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What is the most important sign of infection to monitor in a patient recovering from cancer treatment?
Which of the following is NOT a recommended practice to prevent infections in patients undergoing cancer treatment?
Which treatment option falls under the category of biotherapy for cancer?
What psychosocial aspect is crucial in cancer care for a terminally ill patient?
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In the case of a client with terminal cancer advised to undergo mastectomy, what is a key consideration in her decision-making process?
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Which type of cell is considered to be out of the cell cycle permanently?
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During which phase of the cell cycle does DNA synthesis occur?
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What is the first step in the process of carcinogenesis?
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Which type of cancer spread is most commonly through the lymphatic system?
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Which of the following agents is NOT considered a physical agent in the etiology of cancer?
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What is one of the roles of cytotoxic T cells in the body's defense against tumors?
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What do proto-oncogenes and anti-oncogenes have in common?
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Which dietary habit is considered a risk factor for cancer development?
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What does the 'T' in the T-N-M staging system represent?
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Which grade indicates poorly differentiated tumor cells?
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What is the significance of 'N1' in the N category of the T-N-M system?
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Which imaging test uses sound waves to create images of internal tissues?
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What does 'MX' indicate in the M category of the T-N-M system?
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In cancer grading, what does a Grade 4 tumor signify?
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What is the purpose of imaging tests in cancer diagnosis?
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What does 'N0' signify in the N category of the T-N-M system?
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What is the primary goal of palliative surgery?
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Which of the following describes the use of radiation therapy as adjuvant therapy?
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What should be monitored after a surgery to ensure the patient's safety?
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Which principle is NOT a fundamental aspect of radiation therapy?
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What is a key nursing consideration for a patient receiving sealed source internal radiation?
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What is the main function of reconstructive surgery?
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Which of the following is NOT a guideline for teaching patients about external radiation therapy?
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What role does nursing management play after surgery?
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What is the primary purpose of esophagogastroduodenoscopy (EGD)?
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Which of the following best describes the method used in Positron Emission Tomography (PET)?
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What does a Complete Blood Count (CBC) test primarily measure?
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What type of cancer is the Circulating Tumor Cell (CTC) Test primarily used to monitor?
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What is the primary application of Flow Cytometry?
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What does a high-risk score on the MammaPrint test indicate?
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What unique feature does the BluePrint Test analyze in cancer cells?
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Which statement correctly describes the fiber optic endoscope used in EGD?
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Study Notes
Normal Cell Cycle
- Cells have different division rates depending on their type.
- Permanent cells, such as neurons and cardiac muscle cells, are out of the cell cycle.
- Stable cells, such as liver and kidney cells, are dormant or resting in the G0 phase.
- Labile cells, including GIT cells, skin, endometrium, and blood cells, are continuously dividing.
- The cell cycle consists of four phases:
- G0: Dormant or resting phase.
- G1: Normal cell activities.
- S: DNA synthesis.
- G2: Pre-mitotic phase, synthesizes protein and prepares for cellular division.
- M: Mitotic phase (IPMAT: Interphase, Prophase, Metaphase, Anaphase, Telophase)
Proposed Molecular Cause of Cancer
- Cancer may be caused by changes in DNA structure, altered DNA function, cellular aberration, cellular death, and neoplastic change.
- Proto-oncogenes and anti-oncogenes play a critical role in regulating cell growth and division.
Etiology of Cancer
- Physical agents like radiation, exposure to irritants, sunlight, altitude, and humidity can cause cancer.
- Chemical agents: smoking, dietary ingredients, drugs, and industrial compounds are associated with cancer development.
- Genetics and Family History: Colon cancer and premenopausal breast cancer have a familial predisposition.
- Dietary Habits: Low-fiber, high-fat, processed foods, and alcohol consumption are risk factors for certain cancers.
- Viruses and Bacteria: DNA viruses (Hepatitis B, Herpes, EBV, CMV, Papilloma Virus), RNA viruses (HIV, HTCLV) and bacteria (H. pylori) can contribute to cancer.
- Hormonal Agents: DES (Diethylstillbestrol) is associated with certain cancers.
- Immune Disease: AIDS is a risk factor for various cancers.
Carcinogenesis/Oncogenesis
- Malignant transformation is a process that encompasses initiation, promotion, and progression.
- Initiation: Carcinogens alter the DNA of cells, leading to either cell death or repair.
- Promotion: Repeated exposure to carcinogens leads to abnormal gene expression and a latent period.
- Progression: This irreversible stage involves neoplastic transformation and the development of malignancy.
Pathogenesis of Cancer
- Cellular transformation and derangement theory: Cancer arises from changes in cell behavior and structure.
- Failure of the immune response theory: The immune system's inability to recognize and destroy cancerous cells allows cancer to develop.
Spread of Cancer
- Lymphatic spread: The most common way cancer spreads, involving lymphatic vessels.
- Hematogenous spread: Cancer cells travel through the bloodstream, commonly affecting the liver and lungs.
- Direct spread: Cancer cells spread directly to adjacent tissues through seeding.
Body Defenses Against Tumor
- The Cytotoxic T cells are lymphocytes that directly kill tumor cells
- B cells can produce antibody molecules to target cancer cells
- The T-N-M system is used to stage cancer.
