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Cancer

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a disease process that begins when a cell is transformed by genetic mutation of the cellular DNA. Genetic mutations may result from inherited and or acquired mutations that lead to abnormal cell behavior. The initial genetically altered cell forms a clone and begins to proliferate abnormally invading normal growth regulating processes. The cells acquire a variety of capabilities that allow them to invade surrounding tissues and gain access to lymph nodes and blood vessels which then carry the cell to other areas of the body

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50% of new cancer cases in men and women

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prostate, beast, lung, and colon, rectal

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#1 leading cause of death in cancer

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lung

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Leading risk factor contributing to cancer

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increasing age

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What are the 7 warning signs of cancer?

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C- change in bowel or bladder A- a lesion that does not heal U- unusual bleeding or discharge T- thickening or lump in breast or somewhere else I- indigestion or difficulty swallowing O- obvious changes in wart or mole N- nagging caught or persistent hoarseness

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How do malignant cells differ from normal cells?

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Cancer cell division is continuous and rapid, They appear different because the lose the appearance of the parent cell, large nucleus, lost function and serve no purpose, loose adherence, migrate, invasive growth, less or most chromosomes (not 23), high mitotic index (how it takes to duplicate)

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Apoptosis

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programmed cellular death

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Angiogenesis

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growth of new blood vessels that allow the cancer cells to grow. Process by which the tumor can cause the body to provide it with the nutrients it wants. Signals to the body "feed me"

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Lung metastasizes to the ?

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brain, bone, liver, pancreas

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colorectal metastasizes to the ?

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liver

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breast metastasizes to the?

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bone, brain, lung, liver

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Prostate metastasizes to the?

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bone, lung

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ovarian metastasizes to the?

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abdomen

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mammogram should be screened at

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age 40 and over

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Colonoscopy should be done at

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age 50 and older

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PSA should be screen for at

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age 50 and older

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pap smears should be done

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every 3 years over 21 or sexually active

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grade

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Is the pathologic classification of tumor cells. It tells How aggressive the cancer/tumor is. metallic index- how aggressive. 1-4 scale. 1 looks most like parent cell. 4 looks unrecognizable

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Staging

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process of determining the extent of disease, including tumor size and spread or catastasis to distant site. Staining determines the size of the tumor, the existence of local invasion, lymph node involvement , and metastasis

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TNM

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Including in staging- extent of primary TUMOR , lymph NODE involvement, extent of METATASIS

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malignant

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cancerous cells that demonstrate uncontrolled growth that follows no physical demand (neoplasia)

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benign

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non cancerous

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anaplasia

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a pattern of growth in which cells lack normal characteristics and differ in shape and organization with respect to their cells of origin

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tumor-specific antigens (TSA's)

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proteins food in malignant cell membranes which develop over time as the cell becomes mature. These protein distinguish malignant cells and benign cells of the same tissue. Example- prostate specific antigen (PSA)

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nucleus in cancer cells

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large and irregular shaped

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carcinoma

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epithelial tissue of most organs or glands that are capable of secretions, example: breast, lung, esophagus, prostate , skin

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sarcoma

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bone, most common form bone cancer. Found in femur, humerus. Cartilage, rare. Adipose, arrises from deep set tissue smooth muscle, very rare Skeletal muscle, most common in young children Fibrous tissue, often involves long or flat bone membrane lining cavities , most related asbestos blood vessels, with liver involvement

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myeloma

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plasma cells

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lymphoma

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lymphocytes , may involve lymph nodes or body organs . Hodgkin and non hodgkins

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Leukemia

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hematopoietic cells in bone marrow

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metastasis

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the spread of malignant cells from the primary tumor to distant sites by direct spread of tumor cells to body cavities or through lymphatic and blood circulation. Lymph and blood are key mechanisms by which cancer cells spread.

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carcinogenesis

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malignant transformation

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carcinogens

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substances that cause cancer such as chemicals , physical factors , biological agents that cause mutations in cellular DNA .

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What factors are known to induce carcinogenesis?

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Bacteria, physical agents, chemicals, genetics, diet, hormones

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What are some viruses that cause cancer

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HPV(cervical), hepatitis (liver), epstein-barr(lymphoma)

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physical agents that can cause cancer

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exposure to sunlight, radiation, chronic irritation or inflammation, tobacco

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chemical agents that can cause cancer

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tabacco , work place chemicals

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genetics and cancer

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genetics, sharing environments, cultural, lifestyle factors can all influence cancer risk.

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dietary factors

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including fats alcohol, salt cured or smoked meats, nitrate containing foods and red and processed mets can al be linked

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hormonal factors

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tumor growth may be promoted y disturbances in hormonal balance. Females who menses before age of 12 are at high risk, women who go through menopause after 55 have increased risk, oral contraceptives can have a higher association with the development of cancer as well as delaying child birth past the age of 30

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immune system related to cancer

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people who are immunocompromised have an increase risk of cancer.

