Wk 1: Oncology nursing #1 Flashcards
Define cancer
- a group of diseases characterised by any bodily cell acquiring the ability to divide and multiply in an uncontrolled way forming tumors and masses.
What is significant about cancer cells?
They are derived from normal cells that have undergone a neoplastic transformation.
Can invade near by tissues
Briefly outline the cell cycle
Gap 1-> post mitotic/pre synthesis phase
- growth
Synthesis
- DNA replication
Gap 2-> Post synthesis/Pre mitotic phase
- errors in replication are erased
Mitosis
- prophase
- metaphase
- anaphase
- telophase
Resting phase
What are the two types of normal cell communication that must occur for correct cell function?
Indirectly: exchange of messenger compounds such as hormones or growth factors
Directly: cell to cell contact via cell adhesion molecules and to exchange messenger molecules though cell to cell portals called gap junctions- this allows them to feel what other cells are doing.
Outline the initial process of cancer developing.
Cancer cells are normal cells in which the genetic code has a mix-up/abnormlaitities
This initiates the transformation of the normal cell by interrupted cell to cell communication; in turn upsetting the normal regulatory controls for cell division.
Once transformation occurs and an autonomous cancer cells is born, it divides to produce daughter cells which also divide exponentially, and soon there is a population of cancer cells characterized by uncontrolled growth and spread.
Define doubling time and what does this mean for cencers?
Time taken for the tumour to double its volume
- the average time for most solid tumours being 2-3 months.
- Tumours are usually not clinically detectable until they have doubled around 30 times, equaling about 1 cm in size and around 1 gram in weight.
This may take years, depending on the type of cancer.
Death of the host usually occurs (due to excessive tumour burden) at around 40 doublings.
Define growth fraction
the ratio of the total number of cells to the number of dividing cells.
As a rule, the higher the growth fraction, the more rapidly tumour mass increases.
What is the gompertzian tumor growth curve?
= describes the decrease in cell doubling time as tumour progression occurs. This curve is also useful in describing tumour response to treatments.
Describe the metastatic cascade.
1) Growth and progression of the primary tumour.
2) Cells detach from the primary tumour and motile cancer cells invade and enter the bloodstream or lymphatic vessels.
3) If they successfully evade the immune system, blood and lymph transport them to distant sites where the cells then extravasate and lodge in areas such as bones, lungs or liver,
4)Angiogenesis occurs and a blood supply to the new tumour site is established; feeding the tumour and resulting in further aggressive growth.
What are some physical responses to getting a diagnosis
- Sleep disturbance
- Appetite changes
- Altered sexual interest
- Headaches
- Heart Palpitations
- Feeling ‘stressed’ and ‘on edge’
- Wanting to be around others/ social withdrawal
- Substance use / abuse
What are the 5 domains of supportive psychological care
Physical
social
Psychological
Spiritual
Informational
Describe cell differentiation and why this is significant for cancer
Differentiation: Normal cells acquire certain specialized characteristics of their tissue of origin.
Well differentiated= tumour cells reproduce these features well and look more like the normal cells of the tissues they began to grow in– ie.. Breast cells
Poorly differentiated – tumour cells reproduce these features poorly and are very different from the original cells they started growing in.– ie.. Difficult to tell the cell of origin
- agressive
- immature
- undeveloped
Define Proto-oncogenes?
= are the normal genetic genes that help cells grow and develop normally.
- Promote health growth of cells
- Control the cell cycle
- Promote normal cell survival
- Tell us what needs to be killed of and what needs to be grown
What is oncogenes
= genes that encourage changes to cells that are mutated form of proto-oncogenes
Explain the progression from oncogenes to proto oncogenes
Proto-oncogenes become oncogenes when inappropriately activated by mutations in themselves or other genes normally controlling their function