Cancer Biology Quiz

Oncology Overview

• Oncology is the branch of medicine focusing on tumors.
• A tumor is any abnormal swelling, lump, or mass.

Cancer Cell Characteristics

• Cancer cells divide uncontrollably and invade nearby tissues.
• Cancer cells can spread to other parts of the body via the blood and lymphatic systems.

Benign vs. Malignant Neoplasms

• Benign neoplasm: A slow-growing tumor that doesn't invade other tissues or form metastases. (Resembles normal cells)
• Malignant neoplasm: A rapidly growing tumor that invades surrounding tissues and spreads to other parts of the body (metastasizes). (Does not resemble normal cells)

Cancer Pathophysiology

• Normal cell division follows a sequential pattern called the cell cycle.
• Mitosis is the cell growth phase involving cytoplasmic and nuclear separation, resulting in identical daughter cells.
• Cancer development involves the initiation, promotion, and progression of abnormal cell growth.
• Cancer development can be influenced by genetic changes, carcinogens (chemicals), viruses, hormones, and other factors.
• Cancer cells proliferate (multiply), invade surrounding tissue, infiltrate, and spread to other locations via lymph and blood vessels (metastasis).

Cancer Cell Characteristics (Continued)

• Uncontrolled cell proliferation (division)
• Resistance to apoptosis (programmed cell death)
• Inducing angiogenesis (formation of new blood vessels )
• Invasion and metastasis
• Loss of function

Carcinogenesis

• Initiation: carcinogen invades and changes the DNA of a normal cell
• Promotion: prolonged exposure to a carcinogen and cell proliferation
• Progression: morphology changes and angiogenesis
• Metastasis: spread of cancer to other parts of the body

Cancer Classification (Continued)

• Different tissues/organs have different forms of cancer (e.g., epithelial tumors, connective tissue tumors, blood vessel tumors, muscle tumors, blood-related tumors, etc.)
• Examples: Papilloma (benign epithelial tumor), squamous cell carcinoma (malignant epithelial tumor), Fibroma (benign connective tissue tumor), Fibrosarcoma (malignant connective tissue tumor), Leukemia (malignant blood tumor)

Cancer Staging

• Clinical staging classifies cancer by stages (0-IV) determining the extent of the disease.
• Stage 0: Cancer in situ (early stage)
• Stage I: Tumor limited to the tissue of origin (localized tumor growth)
• Stage II: Tumor has grown and spread to some extent locally.
• Stage III: Extensive local and regional spread
• Stage IV: Metastasis (cancer spread to other parts of the body)
• TNM system is frequently used (T=tumor size, N=node involvement, M=metastasis)

Cancer Grading

• Cancer grading describes the appearance of cancerous cells under a microscope.
• Grading grades cancer cells based on their resemblance to normal cells and ability to grow. (Grade 1 cancer cells closely resemble normal cells, whereas Grade 3 cancer cells look more abnormal and grow and spread more aggressively).
• Grade 1 considered least severe and grade 3 is more severe.

Risk Factors for Cancer

• Age
• Exposure to chemical carcinogens
• Exposure to ionizing radiation
• Hereditary predisposition
• Viral and bacterial infections
• Hormonal imbalances
• Immune system dysfunction
• Diet

Cancer Prevention

• Primary prevention: Making lifestyle changes, avoiding exposure to carcinogens, getting genetic counseling/testing, and using vaccines for cancer prevention.
• Secondary prevention/early detection: Performing regular screening tests.
• Tertiary prevention: Preventing recurrence of disease (e.g., health counseling).

Warning Signs of Cancer

• Significant change in normal bowel habits
• Sores that don't heal
• Unusual bleeding/discharge
• Thickening/lump in breast, testicle, or other body parts
• Difficulty swallowing
• Noticeable/sudden change in mole or wart appearance
• Persistent cough or hoarseness

Cancer Diagnosis

• Health history and physical examination
• Laboratory investigations
• Tumor markers or genetic markers
• Radiologic studies
• Radioisotope scans
• Procedures like sigmoidoscopy or colonoscopy
• Biopsy (needle biopsy, incisional biopsy, or excisional biopsy)

Cancer Management

• Treatment type, stage, and malignancy are considered when choosing cancer treatment.
• Treatment may involve surgery, chemotherapy, radiation, or immunotherapy.
• Surgical treatment can be debulking, curative, or palliative.

Chemotherapy

• Treatment using anticancer drugs interfering with cell functions and reproduction
• Treatment may be combined with surgery, radiation to reduce tumor size (typically before surgery)
• Goals of chemotherapy are cure, control, and palliation (relief of symptoms)

Chemotherapy Administration Routes

• Oral (capsule, tablet, liquid)
• Intravenous (IV - push or infusion)
• Intramuscular
• Intraperitoneal
• Subcutaneous
• Topical

Chemotherapy Safety Precautions

• Personal safety measures to minimize exposure via skin contact, inhalation, and ingestion
• Safe disposal of antineoplastic agents, body fluids, and excreta

Chemotherapy Side Effects

• Nausea and vomiting
• Fatigue
• Hair loss
• Mucositis
• Diarrhea
• Anemia
• Neutropenia
• Thrombocytopenia
• Other potential side effects in various organ systems requiring assessment by a nurse

Radiation Therapy

• Used to destroy cancer cells' ability to grow and multiply using high-energy ionizing radiation.
• Used to cure or control cancer, usually in target areas
• Types: Teletherapy (external beam radiation) and Brachytherapy (internal radiation implantation)
• Can involve interstitial or intracavitary radiation procedures

Radiation Therapy Side Effects

• Acute side effects (during/within 6 months of treatment): Fatigue, skin reactions, gastrointestinal issues, oral mucositis, cardiovascular issues, pulmonary problems, renal issues.
• Chronic side effects (after 6 months of treatment): Fibrosis, skin darkening, obstruction/ulceration/adhesion of various organ tracts, increased risk of infection, xerostomia, taste alteration, pulmonary fibrosis, renal fibrosis, etc.

Nursing Roles for Radiation Patients

• Maintaining optimal skin care for patients (avoid lotions, rubbing, tight-fitting clothes, ensure proper skin care as directed by healthcare professionals.)
• Ensuring protection for healthcare providers from radiation exposure (use shielding, stay at a safe distance from the patient).
• Monitoring for complications (dislodged implants, etc.)
• Providing support and comfort for patients facing challenges like body image concerns

Other Treatment Modalities

• Immunotherapy (modifying the body's biological/immunologic response to stop the malignancy)
• Bone Marrow Transplantation (BMT) (used for hematologic cancers)
• Gene Therapy (correct genetic defects by inserting a desired gene into the target cell)
• Blood component therapy (e.g., granulocyte transfusion for granulocytopenia)
• Additional heat to tumor to destroy it in conjunction with radiotherapy (hyperthermia)
• Pain management
• Palliative care, including psychosocial/psychological care

Nursing Diagnoses related to Cancer Treatment

• High risk of infection
• High risk of injury (e.g., bleeding problems)
• Impaired skin integrity (e.g., erythema, desquamation, alopecia)

Other Nursing Interventions related to Treatment

• Prevention of infection
• Prevention of bleeding
• Minimizing fatigue
• Minimizing stomatitis
• Promoting nutrition
• Supporting/improving body image (coping mechanisms)
• Management of extravasation (in the case of leaking chemotherapy agents)