TNM Staging System
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T - Tumor Size:
- T0: No evidence of primary tumor.
- T1, T2, T3, T4: Increasing size of the primary tumor.
- Tis: Carcinoma in situ (cancer cells are confined to the original location).
-
N - Lymph Node Involvement:
- N0: No regional lymph node involvement.
- N1, N2, N3: Increasing involvement of regional lymph nodes.
-
M - Distant Metastasis:
- M0: No distant metastasis.
- M1, M2, M3: Presence of distant metastasis.
Cancer Grading
- Grade 1: Well-differentiated cells (resemble normal cells).
- Grade 2: Moderately well-differentiated cells.
- Grade 3: Poorly differentiated cells.
- Grade 4: Very poorly differentiated cells (hard to distinguish from normal cells).
Laboratory Tests for Cancer
- Circulating Tumor Cell (CTC) Test: Used to monitor metastatic breast, colorectal, and prostate cancers.
- Complete Blood Count (CBC) Test: Measures the number of blood cells in the bloodstream.
- Flow Cytometry: Diagnoses and classifies certain cancers, such as leukemia and lymphoma, and evaluates the risk of recurrence.
- MammaPrint Test: Determines the risk of breast cancer recurrence.
- BluePrint Test: Identifies the specific mutations driving cancer behavior and aids in treatment decisions.
Imaging Tests Used to Detect Cancer
- Ultrasonography: Uses high-frequency sound waves to create images of internal tissues and organs.
- Magnetic Resonance Imaging (MRI): Provides detailed images of anatomy and physiological processes by using strong magnetic fields and radio waves.
- Computerized Tomography Scan (CT Scan): Uses X-rays and computer technology to create cross-sectional images of the body.
- Esophagogastroduodenoscopy (EGD): An invasive procedure to visualize the upper gastrointestinal (GI) tract, obtain a biopsy, or treat gastrointestinal conditions.
- Positron Emission Tomography (PET): A functional imaging technique that uses radioactive substances to visualize and measure metabolic changes in the body.
Treatment for Cancer
-
Surgery:
- Curative surgery: Aims to completely remove the cancer.
- Radical surgery: Wider tissue removal than curative surgery.
- Palliative surgery: To relieve complications of cancer and improve quality of life.
- Reconstructive surgery: May follow curative or radical surgery to improve function or cosmetic appearance.
-
Radiation Therapy:
- External RT (Teletherapy, DXT): Radiation delivered from a machine outside the body.
- Internal RT (Brachytherapy): Radioactive sources placed inside the body.
-
Biotherapy: Utilizes biological response modifiers (BRMs) to stimulate the immune system to fight cancer.
- Hematopoietic Growth Factors (Ex. Erythropoietin, Neupogen, Neumega): Stimulate the production of blood cells.
- Monoclonal Antibodies (MoAbs): Targeted therapy that binds to specific antigens on cancer cells.
- Bone Marrow Transplantation: Used to replace damaged bone marrow with healthy cells..
Nursing Management in Cancer Care
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Pre-Surgical Nursing:
- Provide education and emotional support to the patient and family.
- Assess patient and family needs for coping mechanisms.
- Encourage active participation in decision-making, if possible.
- Answer questions regarding diagnostic tests and surgical procedures.
-
Post-Surgical Nursing:
- Monitor for complications, such as infection, bleeding, wound dehiscence, fluid and electrolyte imbalance, and organ dysfunction.
- Provide comfort measures.
- Educate the patient on wound care, activity restrictions, nutrition, and medication information.
Radiation Therapy Nursing Considerations
-
Sealed Source IRI:
- Client's back should be turned towards the door.
- Encourage the client to turn to sides at regular intervals.
- Complete bed rest is necessary during the procedure.
- Enema and low-fiber diet are recommended before the procedure.
- Foley catheter should be in place.
- Long forceps and a lead container must be readily accessible.
-
External Radiation Therapy:
- Inform patients that radiation therapy is painless.
- Address grieving related to loss of health, income, sexuality, and body image.
- Answer questions about cancer and treatment options.
- Identify and refer to support groups.
Management of Complications (Radiation Therapy)
-
Infection:
- Fever (above 38.3°C) is a significant indicator.
- Administer prescribed antibiotics for two weeks.
- Maintain aseptic technique.
- Avoid exposure to crowds.
- Avoid fresh fruits and vegetables.
- Practice frequent handwashing.
- Limit invasive procedures.
-
Septic Shock:
- Monitor vital signs closely.
- Administer fluids and medications as prescribed.
- Prepare for possible vasopressors and antibiotics.
-
Bleeding:
- Monitor for signs and symptoms of bleeding.
- Apply pressure to the bleeding site.
- Elevate the affected area.
- Administer blood transfusions, if necessary.
- Limit invasive procedures as much as possible.
Psychosocial Aspects of Cancer Care
- Provide support to both the patient and their family.
- Promote positive self-concept.
- Facilitate coping with the cancer experience.
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Description
This quiz focuses on the normal cell cycle, its phases, and the molecular causes of cancer. It includes key information about cell types, their division rates, and the role of oncogenes. Test your understanding of cancer etiology and the cellular mechanisms involved in tumor development.
