ONCOLOGY NURSING (AN OVERVIEW)

ONCOLOGY NURSING
It is a branch of medicine that deals with the study, detection, treatment and management of cancer

CANCER
abnormal growth that is characterized by a continuing, purposeless, unwanted, uncontrolled and damaging growth of cells that differ structurally and functionally from the normal cells from which they developed.

TERMINOLOGIES
 Neoplasia-uncontrolled cell growth that follows no physiologic demand  Anaplasia-cells that lack normal cellular characteristics and differ in shape and organization  Metaplasia-conversion of one type of mature cell into another; reversible

 Dysplasia-bizarre cell growth resulting in cells that differ in size, shape or arrangement from other cells of the same type.  Hypoplasia-incomplete or underdevelopment w/ decreased number of cells  Hyperplasia-Increase in the number of cells  Hypotrophy-decrease in the organ size /function  Hypertrophy-increase in the size

PREFIX/SUFFIX
Neo- new Plasia- growth Plasm- substance Trophy- size +Oma- tumor Statis- location A- none Ana- lack Hyper- excessive Meta- change Dys- bad

TYPES OF NEOPLASIA
BENIGN - cells grow at the wrong rate, time and location MALIGNANT CARCINOMA -lining cells of skin, the alimentary tract,respiratory tract, bladder or glands such as pancreas, thyroid or salivary glands SARCOMA -bone, cartilage,muscle, fat, fascia, nerve or blood vessel BORDERLINE/ IN SITU - in its place - a tumor that grows only in a specific area (e.g. Bowens disease)

EPIDEMIOLOGY
AGE IS THE MOST OUTSTANDING RISK FACTOR FOR CANCER. Cancer incidence increases progressively with age. Approximately 77% of people diagnosed with cancer are over age 55.

LIFE STYLE HABITS and ENVIRONMENTAL CARCINOGENS

Tobacco Smoking Alcohol Betel Nut Sunshine Industrial irritants and carcinogen Diet

INFECTIONS AND VIRUSES ARE ASSOCIATED WITH AN INCREASED RISK OF CERTAIN FORMS OF CANCER
Human papilloma virus -cervical cancer Epstein-Barr virus -lymphoma Hepatitis B and C -hepatocellular cancer Helicobacter pylori -may be linked to gastric cancer

HEREDITY AND GENETIC FACTORS

Tumour Suppressors, Proto-Oncogenes and Cancer-Oncogenes Cell Cycle Regulatory Genes Inherited Cancer Genes: Inherited and Familial Cancers

IMMUNOLOGIC FACTORS
Failure of the immune system to respond to and eradicate cancer cells Immunosuppressed individuals are more susceptible to cancer

PSYCHOLOGICAL FACTORS: THE POSSIBLE ROLE OF STRESS OR EMOTION IN CANCER DEVELOPMENT

Most psychologists would not claim that stress is a direct cause of cancer but some consider that it may play a part.

PATHOPHYSIOLOGY

THE CELL
the structural and functional unit of all known living organisms the smallest unit of an organism that is classified as living, and is sometimes called the building block of life

COMPONENTS
Cell membrane- separate and protect a cell from its surrounding environment Cytoskeleton - acts to organize and maintain the cell's shape Genetic material
DNA - for their long-term information storage RNA - used for information transport

CELL CYCLE
Cell Proliferation process by which the cells divide and reproduce
regulated

Cell differentiation transformation of cell into specialized cells

CELL CYCLE
Gap 1 or G1 phase cell enlarges, synthesizes protein for DNA replication Synthesis or S phase DNA is replicated, chromosomes are duplicated Gap 2 or G2 phase prepares for mitosis Mitosos or M phase cell division, parent cell produces identical daughter cells with the same genetic material

EVOLUTION OF CANCER CELLS

all cells constantly change through growth, degeneration, repair and adaptation neoplasm refers to both benign and malignant cells growth control mechanism of normal cells is not entirely understood

CARCINOGENS
Are agents that are known to cause cancer KNOWN CARCINOGENS: Viruses Drugs Hormones Chemical and Physical agents

TWO GROUPS OF CARCINOGENS

1 GENOTOXIC CARCINOGENS - Directly alter DNA and cause mutations 2 PROMOTER SUBSTANCES - Cause other adverse biologic effects such as cytotoxicity, hormonal imbalances, altered immunity or chronic tissue damage

CARCINOGENESIS

(1) INITIATION
Non reversible event that occurs when a carcinogen invades and damages the DNA of the cell causing a change in the DNA structure. ONCOGENE gene that normally directs cell growth, if altered, allows growth of cancer TUMOR SUPRESSOR GENE blocks the development of cancer

(2) PROMOTION
Follows initiation Reversible Repeated exposure stimulates cellular proliferation of the initiated cell PROMOTER potentiates the effects of the initiator

(3) PROGRESSION
Malignant tumor grows in size, becomes anaplastic and less differentiated ANGIOGENESIS blood supply is established through the formation of new blood vessels

(4) METASTASIS
Spread of malignant tumor to other location by penetrating into the lymph vessels circulating throughout the body Considered 2nd cancer

IMMUNE SYSTEM & CANCER

All cancer is the result of an immune system that didnt destroy mutant cells Immune system destroys 10,000 mutated (cancer) cells every day. When defense ceases cancer multiplies becomes cancer.

Cause of the distress to the immune system: FOOD => ENZYMES destroyed by COOKING => PANCREAS doubles its size in trying to keep up with the demand => EXHAUSTION => compromised immune system => vulnerable climate to the formation of CANCER

GENETICS & CANCER

AUTOSOMAL DOMINANT CONDITION 50% chance of having a child (male or female) who will also have the condition

GENETICS & CANCER

AUTOSOMAL RECESSIVE CONDITION one gene in the pair changed, not expected to have signs or symptoms (CARRIER) 25% chances of having a child with the condition

X-LINKED RECESSIVE
Female = carrier Since a male has only one X chromosome, he has only one copy of each gene on that chromosome. Therefore, if one of the genes on his X chromosome has a mutation, he will have whatever condition is associated with that mistake

BENIGN VS. MALIGNANT

BENIGN
Usually encapsulated Cells similar in structure to cells from which they originate Well-defined borders Slow growing and limited to one area Possible growth displacement (but not invasion) to adjacent tissue

BENIGN TUMORS

BENIGN VS. MALIGNANT

MALIGNANT
Not encapsulated; not cohesive, and irregular pattern of growth No resemblance to cell of origin No well-defined borders Growth into adjacent cells rather than displacing or pushing them aside Rapid growth through rapid cell division and multiplication

MALIGNANT TUMORS

BENIGN VS. MALIGNANT