Unit Iv - Cancer

Front 1

Risk factors to cancer

Back 1

-tobacco
-alcohol
-drugs; immunosuppressant, chemotherapy
-genetic predisposition
-immune deficiency
-epstein-barr lymphoma
-herpes simplex, megalovirus, HPV
-radiation exposure
-age
-occupational-asbestos
-sunlight
-diet-high fat and calories
-urban dwellers
-stress hormonal

Front 2

Primary prevention

Back 2

--prevention of cancer before it occurs
-avoiding carcinogens, life-style changes, sunscreen
--screening, ID at risk groups, Pap

Front 3

secondary prevention

Back 3

-early detection and interventions
-removing pollups during colonoscopy

Front 4

Seven Warning signals
*CAUTION*

Back 4

C-change iin bowel or bladder habits
A-a sore that does not heal
U-unusual bleeding or discharge
T-thickening or lump in breast or elsewhere
I-indigestion or difficulty swallowing
O-obvious change in wart or mole
N-nagging cough or hoarseness

Front 5

Nursing goals for cancer

Back 5

-prevention
-rehab
-management and education
-detection
-assist w/ treatment

Front 6

Onco =

Ology =

Back 6

onco=cancer
ology=study of

Front 7

neoplasm

Back 7

-neoplasm is now formation, new a abnormal growth of tissue

Front 8

neoplasia

Back 8

neoplasia-uncontrolled cell growth that follows no physiologic demand

Front 9

Anaplasia

Back 9

-poor or no differentiation, >malignancy, poorer prognosis

Front 10

doubling time

Back 10

-amount of time required to deouble the cells/mass

Front 11

growth fraction

Back 11

-fraction or % of cells actively proliferating

Front 12

Tumor burden

Back 12

number of tumor cells in host

Front 13

primary tumor

secondary site

Back 13

the first site of cancer

the site to where the tumor has spread

Front 14

Palliative treatment

Back 14

-goal is to relieve symptoms, not cure

Front 15

adjuvant therapy

Back 15

-treatment which is supplemental to primary treatment

Front 16

Two components to normal cells

Back 16

-nucleus
-cytoplasm

Front 17

Cell cycle

Back 17

cell proliferation
cell cycle
controlled

Front 18

cell proliferation

Back 18

-originates in stem cell and begins when it enters cell cycle

Front 19

cell cycle

Back 19

period between cell divisions plus time cell division occurs

Front 20

Controlled

Back 20

dying cells replace without surplus cells begin produced

Front 21

Normal cell characteristics

Back 21

-differientation
-contact inhibition

Front 22

differientation

Back 22

-cells differ from each other, start the same but specialize

Front 23

contact inhibition

Back 23

-cells adhere to each other, like cells attract and don't crowd each other, orderly

Front 24

Characteristics of cancer cells

Back 24

-larger
-bigger nucleus
-don't resemble normal cells/vary in size and shape
-can't produce more than 2 daughter cells
-specialized for growth and survival even under adverse conditions
-no rules of growth, uncontrolled, rapid, don't recognize crowding
-no purpose, no function, occupy space, acquire nutrition from host but contribute nothing
-release tumor angiogenic factor (TAF) just hours after cancer site is established stimulates formation of new capillaries
-center of mass-necrotic, demands of tumor for blood, oxygen, nutrients are greater that supply
-cell membrane altered affecting fluid movement in and out of cell
-membranes contain less fibronectin, a cellular cement
-more RNA
-chromosomal abnormalitites and fragility of chormosomes
-DNA is substituted or permanently rearranged during mutation of stem cell

Front 25

Stage 1-initiation

Back 25

-initiation-irreversible damage to DNA by carcinogen exposure (chemical, physical, biological)
-drugs, environmental, radiation, inherited chromosomal abnormalities
-cells mutate
-normally, these alterations are reversed by protective mechanisms and mutated cell is destroyed

Front 26

Stage 2-promotion

Back 26

-promotion-repeated exposure to promoting agents cause reversible proliferation of the altered, initiated cell
-cells become progressively less differentiated
-may occur after months
-activity of promoters is reversible

Front 27

Stage 3-progression

Back 27

progression-evolution of metastatic growth potential
-establishes blood supply
-TAF produced
-subpopulations (metastasis)

Front 28

Metastasis

Back 28

-spread from original site to distant organs
-invasion
-lymph nodes/blood
-establishing of secondary site

Front 29

Factors influencing metastasis

Back 29

-cells break away, they travel via
-circulatory system
-lymphatic system
-seeding across body cavities

Front 30

Abnormal but benign

Back 30

-well differentiated
-cohesive
-expansive growth
-slow growth

Front 31

abnormal malignant

Back 31

-poorly differentiated-cells primitive
-not cohesive-can migrate through tissues
-infiltrates and expands
-not encapsulated
-rapid growth

Front 32

how does a Benign tumor effects its host

Back 32

-plug body passages
-ulceration or infection
-function as parent cell
-produce enzymes that weaken or destroy adjacent cells

Front 33

Effects of malignant tumor on host

Back 33

-same as benign but with added systemic effects
-compete for nutrition
-necrosis
-ulceration
-pain
-fatigue
-cachexia (wasting)
-toxemia
-acidosis
-hemorrhage
-obstruction

Front 34

Classification of tumors

Back 34

-staging-clinical aspects of tumor
-grading-cellular aspects of the tumor

Front 35

Why do we classify

Back 35

-to determine treatment
-to determine prognosis
-to evaluate results of management
-statistics

Front 36

Grading system

Back 36

-G1, well differentiated, low grade, closely resembles normal cells from which they arose
G2
G3
G4-poorly differentiated, high grade, retain no normal cell characteristics.

Front 37

Staging

Back 37

-location and degree of metastass
-obtained by clinical, surgical, pathological means
-TNM staging system
T-primary tumor size/depth
N-nodal involvement
M-metastasis

Front 38

Aden
Fibro
Osteo
Chondro
Lip

Back 38

aden-gland
fibro-fibrous tissues
osteo-bone
chondro-cartilage
lip-adipose tissue

Front 39

Types of malignant tumors

Back 39

carcinoma
sarcoma
nervous tissue
hematopoeitic tissue

Front 40

carcinoma

Back 40

-epithelial: skin, glands, mucous membranes, linings of respiratory, GI, GU tracts

Front 41

sarcoma

Back 41

-connective tissue; muscle, fat, bibrous

Front 42

Nervous tissue

Back 42

meninges and nerve cells

Front 43

hematopoeitic tissue

Back 43

lymph and blood

Front 44

Labs for cancer

Back 44

-increased calcium
-increased acid and alk. phosphatase
-increased SGPT, SGOT (liver)
-total protein and albumin
-increased CEA(bowel)/other tumor markers

Front 45

Imaging Tests

Back 45

-radiology
-scans-CT/MRI
-radioisotope scanning
-endoscopy
-biopsy
-bronchoscopy