Cell Cycle and Cancer Biology

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Questions and Answers

What is the most important sign of infection to monitor in a patient recovering from cancer treatment?

Weight loss

Increased appetite

Persistent cough

Fever above 38.3°C (correct)

Which of the following is NOT a recommended practice to prevent infections in patients undergoing cancer treatment?

Regular handwashing

Engage in crowd activities (correct)

Maintain aseptic technique

Avoid giving fresh fruits and vegetables

Which treatment option falls under the category of biotherapy for cancer?

Chemotherapy

Radiation therapy

Surgery

Bone marrow transplantation (correct)

What psychosocial aspect is crucial in cancer care for a terminally ill patient?

Providing support for the client and family Signup and view all the answers

In the case of a client with terminal cancer advised to undergo mastectomy, what is a key consideration in her decision-making process?

The impact of the surgery on her body image Signup and view all the answers

Which type of cell is considered to be out of the cell cycle permanently?

Permanent Cells Signup and view all the answers

During which phase of the cell cycle does DNA synthesis occur?

S Phase Signup and view all the answers

What is the first step in the process of carcinogenesis?

Initiation Signup and view all the answers

Which type of cancer spread is most commonly through the lymphatic system?

Lymphatic Spread Signup and view all the answers

Which of the following agents is NOT considered a physical agent in the etiology of cancer?

Smoking Signup and view all the answers

What is one of the roles of cytotoxic T cells in the body's defense against tumors?

Kill tumor cells Signup and view all the answers

What do proto-oncogenes and anti-oncogenes have in common?

Both are involved in normal cell functioning Signup and view all the answers

Which dietary habit is considered a risk factor for cancer development?

Processed foods Signup and view all the answers

What does the 'T' in the T-N-M staging system represent?

Size of the primary tumor Signup and view all the answers

Which grade indicates poorly differentiated tumor cells?

Grade 3 Signup and view all the answers

What is the significance of 'N1' in the N category of the T-N-M system?

Moderate involvement of regional lymph nodes Signup and view all the answers

Which imaging test uses sound waves to create images of internal tissues?

Ultrasonography Signup and view all the answers

What does 'MX' indicate in the M category of the T-N-M system?

Metastasis unable to be assessed Signup and view all the answers

In cancer grading, what does a Grade 4 tumor signify?

Very poorly differentiated cells Signup and view all the answers

What is the purpose of imaging tests in cancer diagnosis?

To identify treatment options and evaluate treatment response Signup and view all the answers

What does 'N0' signify in the N category of the T-N-M system?

No regional lymph node involvement Signup and view all the answers

What is the primary goal of palliative surgery?

To relieve complications and enhance quality of life Signup and view all the answers

Which of the following describes the use of radiation therapy as adjuvant therapy?

It is used in conjunction with chemotherapy to enhance destruction of cancer cells. Signup and view all the answers

What should be monitored after a surgery to ensure the patient's safety?

Possible complications like infection and organ dysfunction Signup and view all the answers

Which principle is NOT a fundamental aspect of radiation therapy?

Temperature Signup and view all the answers

What is a key nursing consideration for a patient receiving sealed source internal radiation?

Encourage the client to turn to sides at regular intervals Signup and view all the answers

What is the main function of reconstructive surgery?

To improve function and achieve desirable cosmetic results Signup and view all the answers

Which of the following is NOT a guideline for teaching patients about external radiation therapy?

Patients might experience significant pain post-treatment Signup and view all the answers

What role does nursing management play after surgery?

Monitoring response to surgery and complications, ensuring comfort and teaching care Signup and view all the answers

What is the primary purpose of esophagogastroduodenoscopy (EGD)?

To evaluate and manage upper gastrointestinal conditions Signup and view all the answers

Which of the following best describes the method used in Positron Emission Tomography (PET)?

It utilizes radioactive substances to measure metabolic changes. Signup and view all the answers

What does a Complete Blood Count (CBC) test primarily measure?

The quantity of blood cells and their components. Signup and view all the answers

What type of cancer is the Circulating Tumor Cell (CTC) Test primarily used to monitor?

Breast, colorectal, and prostate cancers Signup and view all the answers

What is the primary application of Flow Cytometry?

Diagnosing and classifying certain cancers. Signup and view all the answers

What does a high-risk score on the MammaPrint test indicate?

A high probability of the cancer recurring. Signup and view all the answers

What unique feature does the BluePrint Test analyze in cancer cells?

The mutations driving the cancer's behavior. Signup and view all the answers

Which statement correctly describes the fiber optic endoscope used in EGD?

It allows for visualization of the upper GI tract. Signup and view all the answers

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

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

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.