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Cancer Essay

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CANCER NURSING/ ONCOLOGY NURSING/ NEOPLASTIC DISORDERS/ CELLULAR ABERRATION/ ONCOLOGICAL DISORDERS/ ABNORMAL CELL GROWTH

I. Background
Cancer
* - is a scary word
- a diagnosis of cancer is frightening to most
people although reaction depend on the
particular diagnosis, location, stage,
treatment, effects on bodily function and
prognosis.

II. Pathophysiology
* The cell is the basic structural unit in plants and animals. Differentiated cells work together to perform specific functions. Cell regeneration occurs through cell division and reproduction. Abnormal changes in cells develop for many reasons. These abnormal cells reproduce in the same way as normal cells, but they do not have the regulatory mechanisms to control growth. Thus, abnormal cell growth proliferates in an uncontrolled and unrestricted way.

III.Definition
* Is a neoplastic disorder by abnormal, unrelated cell proliferation * Invades healthy tissues & compete with normal cells for O2, nutrients & space * Can involve all body organs with manifestations that vary according to the body system affected & type of tumor cells * Produces serious health problems such as impaired immune & hematopoetic (blood-producing) function, altered GI structure and function, motor and sensory deficits and decreased respiratory function.

III. Cell biology
* Cancer cells synthesize proteins and glucose more rapidly than do normal cells * Nuclei of cancer cells are abnormally large
* Adhesiveness of cancer cells attracts greater number of growth factors.

IV. Tumors (neoplasms)
* New growths of abnormal tissues are called neoplasms or tumors. * The first part of the tumor’s name indicates the particular cell or tissue. * The suffix –oma indicates it is a tumor.

Four Main Tumor Classifications according to the
tissue type are:
1. Carcinomas – cancers originating from the epithelial cells 2. Lymphomas – cancers originating from organs that fights infection 3. Leukemias – cancers originating from organs that form blood 4. Sarcomas – cancers originating from connective tissues such as bone or muscle

Tumors are classified according to their cell of origin
and whether their growth is benign (not invasive or
spreading) or malignant (invasive or spreading).

Characteristics of Benign and Malignant tumors
CHARAC-TERISTICS | BENIGN TUMORS | MALIGNANT TUMORS |
Speed of Growth | Slow, steady rate | Rapid rate, can be unpredictable | Mode of Growth | Remains localized | Invades surrounding tissue & metastasize to other tissues | Capsule | Encapsulated | Not encapsulated or rarely encapsulated | When palpated | Smooth, easily defined, movable | Have irregular borders and are immovable | Mostly found in | Less profuse blood supply | Greater than normal blood supply | Cell characteristics | Cells resemble the cells of the tissue origin | Cells cannot be readily identified as to tissue of origin | Extend of destruction | Only destroy normal tissue by compression or obstruction of normal tissue | Invade normal tissue and compete with normal cells for O2, nutrients; also destroy by compression and destruction | compression and destruction d) | Rare | More common |

Metastasis | Never occur | Very common |
Effect of neoplasm | Rarely fatal (not harmful) | Fatal if not treated (harmful) | Prognosis | Very good | Poor |

FOUR PRIMARY MECHANISMS BY WHICH THE NEOPLASMS SPREAD:
A. Vascular system – cancer cells penetrate vessels and circulate until trapped; may penetrate the vessel wall and invade adjacent organs & tissues. B. Lymphatic system – cancer cells penetrate the lymphatic system & are distributed along lymphatic channels C. Implantation – cancer cells implant into a body organ certain cells have an affinity for particular organs and body areas. D. Seeding – a primary tumor sloughs off tumor cells into a body cavity, such as the peritoneal cavity.

HOW CANCER METASTASIZES (SPREADING)?
-Cancer cells travel from primary site to more distant site through:
- blood vessels
- lymphatic system or by external means

Primary Site – is the area where is where malignant
cells first form
Secondary Site – or metastatic sites are regions to
which cancer cells have spread.

CA cells (from 1˚ site) secrete enzyme & motility factors ↓
Basement membrane in the blood vessels is disrupted

CA cells escape into circulation

Undetected cells move out of blood

Enzymes are secreted

Cell wall is cut

New tissue is invaded downstream

Chemical attraction occurs

Malignant cells target specific site

New site is invaded

Cell multiply

Metastatic tumor appears
(2˚ site)

Common Sites of Metastasis

BREAST CANCER
-bone
-lung

LUNG CANCER
-brain

COLORECTAL CANCER
-liver

PROSTATE CANCER
-bone
-spine and legs

BRAIN TUMORS
-central nervous system

CLASSIFICATION OF TUMOR CELLS

ORIGIN | MALIGNANT | BENIGN |
Skin | -Basal cell carcinoma-Squamous cell carcinoma -Malignant melanoma | -Papilloma-Nevus (mole) | Epithelium | Adenocarcinoma | Adenoma |
Muscle | Myosarcoma | Myoma |
Connective tissue -Fibrous Tissue -Adipose (fatty) Tissue -Cartilage bone | -Fibrosarcoma-Liposarcoma-Chondrosarcoma | -Fibroma-Lipoma-Chondroma | Nerve tissue | -Neurogenic sarcoma-Neuroblastoma-Glioblastoma | -Neuroma-Ganglioneuroma-Glioma | Bone marrow | -Multiple myeloma-Leukemia | |

V. Etiology
Damage to cellular deoxyribonucleic acis (DNA), causes cancer cells to develop. In many cases, the body repairs such damage; in cancer cells, The DNA remains damaged. Inherited cancers occur when the damage DNA passes to the next generation. In many instances, however, certain factors and agents contribute to the development of cancer. These factors called carcinogens.

A. Environmental factors
a. Virus – the cell changes that a virus incorporates into the genetic information may cause cancerous cell “oncovirus or oncogenic viruses ( e.g. Epstein-barr virus, Hep B virus and human papillomavirus).

b. Physical agents – prolonged exposure to sunlight, radiation and pollutants, chronic irritation/inflammation, tissue trauma. Electromagnetic fields from microwaves, power lines and cellular phones are other possible carcinogens, although study results related to such factors are conflicting.

c. Chemical agents – produce toxic effects by altering DNA str...

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