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A basic introduction to Oncology topic for pathophysiology 401 practical nursing.
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OncologyWhat do cancer cells look like?
● Uncontrolled mitosis, undifferentiated; Where? In the nucleus, the DNA sequence are
all altered d/t exposure to the carcinogen
● What happens? Cancer cells would have prolonged life or replicate excessively =
collection of cells = possible proliferation = undifferentiated cells = if it grows, even
more, = TUMOUR = possibly MALIGNANT if it continues to grow
Some cells become BENIGN instead of MALIGNANT, WHY? b/c of the 3 key players
What are the 3 key players within cells?
1. Oncogene
2. Tumour suppressor
3. DNA repair
Carcinogenesis
● What is it? Normal cells are transformed into cancer cells d/t repeated single risk
factor exposure that can activate or change gene expression = malignant cells
Stages of Carcinogenesis
1. Initiation: factors that cause the first irreversible change in the cell - EXPOSURE to
a carcinogen like genetic/environment/chemical and does NOT create an active
neoplasm
2. Promotion: more changes to DNA d/t continuity of exposure to the carcinogen
● May see dysplasia or neoplasia
● Leading to the development of tumours
● 3 key players are NOT working
3. Progression: result in malignant tumour that can grown and invade locally;
undifferentited
Risk factors
● Genetic factors - breast cancer, leukaemia
● Viruses - hepatic cancer, hpv, hiv
● Radiation - Leukaemia
● Biological like irritation inflammation - colon cancer, UC, IBS, BPH
● Age
● Diet - colon,, gastric cancer
● Hormones - endometrial cancer
Biopsy works by looking at
1. Irregular shape of the cell
2. Size
3. Increase in number if cells
4. DNA mutation
, Benign Malignant
Cells Differentiated, fairly normal Undifferentiated, atypical
mitosis
Growth Slow expanding, encapsulated Rapid.. Grow bigger = more areas are
impacted = gets heavier and it goes
deeper = it may affect sentinel node
Spread Remains localized Invades nearby tissues or metastasizes
to distant sites like bv and lv
Systemic Effects Rare Often present
Life-threatening Only in certain areas like brain Yes, by tissue destruction and tumours
spread
Warning Signs
1. Atypical bleed or discharge in the body - breast cancer: irreg discharge - vaginal/penis
discharge potential cancer
2. Change in bowel or bladder habits; need to know their baseline first!
3. Change in a wart or mole - ABCD + pain
4. Sore that does not heal; have to think if pt has condition that slows down healing like
DM! - so we look for discharge, or has it gone worse and not healing at all
a. ULCERS = Necrosis
5. Unexplained weight loss - energy + O2 = cells live; if replicate faster, they need more
energy and oxygen to replicate resulting to weight loss as it drains all the resources
and loss appetite b/c all the blood goes to that place which causes poor circulation
6. Anaemia or low hgb, and excessive fatigue - all blood pool to support activity of the
tumour leading to decrease in Hgb and low VS, also bone marrow suppression
7. Persistent cough or hoarseness w/o reason
Local Manifestations
● Pain
● Obstruction
● Tissue necrosis and Ulcerations - may lead to infection around the tumour
Systemic Manifestations
● Weight loss and Cachexia (sever wasting syndrome)
● Anorexia
● Severe fatigue
● Infection like pneumonia
● Bleeding - lead to tissue necrosis
● Bone marrow suppression
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