Pathopahysiology

HOST AGENT ENVIRONMENT

F.M. 47 y.o
Tobacco smoker carcinogens
HFD asthma
History of Pulmonary Tuberculosis
Engages in plastic and coal
burning Acts on proto oncogenes
Occasional drinker
Stressful lifestyle
less vegetable diet Activation of oncogene and Inactivation
of tumor suppressor genes

Initiation phase.Carcinogen damages

DNA. Affects structure and function of
cell
carcinogenesis
Promotion phase.Additional assaults
to cell causing further damage

Progression phase. Cell increases in

malignancy in appearance and
behavior.

Antigens on cancer cells take various

forms

Some cancer cells are coated with Some cancer cells express antigens
fibrin and resemble normal cells present on normal cells
 Failure of immune system to
recognize cancer cells as foreign

Heterogenous population of malignant cells with

varying degrees of metastatic potential

Increased tumor size

Increased tissue pressure Increased mechanical expansion

obstruction due to tumor Cells at the center become

(right bronchus) very hypoxic

Tumor enlarges through blood vessels Stimulated production of

proangiogenic molecules,
exceeding antiangiogenic Cancer cells detach from primary tumor
Tumor breaks through pleural sac molecules through cell shedding

Shifting of fluid to alveolar sacs angiogenesis Migrate via lymph or blood circulation or by
direct extension
Hydrostatic pressure continues to rise
Entrapment of cancer cells through a clump,
Fluid shifts into pleural spaces adherence to cells at new site, binding to
exposed basement membrane
Pleural effusion
Continued growth and proliferation at the
S/S: Dyspnea RR= 32 CPM metastatic site
non productive cough
Diminished breath sound
Orthopneic angiogenesis
Stabbing pain at right upper back
Cancer cells established at secondary site/s
 Increased tumor burden in the body

Obstruction of the Interference with blood Increased energy expenditure and few metabolic
Pressure on surrounding Distortion of lumen of vessels, supply of surrounding resources for normal cells
organs and nerves surrounding tissue intestines, ureters,and tissues
s/s pain so on
Disturbance of body metabolism and parasitic
use of body’s nutritional supplies

Depleted fat stores, vitamin deficiencies Protein catabolism

Interfere with organ function (at
secondary sites) Loss of adipose tissues Skeletal muscle breakdown

Activation of inflammatory
response Progressive body wasting and decreased
functioning

Anorexia, weight loss, weakness, fatigue,

Inflammatory response becomes malabsorption, paraneoplastic endocrine
systemic secretions ..etc
Alters perfusion, disturbing oxygen
General physical debility
supply and demand, increased
metabolism

Gradual destruction of organ/s

Prolonged systemic inflammatory

response

Multiple organ system failure

death