CANCER 3.

Innate characteristics and genetic stability of the

 is a disease of abnormal cell growth, cell division, target cell
and cell differentiation. The disease ‘cancer’  PROGRESSION
actually consist of a group of diseases, all of 1. Cellular oncogenes
which are underpinned by (an caused by) 2. Cellular proto-oncogenes
uncontrolled abnormal cell growth. Cancers are a. Epidermal growth factor receptor (EGFR)
always life-threatening but not always fatal. b. C-My
There are many causes of cancers, just as there  Chromosome 8

are many types of cancers.  Promising target for cancer drugs

 is not a single disease with a single cause; rather c. Cell-Signaling Protein: Kirsten Ras
(KRAS/KRAS2)
it is a group of distinct diseases with different
causes, manifestations, treatments, and PATHOPHYSIOLOGY OF CANCER
prognoses.  Proliferative patterns
 the word cancer comes from the greek word  Characteristics of malignant cancer
carninoma which means crab. a. Tumor-Specific antigens
 tumor comes -> neoplasia -> new growth 1. Carcinoembryonic antigen (CEA)
 benign tumor is not that dangerous (slow 2. Prostate-specific antigen (PSA)
growth)  Invasion and metastasis
a. Lymphatic and hematogenous spread
CARCINOGENESIS
is a multistep mechanism and is caused by an accumulation ANGIOGENESIS
of cellular and chemical errors, particularly concerning
 Angio -> blood vessels
the deoxyribonucleic acid (DNA) of a
cell.  How cancer cells make their own blood vessels
GENERAL FEATURE OF CANCER CELLS TUMORS (NEOPLASM)
 Perform cellular proliferation  Benign
 Contact inhibition loss  Malignant
1. Synthesize protein and glucose a. Vascular system
2. Abnormally large nuclei b. Lymphatic system
3. Strong attraction to growth factors. c. Implantation
 INITIATION d. Seeding
1. Carcinogens
a. Chemical DESTRUCTIVE ENZYMES OF MALIGNANT CELLS
b. Physical  Proteinases
c. Biologic agents
 PROMOTION  Collagenases

