Sir Siroy
Cellular Aberration
Group of disorder characterized by abnormal cell
growth and the ability to metastasize with potential
killing the host
Term cancer refers to the group of disease in
which cells grow and spared unrestrained throughout
the body
Normal cells mutate into abnormal cells that take
over normal tissue, eventually harming and
destroying the host
Latin word Carab cancer
Synonymous with neoplasm
Biology of cancer
Cell is the functional unit of the body in humans and
animals
The type of cell: EUKARYOTIC (contains nucleus)
Whist bacteria are prokaryotic
Being multi-cellular humans are made from
100,000,000,000,000 cells, all are derived from a
single fertilized ovum
Cancer
Single word, incorporates a vast diversity of diseases
since there are as many tumor types as there are cell
types in the human body.
It is not a single disease, but a group of
heterogeneous disease that share common biologic
properties (e.g. clone cell growth and invasive
ability)
Cancer research revolution has also demonstrated
that all cancers are genetic and share common
MOLECULAR PATHOENSIS
All CA are the result of mutations in oncogenes. Each
specific cancer occurs thru mutation in specific genes
Oncogene a gene that played a normal role in the cell as a
proto-oncogene and that has been altered by mutation and now
may contribute to the growth of a tumor
-it is a gene that has potential cause cancer
Gene the basic biological unit of heredity a segment of DNA
needed to contribute to a function
Proto-oncogene a normal gene that can become an oncogene
due to mutations
-To help regulate cell growth and differentiation
Chromosomes thread like linear stand of DNA and
associated proteins in the nucleolus of eukaryotic cells that
carries the genes and functions in the transmission of heredity
information.
II.
III.
IV.
Cell-cycle Time
The amount to time regulated for a cell to move from
one mitosis to another mitosis, or the sum of M, G1,
S, G2
The length of the total cell cycle varies with the
specific type of cell
A common misconception is that the rate of Cancer
cells proliferation is faster than that of a normal cell.
Usually cancer cells proliferate at the same rate as the
normal cells of the tissue or origin
Acquired
(environmental)
DNA damaging
agents
Chemicals
Radiation
Viruses
Activation growth
promoting oncogenes
Normal Cell
DNA
damage
Failure of
DNA Repair
Mutation in
the genome
of somatic
cells
Inactivation of
tumor
suppressor
genes
Unregulated cell
proliferation
Alteration in
genes that
requires
apoptosis
Decreased
apoptosis
Clonal Expansion
Angiogensis
Additional
mutation
Escape from
immunity
Tumor progression
Malignant
neoplasm
Invasion of
metastasis
Theories of Carcinogensis
Proposes the process of transforming a normal cell
into a cancer cell
Consists of stages:
I.
II.
III.
Initiation
Cells are exposed to an initiating
agent or carcinogen that makes
them susceptible to manage
transformation
Initiating agents: Chemical,
biological, physical agents, viral,
environmental, lifestyle, genetic
factors, theses are capable of
producing irreversible changes in
the DNA of a cell
Promotion
Promoting agents or
cocarcinogenscause unregulated
accelerated growth in previously
initiated cells.
Is reversible if the promoting
agents are removed during agents
of carcinogenesis
Examples are hormones, plants
products, chemicals and drugs
Chemical carcinogensare called
complete carcinogens because they
can initiate and promote malignant
transformation
Ex: Cigarette
The effect of cocarcinogensmay be
inhibited by certain cancer
reversing or cancer-suppressing
agents.
EX: Vitamins, mineral,
caretenoids, flavonoids, or
certain host characteristics
(eg. Immune function,
age, hormonal factors) or
both.
Progression
Tumor cells acquire malignant
characteristics that include changes
in growth rate invasive potential,
metastatic frequency, morphologic
traits, and responsiveness to
therapy.
(2nd Day)
Immunology and epidemiology
Carcinogenic factors it is becoming increasingly evident
that cancer occurs because of interactions among multiple risk
factors of repeated exposure to a single carcinogenic agent
Risk factors of Cancer:
Having risk factor for cancer means that a person is more
likely to develop the disease at some point in his/her
life.However, having one or more risk factors does not
necessary mean that a person will get cancer. Some people
with one or more risk factors never develop the disease, while
other people who so develop cancer have no apparent risk
factors. This has to do with the pt IMMUNE SYS.
1.
2.
6.
7.
-Fair complication
-Occupational exposure
Risk factors of Colonic Cancer:
-Personal/family hx of polyps
-high fat diet and/or low fiber diet
-history of ulcerative colitis
-Age: > 50 years
Risk factors of Uterine/endometrial Cancer:
-estrogen replacement therapy
-early men
TEN LEADING SITES OF CANCER ON 1998 BOTH
SEXES, PI
Disease
Number
%
Lung
11,123
15.6
Breast
9436
13.2
Liver
5,249
7.3
Cervix
4,536
6.3
Leukemia
3,147
4.4
Colonn
2,963
4.1
Thyroid
2,584
3.6
Stomach
2,563
3.6
Nasopharynx
2,200
3.1
Lymphomas
2,088
2.9
_________________________________________________
-pregnancy
-lactation.
CERVICAL CANCER
-often asymptomatic
-abnormal vaginal bleed (e.g. post-coital bleeding)
EARLY DETECTION:
-paps smear is the primary screening tool for women over age
18.
-Paps smear should be done in between menses (2 weeks after
menses). A woman should not douche, have intravaginal
medications nor have sexual intercourse 24 hours prior to test.
-should be done annually for 2 consecutive years and at least
every 3 years until age 65 for those with normal findings
-for persons at high risk, it should be done yearly. This include
those who are: sexually active, have multiple partners,
commercial sex workers.
COLON RECTAL CANCER
-change in stool
-rectal bleeding
-pressure on the rectum
-abdominal pain
EARLY DETECTION:
-annual digital rectal exam starting at age 40
-annual stool blood test starting at age 50
-annual inspection of colon
PROSTATE CANCER
Symptoms of urethral obstruction:
-urinary frequency
-nocturia
-decrease in stream
-post-void dribbling
EARLY DETECTION:
-digital rectal exam for men
-Prostate specific antigen (PSA) determination a blood test,
confirms diagnosis.
LUNG CANCER
-persons with a long history of smoking and/or smoking 2 or
more packs of cigarette a day
-chronic cough or nagging cough
-dull intermittent, localized pain
-history of wt loss
EARLY DETECTION
-CXR q6months for patients who have history of smoking 2
packs a day
-sputum cytology
DIAGNOSTIC EVALUATION, STAGING, AND NURSING
RESPONSIBILITIES.
LUNG CANCER
-a. starndard roentgenogram or x-ray on chest. Detect any
abnormalities in the lungs.
Nursing responsibilities
-avoid excessive exposure of client and self
-remove radiopaque objects that can interfere with the results
-explain procedure to client.
-b. sputum cytology- examine a sample of sputum under a
microscope to determine whether abnormal cells are present
Nursing responsibilities