Oncology Week 12 Lecture Notes PDF

Oncology week 12 \*Smoking is a risk factor that leads to cancer \*With patho of cancer there\'s altered cell growth and there\'s damaged DNA in the cells \*With normal cells they serve a purpose, there's nonmigratory, tight adherence, orderly growth, mitosis- division that occurs when the condit...

Oncology week 12 \*Smoking is a risk factor that leads to cancer \*With patho of cancer there\'s altered cell growth and there\'s damaged DNA in the cells \*With normal cells they serve a purpose, there's nonmigratory, tight adherence, orderly growth, mitosis- division that occurs when the conditions allow it, it\'s done in a pattern, smaller nucleus to cytoplasm ratio \*Cancer cells there is no useful purpose, harmful to the body and metastasized, loose adherence, no order to fill, continuously divide, they have a larger nucleus to cytoplasm ratio, and they contain abnormal chromosomes \* Division of cells is due to Onko genes that promote cell division, this begins when an abnormal cell is transformed by genetic mutation. \* They form a clone and proliferate, then they acquire invasive characteristics, they infiltrate surrounding tissue, and cells gain access to lymph and blood vessels. \*slide -- terms that may be seen in a case study Benign (oma)- means normal but not in the right place it doesn't infiltrate, it's usually harmless, but sometimes if the tumor grows in the wrong place, it can obstruct function. They are sometimes removed because it interrupts another organ function. (uterine fibroid that\'s benign would be removed). It is well differentiated (looks like the original tissue), encapsulated, and doesn\'t spread. Slow growth, metastasis, globalized no tissue damage does not usually cause death. (slide picture) Malignant (cinoma)- different forms of cell growth, always harmful, considered cancer, it may metastasize from the original site. It is undifferentiated, (no distinguishing features or bare resemblance to the original tissue) not encapsulated, infiltrates tissues there is variable growth, metastasis, usually have anemia, wt. Loss, extensive tissue damage, usually does cause death. Hyperplasia- there is an increase in number of cells, they can be normal or abnormal cells. Metaplasia- change of one type of cell into another, it involves effects on surrounding tissues. There are common pathways that have been found. If you have breast cancer it's going to spread to the bone, liver, and brain. Lung spreads to the brain, colorectal spreads to the liver, prostate spreads to the spine and lungs. Spreads through the lymphatic system through poor circulation from one organ to another, the blood stream is too turbulent for it to survive. Dysplasia- change in size, shape, and arrangement of normal cells INTO abnormal cell Anaplasia- changes in DNA there\'s that loss of differentiation, structural changes and they are irregularly shaped Neoplasia- uncontrolled cell growth Mitosis- cell growth, divide and multiply Apoptosis- programed cell death what cells are supposed to do (cancer cells somehow escape apoptosis) Angiogenesis- cancer developing its own blood supply as the tumor grows larger sometimes it has its OWN vascular supply (side note-some treatments talk about cutting of the blood supply to the tumor how it would help shrink the tumor talking about angiogenesis) Epidemiology-it occurs 1 out of 3 ppl living in north America. Depending on the type of cancer, it effects ppl of all ages, mostly over the age of 65 early detection is key. The leading cause of cancer in men is the lung, colorectal, prostate cancer. Women is lung, colorectal and breast. Gentetics cause cancer BRCA gene --breast, ovarian, and colon cancer (early detection) \* Can do early testing and screening the insurance may pay for extra screenings \* Biosis and bacteria that are thought to be a cause for cancer (HPV- associated with ovarian, throat and mouth cancer) Hepatitis B that is associated with the liver cancer Epstein bar is associated with lymphoma and nasopharyngeal cancer Dietary- alcohol, salts, cured meats, nitrates, processed meat and high calories factor that can cause cancer Hormonal factors such as being on(synthetic) estrogen can cause vaginal and cervical cancer Exposure to carcinogens, physical agents like UV, radiation, Radon (in the soil), chemical agents like tobacco, dyes, pesticides. Role of the immune system- body has its own way of protection from cancer cells, T cells- release of cytokines that attack invaders, B cells produce antibodies, natural killer cells and macrophages Failure of the immune system is because cancer goes unrecognized it doesn't stimulate that immune response; the tumor grows too large for the immunes system to manage it Prevention- \*primary- vaccines for HPV, hepatitis B, smoking cessation and avoiding secondhand smoke, reducing sun exposure, sunscreen spf15 or higher to prevent melanoma, reduce alcohol intake that is related to mouth, throat and esophageal cancer Need to increase fiber, antioxidants, maintain a healthy weight to prevent colon cancer, be aware of your environment, avoid known carcinogens \*Secondary Prevention-is aimed at early detection, regular screenings, PAP tests, PSA (prostate), breast self-exams Mammograms should start at 40 unless family history then starts at 35 Coloscopy is usually at age 50 (dependent on insurance company) \*Tertiary- care and rehab after cancer diagnosis has been made to prevent reoccurrence The impact of cancer- the destruction of normal tissue, can metastasize into vital organs, reduction in immunity in blood producing functions Myelosuppression affects the bone marrow due to treatments-decreased production of normal WBC, RBC, platelets where bone marrow is produces WBC at risk for infection RBC at risk for anemia Platelets risk for bleeding Altered GI structure and function, malnutrition, cachexic (really thin), motor and sensory deficits, if it invades the bone, brain, or compresses nerves, pain is a big factor, decrease respiratory function if the lungs are involved, can impair gas exchange Cancer patients undergo extensive testing to determine the Prescence of tumors, identify possible spread, evaluate the function involved with organs and body parts and obtain tissues and calls for analysis. Includes head to toe assessment, includes some imaging, include lab test, blood, tumor markers, CEA (carcinic) or PSA (prostate), they are just proteins needed to assess the presence of cancer if they are elevated then they would be we would look further for cancer, we could look at urine --bladder cancer (may have blood in the urine) We may look at other body fluid if someone has lung cancer, they develop hoarseness and plural effusions (that could have thoracentesis and test the fluid for cancer cells) can test different bodily fluids in different areas for cancer detection Tumor marking identification- PSA, CEA an analysis of the substance made by that tumor Diagnostic test - Mammography- xray of the breast, MRI, more detailed picture, could do sectioned images of body, Cat scan- cross sections, ultrasounds- could show possible tumors, Endoscopy the go down with the scope with a camera and can biopsy at the same time, could do nuclear medicine as well helps to visualize the tissues- bone, brain scan( injection of radioisotope substance) , PET scans- diagnosed with cancer then they would do this to see if the cancer has spread Sugar given because cancer loves sugar is shown as hotspots on pet scan Staging and grading has to do with TMN classification tumor-local involvement or invasion, Nodes involvement? Metastasis has it spread to another location Primary tumor the larger the size or more extent of the tumor the higher the stage is going to be. The more lymph node the more the stage has progressed Stage zero means carcinoma insitu meaning it is cancer but its encapsulated, so the chances of a better prognosis Stage 1,2,3-the higher the numbers indicate more extensive disease Stage 3 chances are it has spread to different locations vs stage 1 not so much Stage 4 cancer has spread to different organs and tissue, large amount of metastasis Grading 0- normal tissue, grade 4 no resembles of the tissue grading means how abnormal the cells are