Cancer Biology Basics

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Questions and Answers

What is a characteristic of malignant cells?

They promote healthy tissue regeneration.

They grow uncontrollably. (correct)

They only affect one specific area.

They have normal controls of growth.

Which gene is primarily involved in promoting cancer?

Oncogenes (correct)

Tumor suppressor genes

Repair genes

Proto-oncogenes

What role do tumor suppressor genes play in healthy cells?

They facilitate tissue invasion.

They promote rapid cell division.

They enhance blood vessel formation.

They prevent survival of damaged cells. (correct)

Where is NOT a primary site of cancer metastasis?

Skin Signup and view all the answers

What must generally occur for a normal cell to transform into a cancer cell?

Changes in multiple genes Signup and view all the answers

What is the first step in the process of carcinogenesis?

Initiation Signup and view all the answers

Which checkpoint occurs after the G1 phase in the cell cycle?

G1-to-S checkpoint Signup and view all the answers

What characteristic is true of cancer cells?

Uncontrollable growth Signup and view all the answers

From which type of tissue do sarcomas typically arise?

Connective tissue Signup and view all the answers

What does the term 'plasm' refer to in medical terminology?

Substance Signup and view all the answers

What is the role of promoting agents in carcinogenesis?

They cause abnormal expression of genes. Signup and view all the answers

Which term describes a tumor arising from epithelial tissues?

Carcinoma Signup and view all the answers

What does the prefix 'hyper-' typically signify in medical terminology?

Excessive Signup and view all the answers

Which type of cancer originates in epithelial tissue?

Carcinoma Signup and view all the answers

What does a Grade 4 tumor indicate?

Cells are immature and undifferentiated Signup and view all the answers

Which warning sign of cancer is indicated by persistent hoarseness?

Nagging cough or persistent hoarseness Signup and view all the answers

What does the 'N' in the TNM staging system represent?

Node involvement Signup and view all the answers

What is the key characteristic of a benign neoplasm?

Slow-growing and encapsulated Signup and view all the answers

Which option describes the process of metastasis?

Cancer cells spread through blood or lymphatic system Signup and view all the answers

Which of the following is indicative of adenocarcinoma?

Originates in glandular tissue Signup and view all the answers

What does a tumor classified as Tis indicate?

Carcinoma in situ, limited to surface cells Signup and view all the answers

What is the growth rate of adenocarcinoma in non-small cell lung cancer?

Moderate growth rate Signup and view all the answers

What is a common risk factor for liver cancer?

Chronic hepatitis B or C infections Signup and view all the answers

Which type of non-small cell lung cancer is characterized as slow-growing with late metastasis?

Squamous cell Signup and view all the answers

What is the most common type of liver cancer?

Hepatocellular carcinoma Signup and view all the answers

What complication can occur after liver transplantation?

Acute graft rejection Signup and view all the answers

Which nursing diagnosis is related to the risk of impaired gas exchange in lung cancer patients?

Impaired Gas Exchange Signup and view all the answers

What mutation is associated with the development of liver cancer?

DNA mutations Signup and view all the answers

What type of stomach cancer begins in the mucus-producing cells?

Adenocarcinoma Signup and view all the answers

What is the primary reason for the decline in stomach cancer rates worldwide?

Increased use of refrigeration for food preservation Signup and view all the answers

Which of the following is NOT a nursing diagnosis for patients with stomach cancer?

Altered nutrition: greater than body requirements Signup and view all the answers

What age group is most commonly affected by colon cancer?

Older adults, particularly over 50 Signup and view all the answers

Which of the following treatments is NOT typically associated with colon cancer?

Physical therapy Signup and view all the answers

Which type of cancer begins in small polyps that may develop into larger tumors?

Colon cancer Signup and view all the answers

What is the most common type of colon cancer?

Adenocarcinoma Signup and view all the answers

What lifestyle factor is associated with an increased risk of colon cancer?

Low-fiber, high-fat diet Signup and view all the answers

Colon cancer can metastasize most commonly to which organ?

