ONCOLOGY NOTES 7.

MITOCHONDRIA – powerhouse of the cell,

contains enzymes that capture phosphate
INTRODUCTION: bonds like ATP for energy of the cell
8. CYTOSKELETON – (microtubules,
 CELL – smallest functional unit of the human microfilaments & cilia ) – controls shape
specie that retain characteristics for life. and movement of cells and it contains water.

CELL COMPONENTS: NORMAL CELL CYCLE – PHASE

1. PROTOPLASM – matrix of the cell made of; *4 HOURS
 water (70-80%) 1. G0 – dormant or resting phase
 proteins (10-20%) - no cellular activity
2. LIPIDS – (2-3) carbohydrates and 2. G1 – cell starts to prepare for DNA and
electrolytes protein synthesis; cell grows.
*Protoplasm outside the nucleus is the CYTOPLASM, *7 HOURS
the one inside is the NUCLEOPLASM or 3. S1 – DNA replication
KARYOPLASM 4. G2 – RNA synthesis cells prepare to divide
5. M PHASE – mitosis or production of 2
 TISSUE – formed by cells daughter cells; cell division
 ORGANS – formed by tissues
 CHROMATIN – complex structure of DNA’s in LIFE SPAN OF COMMON CELLS:
the cytoplasm  GRANULOCYTES – 10 hours and 3 days
 CHROMOSOME – coils of chromatin that are  STOMACH LINING CELL – 2 days
visible on cell division  SPERM CELLS – 2-3 days
 SKIN EPIDERMAL CELLS – 2-4 weeks
FUNCTIONS:  BONE CELLS – 25-30 years
1. RIBOSOMES - serves as protein synthesis  PLATELETS – 10 days
2. ENDOPLASTIC RETICULUM – flat vesicle
that connects various parts (communication CANCER – abnormal proliferation or uncontrolled
channels for the cell); synthesize lipids, cells growth that tends to spread by other organs
regulate intracellular calcium and (APOPTOSIS)
detoxification of some drugs
3. GOLGI COMPLEX –thin sacs that receives and INCIDENCE AND MORTALITY OF CANCER:
modify carbohydrates and proteins to form a. BREAST CANCER
glycol proteins b. PROSTATE CANCER
4. LYSOSOMES & PERISOMES – acts as NORMAL CELL:
digestive system of the cell through their - Large cytoplasm
hydrolytic enzymes – breakdown of bacteria - Single nucleus
and recycle worn out cells (endosomal – - Single nucleolus
lysosomal degradation) - Fine chromatin
5. PROTEASOMES – acts to degrade misformed ABNORMAL CELL
proteins (proteolysis) - Small cytoplasm
*CASPASE PATHWAY – cytoplasmic degradation - Multiple nuclei
(involved in the main process of programmed cell - Multiple and large nucleoli
death) - Coarse chromatin
6. NUCLEUS – middle part containing hereditary CHARACTERISTICS:
materials and the control center of the cell. a. Cells lose their programmed cell death
site of RNA synthesis in 3 forms: (apoptosis) abnormal cell cycle
a) MESSENGER RNA (MRNA)– copies and b. Non-specific morphology - different size
carries DNA instruction for protein synthesis and shape
to the cytoplasm c. Metastasis – secondary growth and spread to
b) RIBOSOMAL RNA (RRNA) – moves the other body parts
cytoplasm  Extension to surrounding tissues (local
6. TRANSFER RNA (TRNA) – moves amino bleeding)
acids to the site of pro and protein synthesis  Blood vessel penetration
 Release of tumor cell
  Tumor cells are loosely hold together
CLASSIFICATION OF CANCER based on tissue
where they arise:
1. CARCINOMAS – from epithelial cells, Skin,
GIT, Breast, Uterus
2. SARCOMAS – arise from bones, muscles, fats,
lymphatic fluids
TYPES OF PROLIFERATION
A. BENIGN – does not spread; well
differentiated cells
B. MALIGNANT – different/ atypical cell shapes,
harmful and spread to other tissues
C. HYPERPLASIA – increase number of cells
(normal or abnormal)
D. ANAPLASIA – change in the DNA structure in
a Wilm’s tumor
E. METAPLASIA – conversion of one cell type to
another, reversible
F. DYSPASIA – change in shape and size of
normal cells to bizarre one
*PRECANCEROUS CELLS – changes that are not
cancer but could become cancer over time
CANCER ETIOLOGY:
 ONCOGENES – genes that promote cancer
development (normally are permanently
controlled by the 8th day of conception by
tumor suppressor cells; P53
 MUTATION - change in the primary
nucleotide sequence of DNA
 PHENOTYPE – an observed trait
 GENOTYPE – the genetic info defining
phenotype
