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Cancer Essay

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Oncology Nursing Outline
Oncology (from the Ancient Greek onkos - meaning bulk, mass, or tumor, and the suffix -logy - meaning "study of") is a branch of medicine that deals with tumors (cancer). A medical professional who practices oncology is an oncologist.Oncology is concerned with:

The diagnosis of any cancer in a person
Therapy (e.g., surgery, chemotherapy, radiotherapy and other modalities) Follow-up of cancer patients after successful treatment
Palliative care of patients with terminal malignancies
Ethical questions surrounding cancer care
Screening efforts:
o of populations, or
o of the relatives of patients (in types of cancer that are thought to have a hereditary basis, such as breast cancer. A. Characteristics of Normal Cells

The Biology of Normal Cells
1) Have limited cell division
2) Undergo Apoptosis
3) Show specific morphology
4) Perform specific differentiated functions
5) Adhere tightly together
6) Non migratory
7) Grow in orderly and well regulated manner
8) Are euploid

* Normal cell growth (cell cycle) consists of 5 intervals or phases * Differentiation – refers to the process whereby cells develop specific structures and functions in order to specialize in certain tasks * Apoptosis – cell suicide, normal event.

* Cellular adaptation
a. Hypertrophy – refers to an increase in size of normal cells b. Atrophy – refers to the shrinkage of cell size
c. Hyperplasia – refers to an increase in the number of normal cells d. Metaplasia – refers to a conversion from the normal patters of differentiation of one type of cell into another type of cell not normal for that tissue. Replacement of other mature cell. e. Dysplasia – refers to an alteration in the shape, size, appearance and distribution of cells (reversible) f. Anaplasia – refers to disorganized, irregular cells that have nor structure and have loss of differentiation; the result is always malignant (undifferentiated cell)

B. Evolution of Cancer Cells
1. Cancer – refers to a disease whereby cells mutate into abnormal cells that proliferate abnormally Neoplasia – refers to an abnormal cell growth or tumor
- a mass of new tissue functioning independently and serving no useful purpose 2. Invasion – occurs when cancer cells infiltrate adjacent tissue surrounding the neoplasm 3. Metastasis – occurs when malignant cells travel through the blood or lymph system and invade other tissues and organs to form a secondary tumor C. Characteristics of malignant cells

1. Rapid cell division and growth: regulation of the rate of mitosis is lost 2. No contact inhibition: cells do not respect boundaries of other cells and invade their tissue areas 3. Loss of differentiation: cells lose specialized characteristics of function for that cell type and revert back to an earlier, more primitive cell type

4. Ability to migrate (metastasize): cells move to distant areas of the body and establish new site malignant lesions (tumors) 5. Alteration in cell structure: differences are evident between normal and malignant cells with respect to cell membrane, cytoplasm and overall cell shape 6. Self-survival

a. may develop ectopic sites to produce hormones needed for own growth b. can develop a connective tissue stroma to support growth c. May develop own blood supply by secreting angiotensin growth factor to stimulate local blood vessels to grow into tumor

D. Epidemiology of Cancer
1. Incidence of cancer
a. Cancer affects every age group though most cancer and cancer deaths occur in people older than 65 years of age b. Cancer ranks 3rd as the cause of morbidity in the Philippines c. Highest incidence of all cancer is prostate cancer

d. Highest cancer incidence in males in order of frequency: prostate cancer, lung cancer and colorectal cancer e. Highest cancer incidence in females in order of frequency: breast cancer, lung cancer and colorectal cancer

Common sites of cancer and their sites of metastasis

Cancer Type Sites of Metastasis
1. Brain Cancer Central Nervous System
2. Breast cancer Brain
Regional lymph nodes
3. Colon cancer Brain
Lymph nodes
4. Lung cancer Bone
Lymph nodes
Spinal cord
5. Prostate cancer Bladder

External factors causing CANCER
1. Chemical Carcinogens- over 1,000 chemicals are known to be carcinogenic • Alcoholic beverages (Liver, esophagus, mouth, breast colon) - serves as a promoter in cancers of the liver and esophagus - when combined with tobacco, the risks for other cancers are evenhigher • Anabolic Steroid (Liver)

• Arsenic (Lung; Skin)
• Asbestos (Lung; peritoneum)
• Benzene (Leukemia)
Diesel exhaust (Lung)
Hair dyes (bladder)
Pesticides (Lungs)
Sunlight (Skin; eyes)
Tobacco (Lungs; esophagus; mouth; pharynx; larynx)
smokeless tobacco (snuff and chewing tobacco) increases the risk of oral and esophageal cancers * long-term exposure to secondhand smoke increases the risk for lung and bladder cancers

2. Physical Carcinogens
– Radiation
– Chronic Irritation- GERD
3. Viral Carcinogens
- some viral infections tend to increase risk of cancer
Ex: Epstein Barr
Genital herpes
Hepatitis B
Human cytomegalovirus
4. Dietary Factors
- diets in high fat, low in fiber and those containing nitrosamines found in preserved meats and pickled foods promote certain cancers such as colon, breast, esophageal and gastric

Personal factors causing CANCER
1. Immune Functions
2. Age
a. Increased risk for people over age of 65
b. Factors attributed to cancer in elderly include hormonal changes, altered responses and the accumulation of free radicals
c. Age has been identified as the single most important factor related to the development of cancer 3. Gender
a. certain cancers are more commonly seen in specific genders ex: breast cancer –more common in female
colon cancer – more common in males
4. Genetic Risk
- 15% of cancers may be attributed to a hereditary component Ex: Breast, colon, lung, ovarian and prostate cancers
5. Race – can affect any population
- African-Americans experience a higher rate of cancer than any other racial or ethnic group

CARCINOGENESIS: Transformation of Normal Cells into Cancer Cells

1. Initiation – occurs when carcinogen damages DNA
- carcinogenesis cause changes in the structure and function of the cell at the genetic or molecular level. This damage may be reversible or may lead to genetic mutations if not repaired; however the mutations may lead immediately to cancer

2. Promotion – occurs with additional assaults to the cell, resulting in further geneticdamage 3. These genetic events result in a malignant conversion
4. Progression – the cells are increasingly malignant in appearance and behaviour and develop into an invasive cancer with metastases to distant body parts

Comparison of the Characteristics of Normal and Cancer Cells

Characteristic ...

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