1. Alteration of environment in favor of mutated cell  Plasminogen activators -> promote fibrolysis ->

2. Dose of promoter prevents blood clot

 Lysosomal hydrolases
HOW DO MALIGNANT CELLS SURVIVE?  Andrenocarcinoma
 Cancer metastasis  Sarcoma
 Dysplasia -> abnormal tissue  Embryonal
 Primary site -> where cancer begins  Lymphomas
 Leukemias
Common Sites for Metastasis  Myeloma
 Brain
 Liver BENIGN AND MALIGNANT TUMORS
 Lungs Facts about metastatic tumor
 Even with early intervention
 Spinal cord Classification of malignant tumors based on cellular
 Bones origin
ONCOGENETICS - MECHANISM OF CANCER GENES
 Proto-oncogenes, oncogenes, tumour
 G1 checkpoint -> ensures there is no problem c
suppressor genes
cell’s DNA
ENVIRONMENTAL FACTORS
 G2 checkpoint -> ensures there is no problem c
1. Radiation
before it enters M
 Ultraviolet radiation - ultraviolet (UV) sunlight
 Too much cells and cyklin -> cell that enters cell
(or solar radiation) causes basal cell carcinoma
cycle uncontrolled
and squamous cell carcinoma
 DNA mutations -> uncontrolled cell growth
 Ionising Radiation - the list of carcinomas
NORMAL CELLS
caused by ionising radiation is extremely long
Characteristics:
and includes: breast cancer, lung cancer,
1. Reproduce themselves exactly
stomach cancer, etc.
2. Stop reproducing at the right time
2. Alcohol
3. Stick together in the right place
3. Chemicals
4. Self-destruct if they are damaged
4. Some foods
5. Became specialized or mature
5. Air pollution
6. Viruses
HOW DO CANCER CELLS BEHAVE DIFFERENTLY
7. Smoking
FROM HEALTHY ONES?
MICROBIAL AGENTS
 The more frequently a cell divides, the more
 Bacteria
chemotherapy destroys
 Protozoans
 These cells -> hair cells frequently divide = hair
 Fungi
loss
 Viruses
PHYSICAL AGENTS
CANCER: CAUSES, CHARACTERISTICS, LEVELS OF
 Chronic irritation or inflammation
PREVENTION
 Radiation
 Carcinoma
 over exposure to sunlight  Bone marrow and
 Tobacco or cigarette use/environmental tobacco  Pancreas
smoke (ETS)
CHEMICAL AGENTS HORMONAL AGENTS
 Dye  Prolonged estrogen replacement therapy [ERT]
 Asbestos - in homes  Deithylstibestrol [DES]
 Pesticides & formaldehyde  Oral Contraceptives
 Arsenic soot & tars
 Cadmium ROLE OF THE IMMUNE SYSTEM
 Smoke  Normal immune responses
 Electronic nicotine delivery system (ENDS) 1. T-lymphocytes
GENETIC PREDISPOSITIONS 2. B-lymphocytes
 Hereditary cancer syndrome  Immune System evasion
a. Two or more first-degree or second degree 1. Tumor-associated antigens (tumor cell antigen)
relatives 2. Tumor antigen-antibody complexes
b. Early onset of cancer in family members younger  Genetic disorder
than 50 years 1. Hypogammaglobulin
c. Same type of cancer in several family members 2.
d. Individual family members with more than 1 type * if body’s in fight or flight, theres a lot of stress
of cancer Cestisol ephinephrine -> can affect immune cells
e. Hereditary syndromes:
1. BRCA1 and BRCA2 THE IMMUNE SYSTEM
2. MEN1 and MEN2  Innate Immune System
- first line of defense
DIETARY FACTORS [LONG TERM] - nonspecific
 Factors and oils from animal sources  Adaptive Immune System
 Alcoholic beverages - androgen independent
 Salt-cured - memory cells -> long term immunity
 Smoked meats - it’s more on specialize kay mudevelop siya og
 Nitrate- and nitrite- containing foods (ex. Canned antibodies
goods) The immune System Response to Cancer
1st Stage: Presentation - innate immune system
IDIOPATHIC identifies tumor cells
 Breast 2nd Stage: Infiltration -
 Colon 3rd Stage: Elimination -
 Rectal
 Lymphatic LEVELS OF PREVENTION
Primary:  Avoid excessive weight gain throughout the life
1. Health promotion cycle
2. Health education  Achieve and maintain a healthy weight if
3. Genetic screening currently overweight or obese
4. Marriage counselling  Adapt a physically active lifestyle
5. Avoidance of allergens a. Adults engage in at least 30 mins. of moderate to
Secondary: vigorous physical activity, above usual activities, 5 or
1. Early diagnoses more days of the week; 45-60 mins. of intentional
2. Case finding measures physical activity are preferable.
3. Individual and mass screening survey b. Children and adolescents : engage in at least 60
Tertiary: mins. of intentional physical activity at least of 5 days
1. Intent to halt the disease per week.
 Consume a healthy diet, with an emphasis on
HEALTH PROMOTION plant sources
Ten Steps of Cancer Prevention a. Choose foods and beverages in amounts that help
1. Increase intake of fresh vegetable achieve and maintain a healthy weight.
2. Increase fiber intake b. Eat 5 or more servings of a variety of vegetables
3. Increase intake of vitamin a and fruits each day.
4. Increase intake of foods rich in vitamin c c. Choose whole grains in preference to processed
5. Keep weight in normal range {refined} grains
6. Reduce amount of intake of dietary fat
7. Reduce intake of salt-cured, smoke, and nitrate- THE NINE WARNING SIGNS OF CANCER
containing foods.  Change in bowel or bladder habits
8. No cigarette smoking  Any sore that does not heal
9. Reduce alcohol intake  Unusual bleeding or discharge
10. Avoid over exposure to sunlight  Unexplained anemia
 Thickening or lump in breast or elsewhere
CRUCIFEROUS VEGETABLES  Indigestion
 Are non-starchy vegetables that contain dietary  Obvious changes in wart or mole
fiber, folate, carotenoids, glucosinolate, and  Nagging cough or hoarseness
vitamin C.  Sudden weight loss
 Ex. Broccoli, cabbage, cauliflower, arugula,
turnip, kale, bok choy, brussels sprouts Secondary Prevention
 Pap smear
HEALTH PROMOTION  Gualac Test or fecal occult
 Maintain a healthy weight throughout the life  Mammography
 Balance caloric intake with physical activity  Breast-self examination (BSE)
  High blood pressure
SEVEN (7) P’s METHODS OF BREAST EXAMINATION  Type 2 diabetes
 Position
 Perimeter LABORATORY, DIAGNOSTIC TEST
 Palpation DIAGNOSIS OF CANCER
 Pressure  Advocating an expressions of feelings.
 Pattern  Promoting a broad time frame and providing
 Practice privacy and adequate time with family present.
 Plan  Determine the presence and extent of tumor
 Identify possible spread of disease or invasion of
PROSTATE CANCER body tissue
 PSA and digital rectal examination ANUALLY
beginning at age 50 for men who have at least a DIAGNOSTIC EVALUATION INCLUDES:
10 year life expectancy and for younger men….  Review of System
 Physical examination
TISSUES  Imaging studies
Leuprolide (Lupron)  Laboratory test
 Long-term use of leuprolide is associated with 1. Blood
loss of bone mineral density 2. Urine
 Patients co-administered with norethisterone 3. Other body fluids
may experience sudden vision loss, proptosis,  Procedures
diplopia, migraine, thrombophlebitis, and  Pathology analysis
pulmonary embolism and may also be at higher
risk of cardiovascular disease. Patients with a DIAGNOSTIC TEST USED TO DETECT CANCER
history of depression.  Tumor marker identification
- analysis of substance
Feminizing hormone therapy, complications can  Genetic tumor markers
include:  Mammography
 Blood clots in a deep vein or in the lungs  Magnetic Resonance Imaging (MRI)
 Heart problems  Computed Tumography
 High levels of triglycerides, a type of fat, in the - use of narrow beam x-ray
blood  Fluoroscopy
 High levels of potassium in the blood  Ultrasonography
 High levels of the hormone prolactin in the blood  Endoscopy
 Nipple discharge  Nuclear Medicine Imaging
 Weight gain - uses IV injection of ingestion
 Infertility  Position Emission Tomography (PET)
 PET Fusion Stage II: Limited local spread
 Radioimmunoconjugates Stage III: Extensive and regional spread
 Vascular imaging Stage IV: Distant metastasis

