Definitions in Oncology Terminology

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Questions and Answers

Which condition is characterized by bizarre cell growth resulting in cells that differ in size, shape, or arrangement?

Dysplasia (correct)

Metaplasia

Hyperplasia

Neoplasia

What is the term for the suppression of the blood cell-producing function of the bone marrow?

Thrombocytopenia

Myelosuppression (correct)

Alopecia

Neutropenia

What condition is characterized by an abnormally low absolute neutrophil count?

Stomatitis

Thrombocytopenia

Xerostomia

Neutropenia (correct)

Which term refers to the lowest point of white blood cell depression after therapy?

Nadir Signup and view all the answers

In oncology, which term describes the relief of symptoms associated with cancer?

Palliation Signup and view all the answers

Which term is used for a substance that can cause tissue necrosis and damage, especially when extravasated?

Vesicant Signup and view all the answers

Which proliferative pattern involves uncontrolled cell growth not following physiologic demand?

Neoplasia Signup and view all the answers

What percentage of cancer patients in the Philippines are aged 50 years and above?

75% Signup and view all the answers

What is the primary goal of palliative surgery?

To make the patient as comfortable as possible Signup and view all the answers

Which factor is NOT considered when selecting patients for surgery?

Ability to detect non-cancerous conditions Signup and view all the answers

What is a significant concern for patients undergoing cancer surgery?

Changes in normal body functions Signup and view all the answers

Which of the following statements about reconstructive surgery is true?

It may be indicated for various types of cancer. Signup and view all the answers

How should a nurse respond when patients request test results?

Guide their response based on prior physician communication. Signup and view all the answers

What type of complications should the nurse monitor for after cancer surgery?

Fluid and electrolyte imbalance Signup and view all the answers

Which aspect of nursing management is vital for patients undergoing cancer surgery?

Providing emotional support and education Signup and view all the answers

In reconstructive surgery, what is a crucial step prior to the primary surgical procedure?

Explaining possible reconstructive options Signup and view all the answers

What type of agents are known to initiate or promote cellular transformation?

Carcinogens Signup and view all the answers

Which virus is highly associated with Burkitt’s Lymphoma and Hodgkin’s disease?

Epstein-Barr Signup and view all the answers

What is considered a significant risk factor for skin cancer due to ultraviolet exposure?

Fair skin Signup and view all the answers

Which agent is recognized as the most lethal chemical carcinogen, accounting for a large percentage of cancer deaths?

Tobacco smoke Signup and view all the answers

What factor is NOT typically associated with increased cancer risk?

High-fiber foods Signup and view all the answers

What term describes an increased risk for cancer due to deficiencies in diet?

Carcinogens Signup and view all the answers

Which type of factors are highly implicated in familial cancer incidents?

Genetic and familial factors Signup and view all the answers

What immune response failure can lead to clinical cancer development?

Failure to detect malignant cells Signup and view all the answers

Hormonal balance disturbances may promote tumor growth through which mechanism?

Increased hormone receptor density Signup and view all the answers

Which of the following factors is associated with an increased risk of cancers related to obesity?

High caloric dietary intake Signup and view all the answers

What is the third leading cause of death, after heart disease and stroke?

Breast cancer Signup and view all the answers

Which cancer became the most common in the country in 2010?

Breast cancer Signup and view all the answers

What is the primary mechanism by which malignant tumors spread?

By metastasis Signup and view all the answers

Which statement best describes how malignant cells differ from benign cells?

Malignant cells infiltrate surrounding tissues. Signup and view all the answers

What type of tumor typically does NOT cause extensive tissue damage?

Benign tumors Signup and view all the answers

Which characteristic is commonly associated with malignant cells?

Irregularly shaped nuclei Signup and view all the answers

Which cancer is the leading cause of cancer for Filipino men?

Lung cancer Signup and view all the answers

Which of the following is NOT a feature of benign tumors?

Invasive growth Signup and view all the answers

Metastasis is best described as:

Spread to distant sites Signup and view all the answers

Which tissue type has a malignant counterpart known as 'chondrosarcoma'?

Cartilage Signup and view all the answers

Which of the following features is common in all malignant tumors?

Infiltrative growth Signup and view all the answers

How do malignant cells often interact with adjacent tissues?

By being less adherent Signup and view all the answers

Which characteristic does NOT typically define benign tumors?

Extraordinarily large nuclei Signup and view all the answers

What is an effect associated with generalized malignant tumors?

Anemia Signup and view all the answers

What is the main purpose of internal radiation therapy?

To destroy cancer cells directly at the tumor site Signup and view all the answers

Which symptom is least likely associated with toxicity from radiation therapy?

Hypertension Signup and view all the answers

Which action should a nurse take to protect the skin during radiation therapy?

Assess skin integrity regularly Signup and view all the answers

What characteristic is shared by alkylating agents and nitrosureas in chemotherapy?

