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CARE OF PATIENTS WITH CANCER
A.Characteristics of Normal CellsThe Biology of Normal Cells1)Have limited cell division2)Undergo Apoptosis3)Show specific morphology4)Perform specific differentiated functions5)Adhere tightly together 6)Non migratory7)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 specificstructures and functions in order to specialize in certaintasks* Cellular adaptationa.Hypertrophy – refers to an increase in size of normal cellsb.Atrophy – refers to the shrinkage of cell sizec.Hyperplasia – refers to an increase in the number of normal cellsd.Metaplasia – refers to a conversion from the normal patters of differentiation of one type of cell into another type of cell notnormal for that tissuee.Dysplasia – refers to an alteration in the shape, size,appearance and distribution of cellsf.Anaplasia – refers to disorganized, irregular cells that have nor structure and have loss of differentiation; the result is alwaysmalignantB.Evolution of Cancer Cells1.Cancer – refers to a disease whereby cells mutate into abnormal cellsthat proliferate abnormallyNeoplasia – refers to an abnormal cell growth or tumor
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a mass of new tissue functioning independently andserving no useful purpose2.Invasion – occurs when cancer cells infiltrate adjacent tissuessurrounding the neoplasm3.Metastasis – occurs when malignant cells travel through the blood or lymph system and invade other tissues and organs to forma secondary tumor C. Characteristics of malignant cells1. Rapid cell division and growth: regulation of the rate of mitosis is lost2. No contact inhibition: cells do not respect boundaries of other cells andinvade their tissue areas3. Loss of differentiation: cells lose specialized characteristics of function for that cell type and revert back to an earlier, more primitive cell type4. Ability to migrate (metastasize): cells move to distant areas of the body andestablish new site malignant lesions (tumors)5. Alteration in cell structure: differences are evident between normal andmalignant cells with respect to cell membrane, cytoplasm and overall cellshape6. Self-survivala. may develop ectopic sites to produce hormones needed for owngrowthb. can develop a connective tissue stroma to support growthc. May develop own blood supply by secreting angiotensin growthfactor 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 ageb. Cancer ranks 3
rd
as the cause of morbidity in the Philippinesc. Highest incidence of all cancer is prostate cancer d. Highest cancer incidence in males in order of frequency: prostatecancer, lung cancer and colorectal cancer e. Highest cancer incidence in females in order of frequency: breastcancer, lung cancer and colorectal cancer
2. Common sites of cancer and their sites of metastasisCancer TypeSites of Metastasis1. Brain CancerCentral Nervous System2. Breast cancerBrainLiver Regional lymph nodesVertebrae3. Colon cancerBrainLiver LungLymph nodesOvaries4. Lung cancerBoneBrainLiver Lymph nodesPancreasSpinal cord5. Prostate cancerBladder BoneLiver
External factors causing CANCER
1. Chemical Carcinogens- over 1,000 chemicals are known to be carcinogenic
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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
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Anabolic Steroid (Liver)
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Arsenic (Lung; Skin)
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Asbestos (Lung; peritoneum)
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Benzene (Leukemia
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Diesel exhaust (Lung)
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Hair dyes (bladder)
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Pesticides (Lungs)
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Sunlight (Skin; eyes)
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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 andbladder cancers2. Physical Carcinogens
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Radiation
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Chronic Irritation- GERD3. Viral Carcinogens- some viral infections tend to increase risk of cancer Ex: Epstein Barr Genital herpesPapillomavirusHepatitis BHuman cytomegalovirus4. Dietary Factors- diets in high fat, low in fiber and those containing nitrosamines found inpreserved meats and pickled foods promote certain cancers such as colon,breast, esophageal and gastric
Personal factors causing CANCER
1. Immune Functions2. Agea. Increased risk for people over age of 65b. Factors attributed to cancer in elderly include hormonal changes, alteredimmune responses and the accumulation of free radicalsc. Age has been identified as the single most important factor related to thedevelopment of cancer
3. Gender a. certain cancers are more commonly seen in specific gendersex: breast cancer –more common in femalecolon cancer – more common in males4. Genetic Risk- 15% of cancers may be attributed to a hereditary componentEx: Breast, colon, lung, ovarian and prostate cancers5. Race – can affect any population- African-Americans experience a higher rate of cancer than any other racialor ethnic groupCARCINOGENESIS: Transformation of Normal Cells into Cancer Cells1
. Initiation
– occurs when carcinogen damages DNA- carcinogenesis cause changes in the structure and function of the cell atthe genetic or molecular level. This damage may be reversible or maylead to genetic mutations if not repaired; however the mutations maynot lead immediately to cancer 2
. Promotion
– occurs with additional assaults to the cell, resulting in further geneticdamage3. 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 bodyparts
Comparison of the Characteristics of Normal and Cancer Cells
CharacteristicNormal CellsCancer CellsMitotic cell divisionMitotic division lead to 2daughter cellsMitosis leads to multipledaughter cells that may or may not resemble theparent. Multiple mitoticspindlesAppearance1. Cells of same typehomogeneous in size,shape, and growth2. Cells cohesive, formregular pattern of expansion3. Uniform size to nucleus4. Have characteristicpattern of organization5. Mixture of stem cells(precursors) and well-differentiated cells1. cells larger and growmore rapidly than normal;pleomorphic2. Cells not as cohesive;irregular patterns of expansion3. Larger, more prominentnucleus4. Lack characteristicpattern of organization of host cell5. Anaplastic, lack of differentiated cellcharacteristics, specificfunctionsGrowth pattern1. do not invade adjacenttissue2. Proliferate in responseto specific stimuli3. Grow in ideal conditions(ex: nutrients, oxygen,space, correct biochemicalenvironment)4. Exhibit contact inhibition5. Cell birth equals or isless than cell death6. Stable cell membrane7. Constant or predictablegrowth rate8. Cannot grow outsidespecific environment (ex:breast cells grow only inbreast)1. invade adjacent tissues2. Proliferation in responseto abnormal stimuli3. Grow in adverseconditions such as a lackof nutrients4. Do not exhibit contactinhibition5. Cell birth exceeds celldeath6. Loss of cell control aresult of cell membranechanges7. Growth rate erratic8. Able to break off cellsthat migrate throughbloodstream or lymphaticsor seed to distant sites andgrow in other sitesFunction1. have specific,designated purpose1. serve no useful purpose2. do not contribute to the
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| Upload Date: | 10/24/2009 |
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