STAGING OF CANCER TYPES OF SURGERY

 Degree of spread  Diagnostic surgery
GRADE  Staging surgery
 Pathological dx  Curative surgery
 Differentiation  Palliative surgery
 Reconstructive surgery
REASONS FOR STAGING CANCER:  Preventive surgery
1. Gives healthcare providers a common language
2. Guides treatment SIDE EFFECTS OF SURGERY
3. Estimates prognosis  Loss of function of a specific body parts
4. Allows comparison of results overtime  Reduced function as s result of organ loss
5. Standardizes clinical trials  Scarring or disfigurement
 Grieving
DIAGNOSIS OF CANCER
Stage 1: no spread of the cancer FACTORST TO CONSIDER FOR PROPHYLACTIC
Stage 2: the cancer has spread to neighboring tissues SURGERY:
Stage 3: the cancer has spread to nearby lymph  Family history and genetic predisposition
Stage 4: the cancer has spread to tissues and organs  Presence or absence of symptoms
 Potential risks and benefits
TNM  Ability to detect cancer at an early stage
Tumor = tumor size
Node = degree of involvement of lymph nodes SELECTED TECHNIQUES UDES TO REMOVE OR
Metastasis = absence or presence of metastasis DESTROY TUMORS:
 Types of Procedure
GRADING AND STAGING THE TUMORS 1. Electrosurgery
Grading 2. Cryosurgery/Cryoablation
Grade I: Cells differ slightly from normal cells 3. Chemosurgery
Grade II: Cells are more abnormal 4. Laser surgery
Grade III: Cells are very abnormal 5. Photodynamic therapy
Grade IV: Cells are immature and undifferentiated 6. Radiofrequency ablation (RFA)
Staging
Stage 0: Carcinoma in situ TYPES OF BIOPSY
Stage I: Tumor limited to the tissue of origin
 Needle biopsy - cells are aspirated through  People recently vaccinated with live
placed in the tissue microorganisms or viruses.
 Incisional biopsy - removing or taking a small  Pet excreta including fish tanks and aquariums.
sample out of tissue mass 2. Instruct client to avoid contact with people who
 Excisional biopsy - involves in removal of known have a contagious illness
tumor 3. Teach people who come in contact with client to
wash hands prior to touching the clients.
GOALS OF CANCER AND THERAPY
 Cure
 Control
 Palliative
 Prophylaxis

ANTINEOPLASTIC THERAPY
What is chemotherapy?
 Overall goal:
- destroy the cancer cells within

RADIATION THERAPY
 Uses ionizing radiation to kill or limit cancer cells
TYPES OF IONIZING RADIATION
 Electromagnetic

NURSING IMPLICATIONS
1. Initiate bleeding precautions and observe for
bleeding tendency
2. Report any unexplained temperature elevation.
3. NO ACTIVE VACCINATIONS while client is
receiving medication.
4. Report any unusual fatigue
5. Decrease invasive procedures
6. provide diet diet high in IRON.

HEMATOLOGIC SYSTEM:
1. Void exposure to there substances:
 Fresh fruits, vegetables, flowers, and live plants.