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Oncology Nursing
Leading sites of new cancer cases - correct answer Male- prostate Female- Breast Leading cause of cancer deaths - correct answer Male- lung and bronchus Female- lung and bronchus without shape or differentiation, small and round - correct answer Anaplastic A Developmental gene expressed at an inappropriate time, capable of transforming a normal cell into a cancer cell - correct answer Oncogene cancer development; also called carcinogenesis - correct answer Oncogenisis substances that change the activity of a cell's genes so that the cell becomes a cancer cell. May be chemicals, physical agents, or viruses - correct answer Carcinogen COMMON CARCINOGENS - correct answer Alcohol Steroids Arsenic Asbestos Benzene Chemotherapy drugs Diesel exhaust formaldehyde new cell growth not needed for normal body growth - correct answer Neoplasm new, nonmalignant cell growth not needed for normal body growth - correct answer Benign neoplasm cancerous, new growth of cells by invasion that is not needed for normal growth and development
- correct answer Malignant neoplasm a tumor formed in a specific tissue as a result of a carcinogenic agent or event - correct answer Primary tumor a tumor formed as a result of breaking off from a primary tumor and spreading to distant sites (metastisis) - correct answer Secondary tumor
cell division by exact duplication
- Most tissues and organs stop growing by cell division after development is complete - correct answer Mitosis growth that causes tissue to increase in size by enlarging each cell-normal cells - correct answer Hypertrophy growth that causes tissue to increase in size by increasing the number of cells- cancer - correct answer Hyperplasia the amount of time it takes for a tumor to double in size by mitotic cell divisions - correct answer Doubling time the low white blood cell counts that occur after cancer chemotherapy- usually 7 to 10 days after administration - correct answer Nadir chemicals that can cause tissue damage on direct contact - correct answer Vesicant the period of time necessary for one cell to enter and complete one round of cell division by mitosis
- correct answer Generation time Characteristics of normal cells - correct answer - Limited cell division
- to develop normal tissue
- to replace lost or damaged normal tissue to ensure that each organ has adequate number of cells at their functional peak - correct answer Apoptosis specific appearance, size, shape - correct answer Show specific morphology Characteristics- continued - correct answer - Small nuclear-cytoplasmic ratio- size of nucleus is small
- Perform specific differentiated functions
- Adhere tightly together
- Are nonmigratory
- Grow in an orderly and well-regulated manner Characteristics- continued - correct answer - Contact inhibited- each cell divides only when some of its surface is not in direct contact with another cell
- Euploid- having 23 pairs of chromosomes Characteristics of abnormal cell growth
Carcinogenesis: Initiation - correct answer - Proto-oncogenes- specific early embryonic genes that controlled or regulated early rapid growth; remain as normal cellular genes, but have limited function after early embryonic life- usually "turned off"
- Initiation involves these proto-oncogenes being turned back on Carcinogenesis: Initiation 'cont. - correct answer - Carcinogens can penetrate a cell, change the DNA, and turn the genes off or on- inflicts mutations at specific sites on the cell's DNA
- A cancer cell must be able to divide to become a threat Carcinogenesis: Promotion - correct answer - Enhancement of growth
- Latency period- the time between a cell's initiation and the development of a tumor
- Latency may range from months to years
- Promoters may be hormones, drugs, or chemicals Carcinogenesis: Progression - correct answer - The tumor must develop its own blood supply
- Tumor angiogenesis factor(triggers blood vessel growth) Carcinogenesis: Metastasis - correct answer - Cells break off and establish their own colonies
- extension into surrounding tissues
- blood vessel penetration
- release of tumor cells
- invasion
- Local seeding- shedding of cancer cells in the local area of the primary tumor
- Bloodborne metastasis
- Lymphatic spread Common sites of metastasis - correct answer - Breast- bone, lung, liver, brain
- Prostate- bone, pelvic nodes
- Lung- brain, bone, liver, lymph nodes
- Colorectal- liver, lymph nodes
- Melanoma- GI, Lymph, lung, brain Classification of tumors by tissue type: Adeno - correct answer from epithelial glands Classification of tumors by tissue type: Chondro - correct answer from cartilage Classification of tumors by tissue type: Fibro- - correct answer from fibrous connective tissue
