Chapter 20: Neoplasms and Cancer – Flashcards
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what is apoptosis
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programmed cell death
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define tumor
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a cellular growth that is no longer responding to normal body controls - cells continue to reproduce when there is no need for them an enlarging space-occupying mass normal organization, growth inhibition, contact controls, and cell-cell communication are absent surface antigens are altered expanding mass compresses nearby blood vessels
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cancer of the epithelial tissue
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carcinoma
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cancer of connective tissue
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sarcoma
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name some hallmarks of benign tumors (6)
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consist of differentiated cells that reproduce at a higher than normal rate often encapsulated expands but does not spread freely moveable on palpation relatively slow expanding mass mitosis fairly normal
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name some hallmarks of malignant tumors (5)
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made up of undifferentiated, nonfunctional cells irregular shape tend to reproduce more rapidly than normal these cells have lost cellular connections with each other and reproduction is not inhibited in the presence of other similar cells tumor cells infiltrate or spread into surrounding tissue
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tumor cells often secrete enzymes, such as collagenase, which do what?
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break down protein or cells, adding to the destruction and facilitating the tumor's spread into adjacent tissue inflammation and loss of normal cells lead to a progressive reduction in organ function
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name some "naughty" things tumor masses do
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as tumor mass enlarges, the inner cells are frequently deprived of blood and nutrients and die some tumors develop new capillaries in the tumor, thus promoting tumor development some tumors may trap nutrients, depriving normal cells and preventing any tissue regeneration
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what does in situ mean
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refers to neoplastic cells in a preinvasive stage of cancer that may last for months or years
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how are tumors graded
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based on the degree of differentiation of the malignant cells - grade I tumor has well differentiated cells, whereas a grade IV tumor is undifferentiated
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what is anaplasia
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undifferentiated cells varying in size and shape
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is pain an early symptom of cancer
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no, it occurs when the tumor is well advanced
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name 4 local effects of tumors
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pain obstruction tissue necrosis and ulceration infection
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what is cachexia
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severe tissue wasting
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what are paraneoplastic syndromes
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when cancer cells release substances that affect neurologic function or blood clotting or have hormonal effects
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give an example of a paraneoplastic syndrome
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Cushing's syndrome
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what is Cushing's syndrome
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prolonged exposure to inappropriately high levels of the hormone cortisol
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name 6 systemic effects of malignant tumors
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weight loss and cachexia anemia severe fatigue infections such as pneumonia bleeding paraneoplastic syndromes
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what are the three basic mechanisms for the spread of cancer
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invasion metastasis seeding
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what does invasion refer to
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local spread, in which the tumor cells grow into adjacent tissue and destroy normal cells
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what does metastasis mean
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spread to distant sites by blood or lymphatic channels
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what are common secondary sites for many tumors (2)
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lungs liver
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what is seeding
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refers to the spread of cancer cells in body fluids or along membranes, usually in body cavities
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the staging system is based on what three characteristics
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size of the primary tumor (T) extent of involvement of regional lymph nodes (N) spread (invasion or metastasis) of the tumor (M)
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what does carcinogenesis mean
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process by which normal cells are transformed into cancer cells
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name 8 risk factors for cancer
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genetic factors viruses radiation chemicals biologic factors (chronic irritation and inflammation with increased mitosis) diet hormones
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describe the 4 stages of carcinogenesis
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1) initiating factors cause the first irreversible changes in the cell DNA (first mutation) 2) exposure to promoters causes further changes in DNA, causing less differentiation and an increased rate of mitosis 3) continued exposure and changes in DNA result in a malignant tumor that is capable of growth and invasion of local tissue 4) changes in the regulation of growth result in cells that are capable of detaching from the tumor and spreading to distant sites (metastasis)
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can immunodeficiency increase the risk of cancer and why
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yes because there is a response to cancer cells by the immune system - tumor cells are seen as "foreign" and cellular and humoral immunity kicks in
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what is palliative care
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intended to reduce the manifestations and complications related to the cancer and to prolong life
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what is radiofrequency ablation
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needles and electrodes are attached to the tumor - heat is supplied in the form of radio waves to destroy the malignant cells and tissue immediately surrounding the tumor
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why/how does radiation work
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it causes mutations or alterations in the targeted DNA, thus preventing mitosis or causing immediate cell death also damages blood vessels, cutting off blood supply to the tumor cells and starving them