Liver Signup and view all the answers

What typically happens when cancer cells metastasize?

They invade nearby tissues and spread to other body parts. Signup and view all the answers

What is a common characteristic of leukemias?

Unregulated proliferation of leukocytes. Signup and view all the answers

Which type of leukemia is most frequently observed in pediatric patients?

Acute lymphoblastic leukemia. Signup and view all the answers

Which of the following is a risk factor associated with leukemia?

Cigarette smoke. Signup and view all the answers

What is the prognosis for patients with Acute Myeloid Leukemia (AML) receiving treatment?

Less than 1 year on average. Signup and view all the answers

What clinical manifestation is commonly associated with Acute Myeloid Leukemia (AML)?

Weakness and fatigue. Signup and view all the answers

What is the primary goal of medical management in treating Acute Myeloid Leukemia (AML)?

To achieve complete remission with no residual leukemia. Signup and view all the answers

How does Acute leukemia typically present compared to Chronic leukemia?

It has a sudden onset with rapid progression. Signup and view all the answers

Which of the following defines the consolidation therapy in the context of leukemia treatment?

Post-remission therapy to eliminate residual leukemic cells. Signup and view all the answers

What is a significant consequence of decreased erythrocytes and platelets in patients with Acute Myeloid Leukemia (AML)?

Ecchymosis and petechiae. Signup and view all the answers

Study Notes

Cellular Aberrations

Cellular aberrations are deviations from normal cellular functions.

What is Cell Cycle?

The cell cycle is the life cycle of a cell.
It is a series of ordered events, involving cell growth and development, culminating in the formation of two new daughter cells.
The cell cycle is not a linear pathway.

Cell Cycle Checkpoints

The cell cycle checkpoints monitor and control the cell cycle.
G1-to-S checkpoint: Checks for cell size, nutrients/growth factors, and DNA damage.
G2-to-M checkpoint: Checks for cell size and DNA replication.
Metaphase checkpoint: Checks for chromosome spindle attachment.

Normal Cell Growth: The Cell Cycle

Oncogenes promote cell division and growth.
Tumor suppressor genes regulate cell division and repair DNA damage to prevent cancerous changes.

Essential Cellular Functions

Mutagens, carcinogens, viruses, and irradiation can lead to cancer via genetic predisposition.
This impacts normal cellular functions.
Normal cellular functions are transformed to cellular oncogene, leading to an altered cellular function, which results in a "spontaneous" neoplasm.

Carcinogenesis

A three-step process:
- Initiation: Initiators (carcinogens) alter the genetic structure of DNA.
- Promotion: Repeated exposure to promoting agents causes expression of abnormal or mutated genetic information.
- Progression: Altered cells exhibit increased malignant behavior, leading to invasion and metastasis.

Oncology

Oncology is the branch of medicine that studies, detects, treats, and manages cancer and neoplasia.

Root Words

Neo-: New
Plasia-: Growth
Plasm-: Substance
Trophy-: Size
Oma-: Tumor
Statis-: Location

A- Ana- Hyper- Meta- Dys-

A-: None
Ana-: Lack
Hyper-: Excessive
Meta-: Change
Dys-: Bad, deranged

Care of Patients with Cancer

Cancer is a disease that begins when an abnormal cell is transformed by a genetic mutation of cellular DNA.
The cell forms a clone and proliferates abnormally.
Cells acquire invasive characteristics and change surrounding tissues. Cells access lymph and blood vessels to spread to other body areas.

Care of Patients with Cancer-Cellular Origin

Carcinoma: originates in epithelial tissue.
- Adenocarcinoma: originates in glandular tissue (breast, prostate)
- Sarcoma: originates in fat, muscle, blood vessels, nerves, bones

Care of Patients with Cancer-Warning Signs

Change in bowel or bladder habits
A lesion that does not heal
Unusual bleeding or discharge
Thickening or lump formation
Indigestion or difficulty swallowing
Obvious changes in wart or mole
Nagging cough or persistent hoarseness
Unplained anemia
Sudden loss of weight

Other Definitions and Characteristics of Cancer

Benign Neoplasm: Slow-growing, localized, encapsulated, and not cancerous.
Malignant Neoplasm: Aggressive, invades and destroys tissues, characteristic of cancer.
Metastasis: Cells travel through the blood or lymphatic system to another tissue/organ forming a secondary tumor.

