Oncology Module

ONCOLOGY / CANCER NURSING

THE CELLDefinition of Related Terms

Cell - The basic unit of living organism; can reproduce itself Cancer – a disease process whereby cells proliferate abnormally, ignoring growthregulating signals in the environment surrounding the cells.Carcinoma – a new growth or malignant tumor that originates from epithelial cells, the skin, GIT,Lungs, Uterus, breast and other organs.Benign – usually a reference to growths that are encapsulated, remain localized, and are slowgrowingMalignant - terms for growth that are encapsulated but metastasize and grow. These growths arecancerous lesions having the characteristics of disorderly, uncontrolled proliferation of the cellTumor - Abnormal swelling usually from inflammation, or from morbid enlargement.-They are uncontrolled tissue growth that in which cell rapidly multipliesOncology- The study of cancer Staging- a method of classifying malignancies based on the presence and extent of the tumor onthe bodyMetastasis - the transfer of disease from one organ or apart to another not directly connected to it.Undifferentiated cells – cells that lost the capacity for specialized functionsCarcinogenesis – process of transforming normal cells into malignant cellsCarcinogens- agents that initiate or promote cellular transformation.Oncogene- cancer gene that alters the normal cellCarcinoma- usually solid tumors arising from epithelial cellSarcoma- from muscle, bone, fat and other connective tissueLymphoma- malignant tumors in lymphatic systemLeukemia- cancer of the blood Nadir- lowest point of WBC depression after therapy that has toxic effects on th bone marrowMetastasis- spread of cancer cells from the primary tumor to distant sites.

Review of Anatomy and Physiology:Cell

Centrioles- self-replicating organellesmade uf o nine bundles of microtubules andare found only in animal cellsCilia and Flagella – essential for locomotion(single-celled). Cilia function to move fluidor materials past an immobilecell as well as moving a cell or group of cells.Endoplasmic Reticulum –a network of sacsthat manufactures, processes andtransports chemical compounds for use inside and outside of the cell. Provides a pipeline between the nucleus and thecytoplasm.Golgi Apparatus – The distribution and Shipping department for the cell’s chemical productsLysosymes- Main function is digestion. Breaks down cellular waste products and debris fromoutside the cell into simple compounds, which are transferred to the cytoplasm as newcell-building materials.

Mitochondria- are oblong shaped. The main power generators, converting oxygen andnutrients into energy Nucleus- Serves as the information processing and administrative center of thecell.-Stores DNA-Coordinates cell activities

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Growth

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Intermediary metabolism

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Protein synthesis

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Reproduction (cell division)Perixosomes- found inside the cytoplasmPlasma membrane – encloses cell contents. SelectivelyPermeable.Ribosomes- comprised of approx. 60% RNA and 40% protein

Cell Division

Overview of Mitosis

Cell division is an elegant process that enables organisms to grow and reproduce. Through a sequence of steps, the replicated genetic material in a parent cell is equally distributed to two daughter cells. Whilethere are some subtle differences, mitosis is remarkably similar across organisms.Before a dividing cell enters mitosis, it undergoes a period of growth called interphase. Interphase is the"holding" stage or the stage between two successive cell divisions.In this stage, the cell replicates its genetic material and organelles in preparation for division.Mitosis is composed of several stages:

Prophase

In prophase, thechromatincondenses into discrete chromosomes. The nuclear envelope breaks downand spindles form at opposite "poles" of the cell.

Metaphase

In metaphase, the chromosomes are aligned at the metaphase plate (a plane that is equally distant fromthe twospindle poles).

Anaphase

In anaphase, the paired chromosomes (sister chromatids) move to opposite ends of the cell.

Telophase

In this last stage, the chromosomes are cordoned off in distinct new nuclei in the emerging daughter cells.Cytokinesisis also occurring at this time.At the end of mitosis, two distinct cells with identical genetic material are produced.

Before a dividing cell enters mitosis, it undergoes a period of growth called interphase. Some 90 percentof a cell's time in the normal cellular cycle may be spent in interphase.

Stages of Interphase

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G1 phase: The period prior to the synthesis of DNA. In this phase, the cell increases in massin preparation for cell division. Note that the G in G1 represents gap and the 1 representsfirst, so the G1 phase is the first gap phase.

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S phase: The period during which DNA is synthesized.In most cells, there is a narrow window of time during which DNA is synthesized. Note that theS represents synthesis.

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G2 phase: The period after DNA synthesis has occurred but prior to the start of prophase. Thecell synthesizes proteins and continues to increase in size. Note that the G in G2 representsgap and the 2 represents second, so the G2 phase is the second gap phase.

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In the latter part of interphase, the cell still has nucleoli present.

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Thenucleusis bounded by a nuclear envelope and the cell's chromosomes have duplicated but are in the form of chromatin.

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In animal cells, two pair of centriolesformed from the replication of one pair are locatedoutside of the nucleus.

Pathogenesis of Cancer

a.Cellular Transformation & Derangement Theory

-Conceptualizes that normal cells may be transformed into cancer cells due toexposure to some etiologic agents.

b.Failure of the Immune Response Theory

-Advocates that all individuals possess cancer cells. However, the cancer cells arerecognized by the immune response system. So, the cancer cell undergo destruction.Failure of the immune response system leads to inability to destroy the cancer cells.

ROLE OF THE IMMUNE SYSTEM

-malignant cells are capable of developing on a regular basis-Immune system can detect the development of malignant cells and destroys them before cell growth becomes uncontrolled.-Clinical cancer develops when the immune system fails to identify and stop thegrowth of malignant cells. Normal Immune Response-recognizes as foreign certain antigens(tumor associated antigens) on the cellmembrane of cancer cells-macrophages, T lymphocytes, soldiers of the cellular immune response-T-lymphocytes has cytotoxic properties-

Lymphokines

– produced by lymphocytes, capable of killing or damaging varioustypes of malignant cells-

Interferon(IFN)

– produce by the body in response to viral infection, possesses antitumor properties.-

Natural Killer Cells

– subpopulation of lymphocytes, producing lymphokines andcertain enzymes that kills tumors