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name three methods of administering radiation
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1) external sources, such as a cobalt machine 2) internal insertion of radioactive materials at the tumor site 3) instill a radioisotope in a solution in a body cavity to control excessive inflammatory exudate or blood from the tumor
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what type of cells are affected the most by radiation
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those that rapidly reproduce (cancer and normal cells)
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name 4 adverse effects of radiation
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1) bone marrow depression 2) epithelial cell damage 3) damage to ovaries or testes (abdominal radiation) 4) fatigue, lethargy, depression
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decreased leukocytes has what effect
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greatly increases risk of infection
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decreased platelets has what effect
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excessive bleeding
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decreased erythrocytes has what effect
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fatigue and tissue breakdown
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what are antineoplastic drugs
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Acting to prevent, inhibit or halt the development of a neoplasm
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chemotherapy is most effective on what type of cells
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rapidly reproducing cells and on small tumor masses
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how does chemotherapy work
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patients are given a combo of 2 to 4 drugs, each from a different classification
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what are the different classifications of chemotherapy drugs (4)
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antimiotics antimetabolites alkylating agents antibiotics
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how do chemotherapy drugs work
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interfere w/ protein synthesis and DNA replication at different points in the tumor cell cycle, thus destroying the cells
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name four chemotherapy drugs
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adriamycin bleomycin vinblastine dacarbazine
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what is adriamycin, how does it work, when does it work
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antitumor antibiotic binds DNA and inhibits synthesis of nucleic acids works during the S phases
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what is bleomycin, how does it work
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antitumor antibiotic inhibits DNA synthesis
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what is vinblastine, when does it work
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antimitotic drug acts during mitosis
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what is dacarbazine and when does it act
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alkylating agent works at various phases of the cycle
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what are the adverse effects of chemotherapy drugs (3)
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bone marrow depression vomiting epithelial cell damage (hair loss)
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what is nadir
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point of lowest cell count
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what are biologic response modifiers
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agents that augment the natural immune response in the body to improve surveillance and removal of abnormal cells ex. interferon or bacillus Calmette-Guerin
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how does vaccine for tuberculosis (bacillus Calmette-Guerin) treat cancer
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stimulates the movement of macrophages and T lymphocytes to the site, where they may destroy the tumor cell
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what factors contribute to cancer patients being malnourished (7)
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change in taste sensations, anorexia and vomiting, sore mouth or loss of teeth, pain and fatigue, malabsorption due to inflammation in the digestive tract, altered metabolism, and nutrient trapping by the tumor
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what is total parenteral nutrition
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administration of a nutrient mixture directly into a peripheral vein
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define remission
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no clinical signs
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how is a "cure" for cancer defined
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5 year survival without recurrence after diagnosis and treatment
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what type of cancers have the highest rate of recurrence
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skin
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what is the most common form of skin cancer
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basal cell carcinoma
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what is the marker for ovarian cancer
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CA125
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what are early indications of brain tumors (6)
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seizures, signs of pressure such as headache, drowsiness, vomiting, visual problems, impaired motor function
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what are early indications of ovarian cancer (2)
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altered bowel or bladder function increased abdominal girth
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what are signs and symptoms of breast cancer (5)
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Lumps, Nipple Discharge, Skin Changes, Nodes, Bone Pain
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name 5 signs and symptoms of prostate cancer
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Urinary Hesitancy, Nocturia, Poor Stream, Dribbling, Terminal Hematuria
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name 6 signs and symptoms of lung cancer
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Cough, Hoarseness, Hemoptysis, Dyspnea, Pneumonias, Chest Wall Pain
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name 2 signs and symptoms of colon cancer
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Change in Bowel Habits, Bleeding
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name 3 signs and symptoms of ovarian cancer
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Abdominal pain, Discomfort, Mass, Vaginal Bleeding
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name 4 signs and symptoms of testicular cancer
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Painless enlargement, Epididymitis, Gynecomastia, Back Pain
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name a sign of melanoma
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Change in size, color, sensation or surface of preexisting nevus
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name 5 signs and symptoms of bladder cancer
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Hematuria, Bladder Irritability, Dysuria, Urinary Hesitancy or Urgency, Pelvic Pain