Tumor Grading

Examined the tumor through biopsy under a microscope to determine the grade of the cancer.
Increasing abnormality increases the grade, from 1 to 4.

Cancer Staging

Classification of the extent of disease (TNM system):
- Tumor (T): Size and extent of primary tumor.
- Node (N): Regional lymph node involvement.
- Metastasis (M): Distant metastasis.

Numerical Staging System for Cancer

Stage 0: Cancer in-situ (limited to surface cells); Stage 1: Cancer limited to the origin tissue, evidence of growth; Stage 2: Limited local spread of cancerous cells; Stage 3; Extensive local and regional spread; Stage 4: Distant metastasis

Pathophysiology of Cancer

Cancer cells differ from normal cells in size, structure, function, and growth rate.
Control of growth is absent in cancer cells; this uncontrolled growth destroys surrounding tissues/organs via the cardiovascular and lymphatic systems, interfering with vital organs/functions.
Primary sites of cancer metastasis are the bone, lymph nodes, liver, lungs, and brain.

Breast Cancer

Classified as invasive when it penetrates the tissue surrounding the mammary duct and grows in an irregular pattern. Metastasis occurs via lymph nodes. Common sites for metastasis: bone, lungs, brain, liver and skin. Diagnosis via breast biopsy/needle aspiration/surgical removal of the tumor.

Major Prognostic Factors for Breast Cancer

Invasive carcinoma vs in-situ disease
Distant metastases
Lymph node metastases
Tumor size
Locally advanced disease

Cancer Staging (Breast Cancer)

Stage indicators (e.g., 0, I, II, III, IV) refer to primary tumor size, lymph node involvement, and the presence or absence of distant metastases and provide a survival rate and prognosis percentage.

Carcinoma of the Breast-Findings

Presence of lump
Nipple inversion
Breast discharges
Changes in skin - "peau d'orange"
Diagnostics: mammography, UTZ, MRI (possibly) biopsy

Interventions

Nonsurgical: Chemotherapy, radiation therapy, hormonal manipulation
Surgical: Lumpectomy, partial or segmental mastectomy, total mastectomy, modified radical mastectomy, radical mastectomy

Monitoring and Managing Potential Complications

Lymphedema: Occurs after axillary surgery.
Hematoma Formation: Following mastectomy or breast conservation.
Infection

Nursing Interventions

Monitor for adverse effects of radiation and chemotherapy.
Provide psychological support.
Involve the patient in planning and treatment.
Describing surgical procedures to alleviate fear.
Prepare for chemotherapy effects (alopecia, fatigue), administer antiemetics.
Administer I.V. fluids and hyperalimentation as indicated.
Help patient identify support persons.
Suggest psychological interventions for anxiety/depression/sexual problems.
Teach cancer-screening procedures.

Breast Self-Examination (BSE)

Perform 7-10 days after menses or on a specific day of the month.

Lung Cancer

Lung cancer is abnormal cell growth in lung tissue, resulting in a tumor.
Lung cancer may be primary (develops in the lung) or secondary (spreads from another part of the body).
Major categories include small cell and non-small cell lung cancers.
Risk factors include repetitive exposure to inhaled irritants (e.g., cigarette smoke, air pollution).

Risk Factors for Lung Cancer

Exposure to inhaled irritants (e.g., cigarette smoke, air pollution)
Benzopyrenes
Hydrocarbons

Types of Lung Cancer

Small cell (oat cell) and Non-small cell (Adenocarcinoma/Squamous cell/Large cell)

Care of Patients with Cancer of the Liver

Liver cancer starts in liver cells (hepatocytes).
Types include hepatocellular carcinoma (most common), and intrahepatic cholangiocarcinoma/hepatoblastoma (less common).
Risk factors for liver cancer: chronic infection of Hepatitis B/C; liver cirrhosis; inherited liver/hemochromatosis, Wilson's disease; diabetes; exposure to aflatoxins; excessive alcohol consumption.
Liver cancer often undetected until spread within the pelvis/abdomen.
Treatments: Surgery, chemotherapy.