Classification of tumors by tissue type: Gilo- - correct answer from glial cells in the brain Classification of tumors by tissue type: Hemangio- - correct answer from blood vessels Classification of tumors by tissue type: Hepato- - correct answer from the liver Classification of tumors by tissue type: Leiomyo- - correct answer from smooth muscle Classification of tumors by tissue type: Lipo - correct answer from fat/adipose Classification of tumors by tissue type: Lympho - correct answer from lymph tissues Classification of tumors by tissue type: Melano- - correct answer from the pigment producing cells in the skin Classification of tumors by tissue type: Meningio- - correct answer From the meninges in the brain Classification of tumors by tissue type: Neuro - correct answer from the nerve tissue Classification of tumors by tissue type: Osteo - correct answer from the bone Classification of tumors by tissue type: Renal- - correct answer from the kidney Classification of tumors by tissue type: Rhabdo- - correct answer from the skeletal muscle Classification of tumors by tissue type: Squamous- - correct answer from the epithelial layer of skin, mucous membranes,and organ linings
Assessment considerations in the older client: Lung cancer- - correct answer - skin and mucous membranes, how many words between breaths, cough, hoarseness, smoking, exposure, SOB, activity intolerance, frothy sputum, pain, difficulty swallowing Genetic risk: Inherited cancers - correct answer breast, prostate, ovarian Genetic risk: Familial clustering - correct answer breast, melanoma Genetic risk: Bloom syndrome - correct answer leukemia Genetic risk: Familial polyposis - correct answer colorectal Genetic risk: Chromosomal - correct answer leukemia, breast Blood testing- - correct answer expensive, does not diagnose the presence of cancer Racial differences in cancer development- most common - correct answer - White- lung, breast
- Asian- breast, colorectal
- African American- lung, prostate
- Hispanic- prostate, breast Primary prevention - correct answer - Avoid known or potential carcinogens
- Modification of associated factors
- Removal of "at risk" tissues
- Chemoprevention- using drugs, chemicals, natural nutrients, or other substances to disrupt one or more steps important to cancer development
- Vaccination- Gardasil may prevent HPV Primary prevention: Chemoprevention may: - correct answer - Prevent formation of a carcinogen
- Block the action of a carcinogen on DNA
- Enhance elimination of a carcinogen
- Suppress carcinogenic action
- Antipromotion activity
- Suppression of progression Target populations for chemoprevention - correct answer - Healthy people with no known specific cancer risk --People at greater than normal risk because of increased environmental exposure or decreased immune function
- People with precancerous lesions
- People with a history of cancer Secondary prevention: Screening programs- - correct answer - Screening programs-
- Yearly mammogram and breast exam over 40
- Colonoscopy at age 50 and q 10 years
- Yearly fecal occult blood for all adults
- Yearly PSA and DRE for men over 50
- Pap smears every 2-3 years over 30 if they have had 3 normal tests in a row Yearly mammogram and breast exam over - correct answer 40 Colonoscopy at age - correct answer 50 and q 10 years Yearly fecal occult blood for - correct answer all adults
- Yearly PSA and DRE for men over - correct answer 50
- Pap smears every 2-3 years over - correct answer 30 if they have had 3 normal tests in a row Prevention - correct answer - Seek healthcare advice whenever one of the 7 warning signs of cancer are present
- Compliance with the treatment regimen
- Follow-ups are important
- Continue recommended screening practices
- Avoid carcinogens
- Exercise regularly
- Obtain adequate rest
- Reduce stress
- Assist clients to quit smoking
- Teach to limit dietary fat, smoked meats, & red meat THE SEVEN WARNING SIGNS OF CANCER: C-A-U-T-I-O-N - correct answer C- Changes in bowel or bladder habits A- a sore throat that does not heal U- unusual bleeding or discharge T- thickening or lump I- indigestion or difficulty swallowing O- obvious change in a wart or mole N- nagging cough or hoarseness
Primary tumor: no evidence of tumor - correct answer T Primary tumor: carcinoma in situ - correct answer Tis Primary tumor: increasing in size and extent - correct answer T1, T2, T3, T Regional lymph nodes: cannot be assessed - correct answer NX Regional lymph nodes: no metastasis - correct answer N Regional lymph nodes: Increasing involvement - correct answer N1, N2, N Distant Metastasis: cannot be assessed - correct answer MX Distant Metastasis: no distant metastasis - correct answer M Distant Metastasis: distant metastasis - correct answer M
