Cellular Aberration

Anatomy of the Generalized Cell

• Cells are not all the same

• All cells share general structures
• Cells are organized into three main
regions
• Nucleus
• Cytoplasm
• Plasma membrane

Figure 3.1a
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 3.2
 Overview
Normal cells and functions
a. Most normal human cells have 23 pairs of
chromosomes
b. All normal cells (except the sex cells and the mature
red blood cells) have the entire human genome in
every cell
c. Normal cells have about 35,000 genes, and about 50
of these genes are very active during embryonic life
d. Normal cells undergo mitosis either to develop normal
tissue during embryonic development, childhood, and
adolescence or to replace lost or damaged normal
tissue
The Cell Cycle
 The Cell Cycle
The Cell Cycle – consists of 4 phases:
1. Gap 1 (G1) – the cell enlarges and synthesizes
proteins to prepare for DNA replication
2. Synthesis (S) phase – DNA is replicated and the
chromosomes in the cell are duplicated
3. Gap 2 (G) – the cell prepares itself for mitosis
4. Mitosis (M) phase – final step, where the parent
cell divides into two exact copies called daughter
cells, each having identical genetic material
 The Cell Cycle
• The cells after the M phase immediately
enter the G1 where they begin another
cell cycle again
• Or the cells divert into a resting phase
called G0
• The cell cycle is controlled by cyclin-
dependent kinases
• Some cyclins cause a “braking” action
and prevent the cycle from proceeding
• Checkpoints in the cell cycle ensure that it
proceeds in the correct order
 The Cell Cycle
• A malfunction of any of these
regulators of cell growth and division
can result in the rapid proliferation of
immature cells
• In some cases these proliferating immature
cells are considered cancerous (malignant)
• Knowledge of the cell cycle events is used in the
development of chemotherapeutic drugs, which
are designed to disrupt the cancer cells during
different stages of their cell cycle
• In embryonic life, there are early development Overview
genes called proto-oncogenes, and their
activity is not needed after embryonic life
• Other genes are called tumor suppressor
genes, which slow down cell division, repair
DNA mistakes, and tell cells when to die
(apoptosis, or programmed cell death)
• Tumor suppressor genes can also reduce
expression of proto-oncogenes by negative
feedback mechanisms
• Proto-oncogenes are not abnormal genes,
and are part of every human’s normal cellular
DNA
 TERMS:
a.Hypertrophy – increase in the size of
cells, resulting in an increase in the size of
the organ
b.Hyperplasia – an increase in the number
of cells in an organ or tissue, usually
resulting in increased mass of the organ or
tissue
c.Atrophy – reduced size of an organ or
tissue resulting from a decrease in cell
size and number
e. Metaplasia – reversible change in which one
differentiated cell type (epithelial or
mesenchymal) is replaced by another cell type
f. Necrosis – cell death
g. Apoptosis – programmed cell death
h. Differentiation - process by which cells or
tissues undergo a change toward a more
specialized form or function, especially during
embryonic development
i. Dysplasia
j. Anaplasia
e. Dysplasia - abnormal development or
growth of tissues, organs, or cells
f. Anaplasia - the loss of the mature or
specialized features of a cell or tissue, as
in malignant tumors.
 RISK FACTORS
Endogenous risk factors:
1. Genetic predisposition
2. Sex
3. Age
4. Race
5. Family history
 Exogenous risk factors:
1. Alcohol
2. Diet
3. Exercise
4. Occupational exposure
5. Cigarette smoking
6. Sexual activity
 Epidemiology of Cancer
Risk Factors and Signs and Symptoms of Common Cancers
Cancer Site Risk Factors Signs and Symptoms
Breast Female gender Lump or mass
Age >50 years Thickening in breast or axilla
Family history Change in size or contour or
Personal history of breast cancer texture
2 or more first-degree relatives Skin dimpling or retraction
Known BRCA1 or BRCA2 mutation Peau d’orange skin
Biopsy history Nipple discharge, retraction,
Atypical hyperplasia or scaliness
DCIS or LCIS Erythema
Postmenopausal obesity Pain or tenderness
Early menarche/late menopause
Late first pregnancy/nulliparous
OCP
Radiation to chest wall
Alcohol
Obesity and high fat diet
Hormone replacement therapy
 Epidemiology of Cancer
Risk Factors and Signs and Symptoms of Common Cancers
Cancer Site Risk Factors Signs and Symptoms
Prostate Male gender Weak urinary stream and urinary
Age >50 years frequency
African American ethnicity Difficulty in initiating stream or
Family history of first-degree relative stopping urinary stream
(greater if first-degree relative diagnosed Pain or burning on urination
before age 40) Urinary retention
High-fat diet Hematuria

Colorectal Age >60 years

Inflammatory bowel conditions
Sedentary lifestyle
Diet high in fat and low in fruits and
vegetables
Heavy alcohol consumption
Family history of colorectal cancer
especially if before the age of 40
 Epidemiology of Cancer
Risk Factors and Signs and Symptoms of Common Cancers
Cancer Site Risk Factors Signs and Symptoms
Prostate Male gender Weak urinary stream and urinary
Age >50 years frequency
African American ethnicity Difficulty in initiating stream or
Family history of first-degree relative stopping urinary stream
(greater if first-degree relative diagnosed Pain or burning on urination
before age 40) Urinary retention
High-fat diet Hematuria

Colorectal Familial genetic syndromes, e.g., familial Change in bowel habits

adenomatous polyposis (FAP) and Rectal bleeding
hereditary nonpolyposis colon cancer Abdominal pain
(HNPCC) Decreased diameter of stools
Anemia
Rectal pressure or pain
Weight loss
anorexia
 Epidemiology of Cancer
Risk Factors and Signs and Symptoms of Common Cancers
Cancer Site Risk Factors Signs and Symptoms
Lung Cigarette smoking Chronic cough and wheezing
Occupational exposure to asbestos, Persistent respiratory infections
arsenic, chromium, coal products, nickel Dull chest pain
refining, smelter workers, ionizing Hemoptysis
radiation, radon Dyspnea
Weight loss
Hematogenous Spread: Lung
Cancer
 prognostic value for patients with colon cancer.
pancreatic cancers, gastric cancers, colonic cancers, and bronchogenic
cancers.
gastrointestinal adenocarcinoma.
screening of prostate cancer in men older than age 50

antigen present on most of ovarian carcinomas.

Gestational trophoblastic disease

Tumor Staging and Grading
 Types of Biopsy

1.Excisional
2.Incisional
3.Needle
 Types of Surgeries:

1.Surgery as Primary
Treatment
2.Prophylactic Surgery
3.Palliative Surgery
4.Reconstructive Surgery
 Other Therapies:
1. Radiation Therapy
2. Chemotherapy
3. Hematopoietic Stem Cell Transplantation
4. Targeted Therapies (Biologic Modifiers)
5. Gene Therapy
6. Complementary and Alternative
Medicines
 NURSING MANAGEMENT
• Maintaining Tissue Integrity
• Promoting Nutrition
• Relieving Pain
• Decreasing Fatigue
• Improving Body Image and Self-Esteem
• Assisting in Grieving Process
• Monitoring and Managing Potential
Complications
• Promoting Home and Community Based
Care
 The Role of the Nurse
• Education
• Monitoring
• Documentation
• Proper referral
• Being up to date