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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 f. PAPILLOMAVIRUS
- Linked to malignant melanoma,
CLASSIFICATION OF CANCER based on tissue cervical penile
where they arise: g. HUMAN T – LYMPHOTROPHIC VIRUS
1. CARCINOMAS – from epithelial cells, Skin, - Linked to T-cell leukemia
GIT, Breast, Uterus - Lymphoma
2. SARCOMAS – arise from bones, muscles, fats, - Kaposis sarcoma
lymphatic fluids
TYPES OF PROLIFERATION  ENVIRONMENTAL CARCINOGENS
A. BENIGN – does not spread; well *Chemical drugs, tobacco, alcohol, industrial fumes -
differentiated cells can directly alter the DNA that leads to mutation into
B. MALIGNANT – different/ atypical cell shapes, abnormal cells
harmful and spread to other tissues A. CHEMOTHERAPY DRUGS -(Busulfan,
C. HYPERPLASIA – increase number of cells chlorambucil, cychlophosphamide) –
(normal or abnormal) damage normal cell and reduce leukocytes
D. ANAPLASIA – change in the DNA structure in and impaire immune functions
a Wilm’s tumor B. METRONIDAZOLE
E. METAPLASIA – conversion of one cell type to C. BETEL NUT
another, reversible D. COCAINE & HEROIN
F. DYSPASIA – change in shape and size of
normal cells to bizarre one  HORMONES LINKED TO CANCER
a. GONADOTROPIC HORMONES – prostate
*PRECANCEROUS CELLS – changes that are not cancer
cancer but could become cancer over time b. ESTROGEN CONTAINING PILLS – breast and
ovarian cancer
CANCER ETIOLOGY: c. DIETHYL ESTILBESTROL – cervical cancer
 ONCOGENES – genes that promote cancer
development (normally are permanently  INDUSTRIAL CHEMICALS
controlled by the 8th day of conception by a. Polycyclic hydrocarbons
tumor suppressor cells; P53 b. Phenols and by products of petroleum
 MUTATION - change in the primary c. Gasoline and coal that are genotoxic
nucleotide sequence of DNA (arsenic, asbestos, benzopyrene)
 PHENOTYPE – an observed trait  PHYSICAL – radiation, ultra violet rays, tissue
 GENOTYPE – the genetic info defining trauma, chronic irritation
phenotype
 ALLELE – alternative forms of a gene to a  FOOD CARCINOGENS – sugar substitutes,
genetic marker nitrous indules – found in salted and pickled
 VIRUSES – cause damage to cells and induce food, aspergillus fungi – improperly stored
hyperplastic cell growth and it weakens the graine & peanuts, fat radicals – from boiling
immunologic defenses oils
 VIRUSES LINKED WITH CANCER:  FOOD PRESERVATIVES – additives, nitrates
a. HERPES SIMPLEX VIRUS TYPE 1&2 and MSG
- Carcinoma of lips  DIET & OBESITY – high fat and low intake of
- Cervical carcinoma fruits and vegetables: colon and breast cancer
- Kaposis sarcoma  BACTERIA – H. Pylori
b. HUMAN CYTOMEGALOVIRUS  IMMUNOSUPPRESSION – organ transplant
- Kaposis sarcoma and patient with HIV
- Prostate Cancer  ADVANCING AGE – low immune functions
c. EPSTEIN-BARR VIRUS  SEXUAL PRACTICES – multiple sexual
- B-cell lymphoma, Burkitt’s partners; increase mutation of cervix and risk
Lymphoma for HIV infection
d. HUMAN HERPES VIRUS
- Lymphoma GENETIC SUMMARY:
e. HEPATITIS B 1. Chromosomes contain thousand of genes
- Primary hepatocellular carcinoma
2. A GENOM is the complex set of a DNA – 23 4. COMPUTERIZED AXIAL TOMOGRAPHY
pairs (CAT SCAN) – uses x-ray and computer based
3. M Alleles – different; dominant; x-linked analysis of cross sectional scans made along a
single axis of a bodily structure
STAGING OF CANCER - use to detect growth/nodules/
Tx – not assessed tumors of head, neck, chest,
To – no evidence abdomen, pelvis, spine, extremities
Ts – carcinoma site (bones&joints)
T1, T2, T3, T4 – increase size/local extent of tumor 5. PLAIN CT SCAN – may use a contrast to
obtain outline of the mass
Nx – regional lymph nodes N/A Nursing Responsibilities:
No – no regional nodes metastasis  Check instructions for fasting
N1, N2, N3 – increase involvement of regional nodes  Consent signed
 Allergies to drugs
Mx – metastasis N/A  Ensure lab results of required exams all in
Mo – no distant metastasis  Bowel preparation for Abdominal CT Scan
M1 – Distant metastasis 6. MRI
7. ULTRASOUND – uses high frequency of
ASSESSMENT: Warning signs of Cancer sound waves and sends to a monitor to get
C- change in bowel/bladder habit images
A – a sore throat that does not heal 8. TUMOR MARKERS
U – unusual bleeding/discharge 9.
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

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

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