compresses a duct or passageway
blood supply or lymphatic flow may be restricted (ulceration, edema)
digestive tract
airflow in bronci
Local effects of cancer: tissue necrosis and ulceration
may lead to bleeding or infectoin around the tumor
– increased in areas of normal flora become opportunistic
Systemic effects of cancer: weight loss and cachexia
severe tissue waisting
- increased demands placed on body
Systemic effects of cancer: anemia
Common problem
- due to anorexia, chronic bleeding, bone marrow depression
- causes poor tissue regeneration
Systemic effects of cancer: fatigue
Inflammatory changes psychological factors (life threatening illness, depression)
Systemic effects of cancer: infections
host resistance declines
Systemic effects of cancer: bleeding
Tumor cells may erode blood vessels or cause tissue ulceration
bone marrow depression –> poor clotting
common site – GI tract –> mucosa slow to regenerate
Systemic effects of cancer: paraneoplastic syndromes
Certain tumor types
– tumor cells release substances that affect neurological function and may have hormonal effects
Cancer diagnostic tests: routine screening
Educate patients
- essential for early detection
- following treatment to detect any further tumors
Cancer diagnostic tests: self examination
Educate patients
- early detection, if done consistently
- breast, testicular, skin
Cancer diagnostic tests: blood tests
RBC and hemoglobin
Measure blood cell levels during treatment
Tumor markers…may detect tumor markers (PSA test), BRAC-1
Cancer diagnostic tests: radiologic, ultrasound, MRI, CT
Methods of visualizing changes in tissues or organs
Cancer diagnostic tests: cytological test
Require biopsy or cell sample
— determine degree of differentiation and tumor type
— may be test for growth promoter sensitivities (e.g. estrogen dependent tumors)
— most dependable confirmation of malignancy
Cancer diagnostic tests: genomic tumor assessment
ID genomic mutations that are independent of heredity but only occur with the disease itself
Spread of Malignant tumors: secondary tumors
Cells identical to primary tumor
Spread of Malignant tumors: invasion
Local spread - grows to adjacent tissues
— ex. Uterine carcinoma invaded vagina
Spread of Malignant tumors: metastasis
Spread to distant sites by blood or lymphatic channels
Cells erode into vein/lymphatic vessel traveling until lodge into hospitable environment (typically lymph nodes near by)
Ex. Carcinoma of colon spreads to liver
Spread of Malignant tumors: seeding
Spread of cancer cells in the body fluids or along membranes
— typically within cavities
— ovarian to throughout peritoneal cavity
Why is staging of cancer essential
To standardize comparative studies of treatments and outcomes
- used to estimate prognosis
Staging of cancer: most common system used in TMN system
- Size of primary tumor (T)
- Involvement of regional lymph nodes (N)
- Spread (metastasis) of tumor (M)
Staging of cancer: stage 1 and stage 4
Stage 1: small, well localized, easy to treat, good prognosis
Stage 4: well advanced at multiple sites, difficult to treat, poorer prognosis
Carcinogenesis
Process by which normal cells form into cancer cells
Combination of factors or repeat exposure to single risk factor leads to changes - activates or changes gene expression - leading to transformation of normal cell to malignant cell
Cancer is thought to be a multi factorial disease because of what
- environmental effects
- changes in gene expression (heredity)
- infection in some cases
Stages of carcinogenesis
- Initiating factors —> procarcinogens cause the first irriversible change in cellular DNA
A. Do not create an active neoplasm - Exposure to promoters causes further damage
A. Less differentiation and increase mitosis and or lack of apoptosis
B. Includes hormones and environmental Cham
C. Dysplasia or analysis may be evident
D. Process may lead to tumor dev. - Continued exposure — malignant tumor capable of growth and invasion
- Changes in regulation of growth factors - cells capable of detaching and spreading, metastasis
- Tumors with metastasize readily and reproduce quickly (aggressive)
Cancer host defences
Cancer suppressor genes inhibit neoplastic growth
Immune system ID foreign neoplastic material
Immunodeficiency shown to increase risk of cancer
Cancer treatment
Depends on type and location
- surgery, chemo, radiation, immunotherapy
Can be combination of these
Cancer treatment: surgery
Removal of tumor and surrounding tissue
- laparoscope (minimizes tissue damage, improves recovery time)
Removal of adequate surrounding tissue may result in what
Changes in function
Cancer surgery: radiofrequency ablation (RFA)
Alternative surgery for small single tumors in solid or fluid-filled organs, but not the lungs
- heat in form of radio waves
Cancer treatment: radiation
Causes mutation in DNA
— prevents mitosis or causes immediate death
— damages blood vessels which cuts off blood supply to tumor cells and starves them
Some types of cancer are radio resistant
Radiation: methods of administration
External sources,
Internal insertion
Instill radio scope in solution into body cavity
Radiation precautions
Minimize radiation exposure of support people, shielding material for body regions not affected
Radiation adverse effects
Bone marrow depression: decreased leukocytes - increase risk for infection
Decrease RBC: fatigue, tissue breakdown, decreased platelets, excessive bleeding
Epithelial cell damage: damage to blood vessels and skin, hair loss
Infertility - caused by abdominal radiation
Nonspecific fatigue and lethargy - leads to depression
Chemotherapy
Anti neoplastic drugs
Usually combination of two to four drugs
- given at periodic intervals
Chemotherapy classifications
Antimitotics
Antimetabolites
Alkyating agents
Antibiotics
How do chemo drugs work
Interfere with protein synthesis and or DNA replication
Chemo adverse effects
- Bone marrow depression: If cell number low may need transfusions or cessation of therapy until bone marrow recovers
- Vomiting: Occurs at any point, anti-emetic drugs may help
- Epithelial cell damage: hair loss, breakdown of skin, mouth sores, diarrhea, candidiasis infection in mouth (thrush)
- Damage to specific areas within antineoplastic drugs
Cancer treatments: hormones
Tamoxifen estrogen blocking agent used in breast cancer treatment
Cancer treatment: glucocorticoid
Decrease mitosis and increase erythrocyte counts
Cancer treatment: blocking agents
Act to block receptors for the growth promoters on cancer cells
Cancer treatment: biological response modifiers (BRM)
Augment the natural immune response
Cancer treatment: angiogenesis inhibitors
Inhibit stimulus for growth of blood vessels
Cancer treatment: analgesics
Prescribed to alleviate pain
May be used In high doses
Cancer treatment: gene therapy
Experimental cancer treatment design to replace mutated jeans with a healthy copy of the gene, and activate a mutated gene, introduce a new gene
Cancer treatment: nutrition
Patients with advanced cancer are often malnourished. Many contributing factors for this
Cancer treatment: complimentary therapies
Healthcare workers need to be aware of these different types of therapies to advise patients. Massage, meditation, counseling, exercise, therapeutic touch
Remission
No clinical signs of cancer
- client may experience several remissions
Cancer free states generally defined as _____ survival without reoccurance
5-year
Some cancers such as childhood leukemia s can be considered cured after a _____, cancer free period
10 year
Most common cancer in men
Prostate
Lung
Colorectal
Most common cancer in females
Breast
Lung
Colorectal
Examples of malignant tumors: skin cancer
Visible, easily diagnosed and treated
Excellent prognosis with exceptions of malignant melanoma
Malignant tumors: ovarian cancer
Poor prognosis because of hidden nature of cancer. High mortality rates
Malignant tumors: brain tumors
Both benign and malignant tumors Are life-threatening because of compression of brain tissue. Primary tumor usually fatal, no metastases