Both alter DNA structure Signup and view all the answers

What is a common side effect of antimetabolites in chemotherapy?

Proctitis Signup and view all the answers

In chemotherapy, what does 'extravasation' refer to?

The leakage of chemotherapy drugs into surrounding tissue Signup and view all the answers

What type of chemotherapy drug acts by binding to DNA and preventing RNA synthesis?

Antitumor antibiotics Signup and view all the answers

What is an essential aspect of nursing management during radiation therapy?

Educating patients about the absence of pain during treatment Signup and view all the answers

Which side effect is most commonly associated with alkylating agents in chemotherapy?

Gonadal suppression Signup and view all the answers

What should be done immediately if extravasation of a vesicant is suspected?

Stop the administration and aspirate the vesicant Signup and view all the answers

Which of the following is a primary use for chemotherapy?

To destroy systemic malignancies Signup and view all the answers

Which type of chemotherapeutic agent is known for causing bone marrow suppression as a side effect?

Both A and B Signup and view all the answers

Which statement is true regarding the administration of vesicants in chemotherapy?

Only specially trained personnel should administer them. Signup and view all the answers

What is an expected side effect of hormonal agents in chemotherapy?

Fluid retention Signup and view all the answers

Study Notes

Definition of Terms

Dysplasia is abnormal cell growth where cells differ in size, shape or arrangement.
Neoplasia is uncontrolled cell growth with no physiological demand.
Cytokines are substances produced by immune cells to enhance the immune system.
Myelosuppression is the suppression of the blood cell producing function of the bone marrow.
Nadir is the lowest point of white blood cell count after therapy that affects the bone marrow.
Neutropenia is an abnormally low neutrophil count.
Palliation provides relief of symptoms associated with cancer.
Stomatitis is inflammation of the oral tissues often associated with chemotherapy.
Thrombocytopenia is a decrease in circulating platelets, increasing the risk of bleeding.
Vesicant is a substance that can cause tissue necrosis and damage, especially when extravasated (leaked outside a blood vessel).
Xerostomia is a dry mouth caused by decreased function of salivary glands.
Alopecia is hair loss.
Cure is prolonged survival and disappearance of all evidence of a disease, so that the patient has the same life expectancy as anyone else in their age group.

Proliferative Patterns

Several patterns of cell growth exist: hyperplasia, metaplasia, dysplasia, anaplasia, and neoplasia.
The growth of cancerous cells are described as malignant neoplasms.
The degree of anaplasia (lack of cell differentiation) determines malignant potential.

Normal Cells vs Cancer Cells

Normal cells have a specific structure and function and are well differentiated. They have a limited life span.
Cancer cells are poorly differentiated or undifferentiated. They have an unlimited life span and are able to metastasize (spread).

Oncology Nursing

Oncology nursing is a broad field that encompasses cancer prevention and end-of-life care.
Oncology nurses care for and educate cancer patients.
Oncology nurses work in a multidisciplinary team across various settings such as inpatient wards and bone marrow transplant units.

Epidemiology

Cancer can occur at any age, but 75% of cancer patients in the Philippines are 50 years old and above.
Cancer is the 3rd leading cause of death in the Philippines.
Breast cancer is the most common cancer in the Philippines, with 16% of 50,000 cases resulting in death.
Lung cancer is the leading cause of cancer death for Filipino men, and was the leading cause of cancer death in the country before breast cancer.

Pathophysiology of the Malignant Process

Cancer begins when an abnormal cell is transformed by mutation of the cellular DNA.
The abnormal cell forms a clone and proliferates abnormally.
The abnormal cell ignores growth-regulating signals in its environment.
Cancer cells acquire invasive characteristics and changes occur in surrounding tissues.
Cancer cells infiltrate the tissues and gain access to lymph and blood vessels, spreading to other parts of the body (metastasis).
Cancer is not a single disease, but a group of diseases with differing causes, manifestations, treatments and prognoses.

Tumors and Tissue Types

Benign tumors do not spread to distant sites and are encapsulated. They are usually slow-growing and well-differentiated.
Malignant tumors are not encapsulated and can spread to distant sites (metastasize). They are usually fast-growing and poorly-differentiated, and can infiltrate surrounding tissues.

Characteristics of Benign vs Malignant Neoplasms

Benign tumors: Well-differentiated, grow by expansion, slow growing, does not metastasize, usually localized, causes little tissue damage, does not usually cause death.
Malignant tumors: Undifferentiated, grows at the periphery and infiltrates surrounding tissues, variable rate of growth, does metastasize, generalized effects such as anemia, weakness, weight loss, causes tissue destruction, usually causes death.