Care of Patients with Cancer of the Stomach

Stomach cancer typically begins in mucus-producing cells (adenocarcinoma).
Predominantly found in the stomach's lower part of the swallowing tube (gastroesophageal junction).
Risk Factors: Diet high in salted/smoked foods, low in fruits/veggies, family history of stomach cancer, infection w/Helicobacter pylori, long-term stomach inflammation, pernicious anemia, smoking, stomach polyps.
Stages of Stomach Cancer: -Stage 1: Tumor is restricted to the top layer of tissue -Stage 2: Cancer spread to deeper muscle or involves more lymph nodes -Stage 3: Cancer may have grown through all the layers -Stage 4: Cancer that has spread to other parts of the body

Care of Patients with Cancer of the Colon

Cancer starts in the large intestine (colon).
Cancer typically occurs in older adults
Risk factors for colon cancer: Age, African-American race, inflammatory intestinal conditions, inherited syndromes, family history of colon cancer, low-fiber/high-fat diet, diabetes, obesity, smoking, alcohol use, radiation.
Stages of colon cancer (e.g., A, B, C, D).
Types of colon cancer include adenocarcinoma (most common).

Care of Patients with Cancer of the Ovaries

Begins in the ovaries (egg-producing cells).
Often undetected until it has spread to the pelvis/abdomen.
Treatment: Surgery, Chemotherapy.
Risk Factors: Older age, inherited gene mutations (BRCA1/2, Lynch syndrome), family history of ovarian cancer, estrogen hormone replacement therapy (high doses), age when menstruation started, menopause.
Types of Ovarian Cancer:
Epithelial tumors: 90% of ovarian cancers; begin int he thin layer of tissue covering the outside of the ovaries.
Stromal tumors: 7% of ovarian cancers: Begin in the ovarian tissue that contains hormone-producing cells.
Germ cell tumors: Rare ovarian cancers, begin in the egg-producing cells.

## Leukemias

Neoplastic proliferation of white blood cells (WBCs) in the blood or bone marrow. Characterized by rapid, continuous turnover of cells leading to an increased level of WBCs in circulation.
Acute leukemias: Abrupt onset within weeks/months, rapidly progressing; common in young children, adults.
Chronic leukemias: Evolving over many months/years, slowly progressing, common in older patients.

Acute Myeloid Leukemia (AML)

Results from defects (mutations) in stem cells differentiating into myeloid cells.
Commonly diagnosed in adults (60 years).
High mortality rates. Treatments include induction therapy, and supportive therapies.

Chronic Myeloid Leukemia (CML)

Mutation in myeloid stem cells.
A section of DNA is missing from chromosome 22 and translocated onto chromosome 9, on the BCR (chromosome 22) and ABL gene (chromosome 9).
Symptoms include enlarged spleen, fatigue, anorexia (loss of appetite), weight loss.
Treatment: Imatinib mesylate (Tyrosine-kinase-inhibitor), and supportive therapies.

Acute Lymphoblastic Leukemia (ALL)

Uncontrolled proliferation of immature lymphoid cells (lymphoblasts).
Common in children (4 years of age). Adults less commonly affected.
Treatments: Chemotherapy.

Chronic Lymphoid Leukemia (CLL)

Common malignancy in older adults (60+ years of age). CLL arises from a malignant clone of B lymphocytes.
Diagnosis is often made incidentally.
Symptoms include lymphadenopathy, splenomegaly, infection, and unintentional weight loss.
Treatments: Chemotherapy, monoclonal antibodies

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Test your knowledge on the fundamental characteristics of malignant cells and the roles of genes in cancer development. This quiz covers essential concepts such as tumor suppressor genes and the process of cancer metastasis. Perfect for students studying cancer biology or related fields.