Concepts of Cellular Growth and Aberration

Glossary

alopecia:

hair loss

anaplasia:

cells that lack normal cellular characteristics and differ inshape and organization with respect to their cells of origin; usually,anaplastic cells are malignant.

biologic response modifier (BRM) therapy:

use of agents or treatment methodsthat can alter the immunologic relationshipbetween the tumor and the host toprovide a therapeutic benefit

biopsy:

a diagnostic procedure to remove asmall sample of tissue to be examinedmicroscopically to detect malignant cells

brachytherapy:

delivery of radiation therapythrough internal implants

cancer:

a disease process whereby cells proliferateabnormally, ignoring growthregulatingsignals in the environmentsurrounding the cells

carcinogenesis:

process of transforming normalcells into malignant cells

chemotherapy:

use of drugs to kill tumorcells by interfering with cellular functionsand reproduction

control:

containment of the growth of cancer cells

cure:

prolonged survival and disappearanceof all evidence of disease so that the patienthas the same life expectancy as anyoneelse in his or her age group

cytokines:

substances produced by cells of the immune system to enhance productionand functioning of components of the immune system

dysplasia:

bizarre cell growth resulting in cells that differ in size,shape, or arrangement from other cells of the same type of tissue

extravasation:

leakage of medication fromthe veins into the subcutaneous tissues

grading:

identification of the type of tissuefrom which the tumor originated and thedegree to which the tumor cells retain thefunctional and structural characteristics of the tissue of origin

hyperplasia:

increase in the number of cells of a tissue; most oftenassociated with periods of rapid body growth

malignant:

having cells or processes that are

characteristic of cancer

metaplasia:

conversion of one type of mature cell into another type of cell

metastasis:

spread of cancer cells from theprimary tumor to distant sites

myelosuppression:

suppression of the bloodcell–producing function of the bonemarrow

nadir:

lowest point of white blood cell depressionafter therapy that has toxic effectson the bone marrow

neoplasia:

uncontrolled cell growth that follows no physiologicdemand

neutropenia:

abnormally low absolute neutrophilcount

oncology:

field or study of cancer

palliation:

relief of symptoms associatedwith cancer

radiation therapy:

use of ionizing radiationto interrupt the growth of malignant cells

stomatitis:

inflammation of the oral tissues,often associated with some chemotherapeuticagents

staging:

process of determining the size andspread, or metastasis, of a tumor

thrombocytopenia:

decrease in the numberof circulating platelets; associated with thepotential for bleeding

tumor-specific antigen (TSA):

protein onthe membrane of cancer cells that distinguishesthe malignant cell from a benigncell of the same tissue type

vesicant:

substance that can cause tissuenecrosis and damage, particularly whenextravasated

xerostomia:

dry oral cavity resulting fromdecreased function of salivary glandsPathophysiology of the Malignant ProcessCancer is a disease process that begins when an abnormal cell istransformed by the genetic mutation of the cellular DNA. Thisabnormal cell forms a clone and begins to proliferate abnormally,ignoring growth-regulating signals in the environment surroundingthe cell. The cells acquire invasive characteristics, andchanges occur in surrounding tissues. The cells infiltrate these tissuesand gain access to lymph and blood vessels, which carry thecells to other areas of the body. This phenomenon is called

metastasis

(cancer spread to other parts of the body).Cancer is not a single disease with a single cause; rather, it is agroup of distinct diseases with different causes, manifestations,treatments, and prognoses.

PROLIFERATIVE PATTERNS

During the life span, various body tissues normally experience periodsof rapid or proliferative growth that must be distinguished frommalignant growth activity. Several patterns of cell growth exist:hyperplasia, metaplasia, dysplasia, anaplasia

,

and neoplasia.Cancerous cells are described as malignant

neoplasms. Theydemonstrate uncontrolled cell growth that follows no physiologicdemand. Benign and malignant growths are classified and named bytissue of origin, Benign and malignant cells differ in many cellulargrowth characteristics, including the method and rate of growth, abilityto metastasize or spread, general effects, destruction of tissue, andability to cause death. The degree of anaplasia (lack of differentiationof cells) ultimately determines the malignant potential.

CHARACTERISTICS

OF MALIGNANT CELLS

Despite their individual differences, all cancer cells share somecommon cellular characteristics in relation to the cell membrane,special proteins, the nuclei, chromosomal abnormalities, and therate of mitosis and growth. The cell membranes are altered incancer cells, which affects fluid movement in and out of thecell. The cell membrane of malignant cells also contains proteinscalled

tumor-specific antigens

(for example, carcinoembryonicantigen and prostate-specific antigen), which develop as they becomeless differentiated (mature) over time. These proteins distinguishthe malignant cell from a benign cell of the same tissuetype. They may be useful in measuring the extent of disease in aperson and in tracking the course of illness during treatment orrelapse. Malignant cellular membranes also contain less fibronectin,a cellular cement. They are therefore less cohesive and donot adhere to adjacent cells readily. Typically, nuclei of cancer cells are large and irregularly shaped(pleomorphism). Nucleoli, structures within the nucleus thathouse ribonucleic acid (RNA), are larger and more numerous inmalignant cells, perhaps because of increased RNA synthesis.Chromosomal abnormalities (translocations, deletions, additions)and fragility of chromosomes are commonly found when cancercells are analyzed.Mitosis (cell division) occurs more frequently in malignantcells than in normal cells. As the cells grow and divide, more glucoseand oxygen are needed. If glucose and oxygen are unavailable,malignant cells use anaerobic metabolic channels to produceenergy, which makes the cells less dependent on the availability