Define hypertrophy
increase in the size of NL cells
define atrophy
shrinkage of cell size
define hyperplasia
increase in number of NL cells
define metaplasia
conversion from NL pattern of differentiation of one type of cell into another type of cell not NL for that tissue.
define dysplasia
alteration in size, shape, appearance, and distribution of cells
define anaplasia
disorganized, irregular cells that have no structure and have loss differentiation. result is almost always malignant
define neoplasia
ABN cell growth (tumor)
Where do mature cells of the trachea, lungs, and epithelium differentiate from?
endoderm
Where do mature cells of the muscles, bones, and connective tissue differentiate from?
mesoderm
where do mature cells of the brain, skin, and glands differentiate from?
ectoderm
State and describe the 3 factors that cause the development of cancer.
1. lost intracellular equilibrium: cells divide indiscriminately d/t mutations
2. loss of contact inhibition: cells invade other cell's space (metastasis)
3. loss of differentiation: cells lose specialized characteristics of function & revert back to more
What are the 3 stages of cancer development?
1. initiation
2. promotion
3. progression
Describe what happens in the initiation process of ca development.
The target cell is altered by some type of outside influence (virus, hormone, chemicals, radiation, genetics). The cell then becomes cancerous.
Describe what happens in the promotion process of ca development.
Ca cell starts to proliferate/multiply. At this stage, the body probably will not recognize the ca cell as being ABN.
Describe what happens in the progression process of ca development.
Ca cells have not been attacked by the immune system, and s/s of clinical disease begin to appear; regional spreading and metastasis occurs.
What are the 4 common metastasis sites?
Organs that filter the blood: lungs, kidneys, liver, brain
When does the ability to metastasize develop?
when the tumor develops it's own blood supply.
What are tumor-associated antigens (TAA)?
Ca cells may have altered cell surface antigens as a result of malignant transformation
What defense mechanisms act directly on Ca cells and destroy them (4)?
1. cytotoxic T cells
2. natural killer cells
3. macrophages
4. B lymphocytes
What is the body's response to TAAs?
immunologic surveillance
lymphocytes continually check cell surface for antigens so they can detect and destroy ABN cells
Describe the tumor escape mechanism.
tumor cells have "blocking antibodies" that cover up the TAA so the body's immune system does not recognize cells as ABN (they cannot read the TAAs)
List the characteristics of a benign neoplasm (6).
1. well differentiated
2. usually encapsulated (easily removed)
3. expansive mode of growth
4. similar to parent/origination cell
5. METASTASIS IS ABSENT
6. rarely recur once removed
List the characteristics of a malignant neoplasm (7).
1. can range from well differentiated to undifferentiated
2. ABLE TO METASTASIZE
3. is infiltrative and capable of expansive growth
4. frequent recurrence
5. has its own blood supply
6. rarely encapsulated
7. becomes less like the parent cell-makes more d
Where do carcinomas originate from?
embryonal ectoderm (skin & glands), and the endoderm (mucous membrane of respiratory tract, GI & GU tracts)
Where do sarcomas originate from?
embryonic mesoderm (connective tissue, muscle, bone, and fat)
Where to lymphomas and leukemias originate from?
the hematopoietic system (where blood cells are produced)
Describe how a cancer is classified histologically.
the appearance of cells and degree of differentiation are evaluated to determine how closely cells resemble tissue of origin.
Describe ABN cells that are classified as "grade 1".
cells differ slightly from NL cells and are well differentiated
Describe ABN cells that are classified as "grade 2".
cells are more ABN and moderately differentiated
Describe ABN cells that are classified as "grade 3".
cells are very ABN and poorly differentiated
Describe ABN cells that are classified as "grade 4".
cells are immature, primitive, and undifferentiated; the cell of origin is difficult to determine.
List and describe the 5 clinical staging classifications of cancer.
0 = cancer in situ (at infant state)
1 = tumor limited to tissue of origin; localized tumor growth
2 = limited to local spread
3 = extensive local and regional spread
4 = metastasis; ca found in multiple sites
Early cancer detection tips for colon/rectal ca (3).
1. occult blood test yearly > 50 y/o
2. digital rectal exam and flex sig Q 5 yrs > 50 y/o
3. colonoscopy Q 10 yrs
What are the 7 warning signs of ca?
Spell CAUTION
C = change in bowel or bladder habits
A = a sore that does not heal (ie mole, skin tag)
U - unusual bleeding or d/c from any body orifice
T = thickening or a lump in the breast or elsewhere
I = indigestion or dysphagia
O = obvious change in
What are early detection tips for prostate cancer?
1. yearly digital rectal exam > age 50
2. yearly PSA test at age 50
What is the only definitive way to dx cancer?
biopsy
State 9 general/common SE's to ca treatments.
1. bone marrow suppression
2. fatigue & muscle weakness
3. N/V/D/C
4. stomatitis
5. hair loss
6. Pulmonary fibrosis & pneumonia
7. reproductive problems
8. arrythmias
9. CHF
What is the most common SE of chemotherapy?
myelosuppression (bone marrow suppression)
What are the nutritional complications of ca?
1. malnutrition
2. altered tast sensation
Why are secondary malignancies usually resistant to therapy?
B/C they are often brought about by chemo or radiation, they are less susceptible to further treatments; they are harder to treat.
Describe the 4 s/s of superior vena cava syndrome.
1. facial and periorbital edema
2. distention of veins of head, neck and chest
3. seizures
4. HA
What is superior vena cava syndrome?
obstruction of vena cava by tumor or thrombosis.
What are the 3 s/s of sopinal cord compression?
1. intense localized, persistant back pain
2. motor weakness
3. changes in bladder or bowel function
What are the 7 s/s of third spacing syndrome?
1. hypovolemia
2. hypotension
3. tachycardia
4. low central venous pressure
5. decreased urine output
6. changes in LOC
7. decreased cardiac output
What are the 9 s/s of hypercalcemia?
1. apathy
2. depression
3. fatigue
4. muscle weakness
5. EKG changes
6. polyuria
7. nocturia
8. anorexia
9. N/V
Why can hypercalcemia be life threatening?
can lead to fatal arrythmias
At what point are sodium levels emergent?
when they reach 120 or below. 116 is incompatible with life.
What is tumor lysis syndrome?
it is triggered by chemo's rapid destruction of large numbers of tumor cells. Increased phosphage causes hypocalcemia which can result in renal failure.
What are the 4 hallmark s/s of tumor lysis syndrome, and when does it usually occur?
1. hyperuricemia (high uric acid)
2. hyperphosphatemia
3. hyperkalemia
4. hypocalcemia
5. usually occurs within 24-48 hrs after chemo initiation.