Cancer Biology Quiz

Oncology Nursing Management in Cancer Care

• Oncology nursing focuses on the management of cancer care.
• Neoplasia: New growth of tissue
• Tumor: A swelling characterized by abnormal cell growth exceeding normal limits, lacks defined borders or restrictions.
• Metastasis: The ability of a tumor to spread.
• Tumors are categorized based on behavior and parenchymal (tissue-specific) components.
  • Benign tumors are non-cancerous.
  • Malignant tumors are cancerous
• All tumors, both benign and malignant, have two basic components:
  • Parenchyma: Composed of proliferated neoplastic cells.
  • Stroma: Supportive tissue consisting of connective tissue, blood vessels and lymphocytes.
• Tumor nomenclature often ends with "-oma" for benign tumors (e.g., fibroma, chondroma).
  • Epithelial tumors (originating from the lining of tissues) often have the suffix "-adenoma" (e.g., adenoma).
  • Malignant tumors often have the suffix "-carcinoma" (epithelial) or "-sarcoma" (mesenchymal).
• Malignant tumors include:
  • Epithelial examples: Adenocarcinoma, squamous cell carcinoma.
  • Mesenchymal examples: Fibrosarcoma.
• Benign and malignant tumors differ in:
  • Benign Tumors: Resemble normal cells (well differentiated), mitosis is rare, growth is slow, often encapsulated, non-invasive, do not metastasize.
  • Malignant Tumors: Do not resemble normal cells (undifferentiated), mitosis is frequent, growth is fast, often uncapsulated, invasive, frequently metastasize.
• Metastasis is the spread of cancer from the primary site to other parts of the body.
• Cancer is a disease process initiated by the genetic mutation of cellular DNA, transforming an abnormal cell. These cells are invasive and infiltrate other tissues.
• Characteristics of malignant cells: Uncontrolled growth, altered metabolism, irregular shape, presence of tumor-specific antigens.
• Metastasis mechanisms: Lymphatic, hematogenous (blood), and angiogenesis.
• Cancerogenic agents and risk factors:
  • Viruses, bacteria
  • Chemical agents (tobacco, asbestos)
  • Physical factors (sunlight, radiation)
  • Behavior and lifestyle related factors (alcohol, chronic irritation, obesity)
  • Genetic and dietary factors
  • Hormonal factors
  • Role of the immune system
• Cancer incidence increases with age due to somatic mutation accumulation and weakened immunity.
• Common environmental factors related to cancer: Workplace exposures, nutrition (obesity), behaviors (alcohol, smoking, STDs), viral diseases. Alcohol use and smoking can increase the risk for certain cancers of the oropharynx, larynx, esophagus, liver, lung, lips, pharynx, larynx, esophagus, pancreas, and bladder.
• Cancer warning signs (CAUTION): Changes in bowel/bladder habits, sores that don't heal, unusual bleeding/discharge, thickening/lumps, indigestion/swallowing difficulties, changes in moles/warts, nagging cough/hoarseness
• Primary prevention of cancer involves reducing cancer risk in healthy individuals by avoiding known carcinogens, educating patients on healthy lifestyles, improving diet, educating the public.
• Secondary prevention involves early detection, screening, and intervention. Secondary prevention methods include self-breast exams, self-testicular exams, screening colonoscopies, and Pap tests. Assessing patients at high risk
• Diagnostic cancer tests include biopsies, tumor staging and grading (TNM classification), blood tests.
• Staging determines the size and presence of metastasis of tumors.
  • TNM classification:
    • T: Extent of primary tumor
    • N: Lymph node involvement
    • M: Extent of metastasis
• Grading classifies tumor cells based on their tissue of origin and their resemblance to normal cells, commonly graded from I-IV.
  • Grade I: Well-differentiated tumors
  • Grade IV: Poorly differentiated tumors.
• Cancer treatment goals include cure, control, and palliation.
• Surgical treatment approaches include diagnostic, prophylactic, and reconstructive surgeries.
• Primary surgical treatment often involves local or wide excision (radical) to remove the entire tumor and surrounding tissue.
• Types of biopsy include excisional, incisional, needle biopsy.
• Palliative surgery is performed when a cure isn't possible to relieve symptoms, such as pain, including colostomy for bowel obstruction.
• Reconstructive surgery may be performed after a curative or radical surgery to improve function in areas like breast, head, neck, and skin.
• Nursing management in cancer surgery involves pre-operative assessment, education, frequent communication with both patients and medical team about procedure related restrictions. Comprehensive after-operative evaluation and care, including monitoring for complications.
• Types of radiation therapy (external, internal) are used to treat tumors. Internal radiation uses needles or implants. Radiation therapy often requires patient immobilization. A lethal tumor dose is calculated based on normal tissue sensitivity.
• Toxicity of radiation therapy: Skin integrity impairment (alopecia, erythema), altered oral mucosa (stomatitis, xerostomia), esophageal irritation, anorexia, nausea, diarrhea, anemia, fatigue, malaise.
• Nursing management in radiation therapy involves patient/family education, providing oral hygiene, and protecting caregivers.
• Chemotherapy agents target cellular function to destroy tumor cells, treating systemic cancers.
  • Chemotherapy timing in relation to the cell cycle.
• Types of chemotherapy agents, classifications, and routes of administration.
• Potential adverse effects of chemotherapy include GI effects (nausea, vomiting, diarrhea), myelosuppression, renal damage, cardiopulmonary and reproductive system toxicity, and neurologic effects.
• A bone marrow transplant (BMT) is used to treat hematological cancers and cancers with bone marrow involvement. Procedures include treating with chemotherapy to ablate bone marrow, graft-versus-host disease, venous occlusive disease, follow-up care, and surveillance.
• Collaborative problems related to cancer treatments include infection, bleeding, superior vena cava syndrome, hypercalcemia, spinal cord compression, pericardial effusion, disseminated intravascular coagulation (DIC).
• Hospice care offers multidisciplinary care for terminally ill patients and families. The focus is on quality of life, symptom management, and psychosocial/spiritual care.
• Oncologic emergencies like superior vena cava syndrome,spinal cord compression, pericardial effusion, and cardiac tamponade, disseminated intravascular coagulation(DIC), syndrome of inappropriate ADH secretion, and tumor lysis syndrome.