Characteristics of Malignant Cells

Cell membranes are altered, affecting fluid movement.
Cell membranes contain tumor-specific antigens, which develop as cells become less differentiated over time.
Cell membranes have less fibronectin, making them less cohesive and less likely to adhere to adjacent cells.
Nuclei are often large, irregular and pleomorphic (different in size and shape).
Nucleoli (structures that contain RNA within the nucleus) are larger, possibly due to increased RNA synthesis.
Chromosomal abnormalities are usually found.
Mitosis is more frequent.

Invasion and Metastasis

Invasion – the growth of a primary tumor into the surrounding host tissues.
Metastasis – The spread of malignant cells from the primary tumor to distant sites.

Invasion

Mechanical pressure exerted by rapidly proliferating neoplasms may force finger-like projections of tumor cells into surrounding tissues and interstitial spaces.
Since malignant cells are less adherent, they may break off from the primary tumor and invade adjacent structures.

Metastasis

Cells/emboli can be shed from the primary tumor, traveling within the body cavity and “seeding” the surfaces of other organs.
Most commonly, tumor emboli enters the lymph channels by way of interstitial fluid that communicates with lymphatic fluid.

Etiology (Causes of Cancer)

Viruses and Bacteria
Physical Agents
Chemical Agents
Genetic and Familial Factors
Dietary Factors
Hormonal Agents

Viruses and Bacteria

Viruses can incorporate themselves in genetic structure of cells, altering future generations of that cell population.
Epstein-Barr virus is highly associated with Burkitt’s Lymphoma and Hodgkin’s disease.
Herpes Simplex virus is associated with dysplasia and cancer of the cervix.
Hepatitis B is implicated in cancer of the liver.
HIV is associated with Kaposi’s Sarcoma.

Physical Agents

Exposure to ultraviolet sun rays, especially to fair skinned people, can increase the risk for skin cancer.
Exposure to ionizing radiation can increase cancer risk.

Chemical Agents

Tobacco smoke is thought to be the single most lethal chemical carcinogen.
Other chemical agents include aromatic anilines, pesticides, formaldehydes, arsenic, soot, tars, asbestos, lime, betel nut, cadmium, chromium compounds, nickel and zinc ores, beryllium compounds and polyvinyl chloride.

Genetic and Familial Factors

Most cancers appear to run in families. This may be due to genetics, shared environment, or cultural/lifestyle factors.

Dietary Factors

Dietary factors are related to 35% of all environmental cancers.
Risk for cancer increases with long term ingestion of carcinogens or co-carcinogens, OR chronic absence of proactive substances in the diet.
Obesity is associated with various cancers, such as endometrial, breast, colon, kidney and gallbladder.

Dietary Factors: Increased Cancer Risk

Increased risk: Fats, alcohol, salt-cured or smoked meats, foods with nitrates/nitrites, high caloric intake.

Dietary Factors: Decreased Cancer Risk

Decreased risk: high-fiber foods, cruciferous vegetables (cabbage, broccoli, cauliflower) carotenoids (carrots, tomatoes, spinach, dark leafy vegetables).

Hormonal Agents

Tumor growth may be promoted by disturbances in hormonal balance.

Immune System

The human immune system can detect the development of malignant cells and destroy them before cell growth becomes uncontrolled.
When the immune system fails to identify and stop the growth of malignant cells, clinical cancer develops.
Immunoincompetent patients (patients who receive immunosuppressive therapy, patients with immunodeficiency diseases like AIDS) can have increased risk for cancer.

Immune System: Normal Immune Response

The immune system recognizes as foreign certain antigens on the cell membranes of many cancer cells.

Screening

Screening is offered selectively to patients and discussed thoroughly with the patient and family.
Factors considered in screening include: family history or genetic predisposition, presence or absence of symptoms, the potential risks and benefits of screening, the ability to detect cancer at an early stage, and the patient's acceptance of the postoperative outcome.

Surgery

Palliative surgery aims to relieve symptoms and improve quality of life when a cure is not possible. The goals of palliative surgery are to make the patient as comfortable as possible, and to promote a satisfying and productive life for as long as possible. The patient and family define quality of life. The goal is to reduce complications, and to relieve symptoms such as ulcerations, obstructions, hemorrhage, pain, and malignant effusions.
Reconstructive surgery may follow curative or radical surgery. It improves function or obtains a more desirable cosmetic effect. Patients are informed about the possibility of reconstructive surgery options before the primary surgery by the surgeon who will perform the reconstruction. This may be indicated for breast, head, neck, and skin cancers.