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detection and prevention of cancer

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primary, secondary, and tertiary prevention of cancer is important for addressing cancer and all individuals are encouraged to comply with detection efforts

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primary prevention

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is concerned with reducing the risks of the disease through health promotion and risk reduction strategies. By acquiring the knowledge and skills necessary to educate the community about cancer risks, nurses in all setting play a big role in cancer prevention

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Secondary prevention

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involves screening and early detection activities that seek to identify early stage cancer in individuals who lack signs and symptoms suggestive of cancer.

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tertiary prevention

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improved screenings, diagnosis, and treatment approaches. These efforts focus on monitoring for an preventing recurrence of the primary cancer as well as screening for developmental of second malignancies in cancer survivors

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Diagnosis of cancer

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a diagnosis is based on assessment of physiologic and functional changes and results from diagnostic evaluation. 1. determine the extent of cancer. 2. identify possible metastasis 3. evaluate function of involved body system and organs 4. obtain tissue and cells for analysis including evaluation of tumor stage and grade

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Surgery to treat cancer

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surgical removal of the entire cancer remains ideal and the primary treatment, also most frequently used treatment however it can depend on many different factors. Diagnostic surgeries and biopsies are performed to obtain tissue to sample for histologic analysis of cells suspected to be malignant

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Three most common biopsies

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excisional, incisional, and needle methods. The biopsy type is determined by size and location of the tumor

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prophylactic surgery

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removing nonmetal tissues or organs that are at an increased risk for developing cancer, maybe due to a family history or sign and symptoms may be present

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palliative surgery

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when surgical cure is no longer an option making ht patient as comfortable as possible maybe needed which means removing a malignant area or blockage

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reconstructive surgery

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may follow a curative or radical surgery in an attempt to improve function or to obtain a more desirable cosmetic effect

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radiation therapy

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may be used to cure cancer, control cancer. Maybe administered prophylactically to prevent the spread the primary cancer to a distant area

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Alopecia

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temporary or permanent thinning or complete loss of hair is a potential adverse effect of radiation therapy and various chemo therapy agents.

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malignant skin lesions

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skin lesion may occur with local extension or catastasis of the tumor into the epithelium and it surrounding lymph and blood vessels. Either locally invasive or metastatic cancer the skin may result in redness, discoloration, or progression to wounds involving edema, exudates, and tissue necrosis. Nurse must assess malignant skin lesions for size, appearance, condition of surrounding skin, odor, bleeding, drainage , and pain.

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nutritional problems

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most patient experience some weight loss during their illness. Anorexia, malabsorption, and cancer related anorexia-cachexia syndrome (CACS) are some nutritional issues related to cancer. Nutritional concerns included decreased protein and calorie intake

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anorexia

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Patient with cancer may experience alterations with taste which is caused by increased salty, sour, and metallic taste sensations and altered responses to sweet and bitter flavors. taste changes can contribute to a decrease in appetite and nutritional intake and subsequently protein-calorie malnutrition

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malabsorption

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some patient with cancer are unable to absorb nutrients from the gastrointestinal system s a result of tumor activity and or cancer treatments. malignancy can affect the GI system in many ways- impaired enzyme production, interference with protein and fat digestion. which can lead to GI irritation, peptic ulcer disease, and fistula formation

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cancer related anorexia-cachexia syndrome

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results from a combination of increased energy expenditure and decreased intake. It can occur in the curative or palliative stages of treatment. The patient will continue to have weight loss and malnutrition characterized by a loss of adipose tissue, visceral protein and skeletal muscle mass. They will complain of loss of appetite, fatigue

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three step approach to treat cancer pain

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analgesics are administered based on the patient reported level of pain

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acute fatigue

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occurs after an energy demanding experience

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cancer related fatigue

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a distressing persistent , subjective sense of physical, emotional, and or cognitive tiredness r exhaust related to cancer and or cancer treatment that is to proportional to recent activity and interferes with normal functioning

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infection

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for patients in all stages of cancer the nurse must assess for infection because prevention and prompt treatment is crucial with cancer patients. The nurse must monitor lab values to detect early changes in WBC counts. Neutrophils are the body's primary initial defense against infection. Neutropenia is a abnormally low count associated with increased risk for infection

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Nadir

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the lowest ANC (absolute neutrophil count) after myelosuppressive chemotherapy , targeted therapy, or radiation therapy that surpasses bone marrow function. 10th day of chemo counts are at its lowest

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What kills oncology patients?

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bleeding and infection

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