 ALLELE – alternative forms of a gene to a
genetic marker
 VIRUSES – cause damage to cells and induce
hyperplastic cell growth and it weakens the
immunologic defenses
 VIRUSES LINKED WITH CANCER:
a. HERPES SIMPLEX VIRUS TYPE 1&2
- Carcinoma of lips
- Cervical carcinoma
- Kaposis sarcoma
b. HUMAN CYTOMEGALOVIRUS
- Kaposis sarcoma
- Prostate Cancer
c. EPSTEIN-BARR VIRUS
- B-cell lymphoma, Burkitt’s
Lymphoma
d. HUMAN HERPES VIRUS
- Lymphoma
e. HEPATITIS B
- Primary hepatocellular carcinoma
f. PAPILLOMAVIRUS
- Linked to malignant melanoma,
cervical penile
g. HUMAN T – LYMPHOTROPHIC VIRUS
- Linked to T-cell leukemia
- Lymphoma
- Kaposis sarcoma
 ENVIRONMENTAL CARCINOGENS
*Chemical drugs, tobacco, alcohol, industrial fumes -
can directly alter the DNA that leads to mutation into
abnormal cells
A. CHEMOTHERAPY DRUGS -(Busulfan,
chlorambucil, cychlophosphamide) –
damage normal cell and reduce leukocytes
and impaire immune functions
B. METRONIDAZOLE
C. BETEL NUT
D. COCAINE & HEROIN
 HORMONES LINKED TO CANCER
a. GONADOTROPIC HORMONES – prostate
cancer
b. ESTROGEN CONTAINING PILLS – breast and
ovarian cancer
c. DIETHYL ESTILBESTROL – cervical cancer
 INDUSTRIAL CHEMICALS
a. Polycyclic hydrocarbons
b. Phenols and by products of petroleum
c. Gasoline and coal that are genotoxic
(arsenic, asbestos, benzopyrene)
 PHYSICAL – radiation, ultra violet rays, tissue
trauma, chronic irritation
 FOOD CARCINOGENS – sugar substitutes,
nitrous indules – found in salted and pickled
food, aspergillus fungi – improperly stored
graine & peanuts, fat radicals – from boiling
oils
 FOOD PRESERVATIVES – additives, nitrates
and MSG
 DIET & OBESITY – high fat and low intake of
fruits and vegetables: colon and breast cancer
 BACTERIA – H. Pylori
 IMMUNOSUPPRESSION – organ transplant
and patient with HIV
 ADVANCING AGE – low immune functions
 SEXUAL PRACTICES – multiple sexual
partners; increase mutation of cervix and risk
for HIV infection
GENETIC SUMMARY:
1. Chromosomes contain thousand of genes
 2. A GENOM is the complex set of a DNA – 23
pairs
3. M Alleles – different; dominant; x-linked
STAGING OF CANCER
Tx – not assessed
To – no evidence
Ts – carcinoma site
T1, T2, T3, T4 – increase size/local extent of tumor
Nx – regional lymph nodes N/A
No – no regional nodes metastasis
N1, N2, N3 – increase involvement of regional nodes
Mx – metastasis N/A
Mo – no distant metastasis
M1 – Distant metastasis
ASSESSMENT: Warning signs of Cancer
C- change in bowel/bladder habit
A – a sore throat that does not heal
U – unusual bleeding/discharge
T – thickening in a lump/mole
I – indigestion/ difficulty swallowing
O – obvious change in a wart/mole
N – nagging cough or hoarseness
U – unexplained anemia
S – sudden weight loss
P – persistent headache
4. COMPUTERIZED AXIAL TOMOGRAPHY
(CAT SCAN) – uses x-ray and computer based
analysis of cross sectional scans made along a
single axis of a bodily structure
- use to detect growth/nodules/
tumors of head, neck, chest,
abdomen, pelvis, spine, extremities
(bones&joints)
5. PLAIN CT SCAN – may use a contrast to
obtain outline of the mass
Nursing Responsibilities:
 Check instructions for fasting
 Consent signed
 Allergies to drugs
 Ensure lab results of required exams all in
 Bowel preparation for Abdominal CT Scan
6. MRI
7. ULTRASOUND – uses high frequency of
sound waves and sends to a monitor to get
images
8. TUMOR MARKERS
9.

EARLY DETECTION MEASURES:

A. BREAST SELF EXAM/ TESTICULAR SELF
EXAM
B. SKIN INSPECTION
C. PAP SMEAR – start >30 years
D. FOBT – Fecal Immunochemical (FIT)
E. COLONOSCOPY & SIGMOIDOSCPY – for
colorectal cancer

NSG. RESPONSIBILITY FOR ENDOSCOPY

1. Checked prescribed diet – soft to liquid diet
2. Check consent if signed before preparation
3. Administer cleansing or fleet enema
suppositories as ordered
4. WOF diarrhea & S/S of dehydration

DIAGNOSTIC PROCEDURES
1. BIOPSY, FNAB, INCISIONAL/EXCISIONAL
2. EXFOLIATIVE CYTOLOGY – examination of
all recovered from the sediment of exudate,
secretions or washing from tissue (sputum,
vaginal secretion, gastric washing and
urine)
3. X-RAY – obtains outline of the mass