Nursing Management in Cancer Surgery

Patients undergoing surgery are often anxious about the procedure, possible findings, limitations, changes in normal body function, and prognosis. Provide education and emotional support by assessing the patient and family needs, and exploring fears and coping mechanisms. Encourage them to take an active role in decision making when possible.
When the patient or family asks about the results of diagnostic testing, the nurse's response is guided by the information the physician previously conveyed to them. The patient and family may ask for clarification of information provided by the physician, especially if they were anxious at the time.
After surgery, the nurse assesses the patient’s responses to the surgery and monitors for possible complications such as infection, bleeding, thrombophlebitis, wound dehiscence, fluid and electrolyte imbalance, and organ dysfunction.### Radiation Therapy
Radiation therapy uses high-energy radiation to destroy cancer cells or slow down their growth.
Higher energy levels allow for deeper penetration into the body, targeting tumors more effectively.
Internal radiation involves inserting a radioisotope into a specifically positioned applicator after verifying its position using x-ray.
Radioisotopes remain in place for a prescribed period and are then removed.
Common side effects of radiation therapy include altered skin integrity, alopecia, erythema, desquamation, xerostomia, loss of taste, dysphagia, thrombocytopenia, leukopenia, fatigue, malaise, and anorexia.
Toxicity may be increased when radiation therapy is administered concomitantly with chemotherapy.

Nursing Management for Radiation Therapy

Nurses are responsible for explaining the radiation therapy procedure to the patient and family.
Nurses educate patients about the equipment used, the duration of the procedure, and any potential immobilization required during the procedure.
Patients should be informed that there is no pain during the procedure.
If radioactive implants are used, nurses must inform patients and families about restrictions placed on visitors, healthcare personnel, and other radiation procedures.
Nurses should assess the patient’s nutritional status and general well-being.
Nurses should assess skin frequently for changes and protect it from irritation.
Patients are instructed to avoid using ointments, lotions, or powders on the radiation area.
Gentle oral hygiene is essential to remove debris, prevent irritation, and promote healing.
Nurses provide reassurance by explaining that common symptoms are a result of treatment and do not indicate deterioration or progression of the disease.

Chemotherapy

Antineoplastic agents, also known as chemotherapy drugs, are used to destroy tumor cells by interfering with cellular functions and reproduction.
Chemotherapy is primarily used to treat systemic disease as opposed to lesions that are localized (amenable to surgery or radiation).
Each time a tumor is exposed to chemotherapy, a percentage of tumor cells, depending on the dosage, is destroyed.
Repeated dosages of chemotherapy are necessary over a prolonged period to achieve tumor regression.
The goal of chemotherapy treatment is to eradicate enough tumor cells so that the remaining cells can be destroyed by the body's immune system.

Classification of Chemotherapeutic Agents

Different types of chemotherapy drugs have unique mechanisms of action and side effects.
Alkylating agents work by altering DNA structure, initiating breaks in DNA, and cross-linking DNA strands. Common side effects include bone marrow suppression, nausea, vomiting, stomatitis, alopecia, gonadal suppression, and renal toxicity.
Nitrosureas have a similar mechanism of action to alkylating agents and can cross the blood-brain barrier. Common side effects include myelosuppression, nausea, and vomiting.
Topoisomerase I inhibitors induce breaks in DNA by binding to the topoisomerase I enzyme, preventing cells from dividing. Common side effects include bone marrow suppression, diarrhea, nausea, vomiting, and hepatotoxicity.
Antimetabolites interfere with the biosynthesis of metabolites or nucleic acids necessary for cell function. Common side effects include nausea, vomiting, diarrhea, bone marrow suppression, proctitis, stomatitis, renal toxicity, and alopecia.
Antitumor antibiotics interfere with DNA synthesis by binding to DNA and prevent RNA synthesis. Common side effects include bone marrow suppression, nausea, vomiting, alopecia, anorexia, and cardiac toxicity.
Mitotic Spindle Poisons disrupt cell division:
- Plant Alkaloids arrest metaphase by inhibiting mitotic tubular formation. Common side effects include bone marrow suppression, neuropathies, and stomatitis.
- Taxanes arrest metaphase by inhibiting tubulin depolymerization. Common side effects include bradycardia, hypersensitivity, bone marrow suppression, alopecia, and neuropathies.
Hormonal agents bind to hormone receptor sites, altering cellular growth and blocking the binding of estrogen to receptors, inhibiting RNA synthesis. Common side effects include hypercalcemia, jaundice, increased appetite, masculinization, feminization, sodium/fluid retention, nausea, vomiting, and vaginal dryness.

Chemotherapy - Extravasation

Extravasation is a serious complication that can occur when vesicants are administered intravenously.
Vesicants are drugs that cause tissue necrosis and damage to underlying tendons, nerves, and blood vessels if they are deposited into the subcutaneous tissue.
Only trained physicians and nurses should administer vesicants.
If extravasation is suspected, administration is stopped, ice is applied to the site (unless the vesicant is a vinca alkaloid), and a neutralizing solution is injected.

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This quiz tests your knowledge of important oncology terms and their definitions, such as dysplasia, neoplasia, and myelosuppression. Understanding these terms is crucial for anyone studying cancer treatment and its effects. Challenge yourself to see how well you grasp these concepts!