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NUR 211 Cancer Summary
This is a comprehensive and detailed summary on Chapter 15; Cancer. *Essential Study Material!!
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Chapter 15: Management of Patients with Oncologic DisordersVocabulary:
Alopecia: hair loss
Anaplasia: usually malignant, differ in shape and organization from their cells of origin, pattern
of growth
Angiogensis: growth of new blood vessels that allow cancer cells to grow
Apoptosis: normal cell mechanism of programmed cell death
Benign: not cancerous, may grow but will not spread
Brachytherapy: delivery of radiation therapy through internal implants placed inside or next to
the tumor
Cancer: abnormal cell proliferation, in which cells ignore growth-regulating signals in the
surrounding environment
Carcinogenesis: process of transforming normal cells into malignant cells
Carcinogens: chemical and physical factors and other agents that can cause cancer
Chemotherapy: medications used to kill tumor cells by interfering with cellular functions and
reproduction
Cytokines: substance produced by cells of the immune system to enhance functioning of the
immune system
Extravastation: leakage of intravenous medication from the veins into subQ tissue
Grading: type of tissue of origin, and degree to which the tumor cells retain the function and
structural characteristics of the tissue of origin
Graft-versus-host disease: an undesirable response in which T lymphocytes of donor tissue
attach against recipient tissue
Graft-versus-tumor effect: desirable response in which donor immune cells respond against the
malignancy
Malignant: having cells or processes that are characteristics of cancer
Metastasis: spread of cancer cells from primary tumor to distant sites
Mucositis: inflammation of the lining of the mouth, throat, GI tract associated with cancer
therapies
Myelosuppression: suppression of blood cell producing function of the bone marrow
Nadir: lowest point of WBC suppression after therapy that have toxic effects on the bone marrow
Neoplasia: uncontrolled cell growth; cancer
Neutropenia: low absolute neutrophil count
Oncology: study of cancer
Palliation: promotion of comfort
Precision medicine: using technology and advances in research to individualize plan of care
Radiation therapy: the use of radiation to kill malignant cells
Staging: process of determining the extent of the disease: tumor size and metastasis
Stomatitis: inflammation of the oral tissue often associated with radiation to the head and neck
area
Targeted therapies: minimize effects on healthy tissue
Thrombocytopenia: decrease in the number of circulating platelets, increase risk of bleeding
Vesicant: substance that can cause inflammation, damage, necrosis, with leakage of IV
medication from blood vessels and contact with tissue
Reading Notes:
Precision medicine is now available and help with direct patient care and individualized patient
care
, Epidemiology
Cancer is the second leading cause of death in the US
Leading cancers for women are lung, breast, and colorectal
Leading cancers for men are lung, prostate, and colorectal
Higher in men than women and 78% of all are diagnosed above the age of 55
Pathophysiology of the Malignant Process
Cancer starts when a cell in transformed from mutation within the DNA
o Can be inherited or acquired
The mutations can lead to alternations in the cell signaling transduction processes -> turning cell
activities either on or off -> lead to cancer development
Anaplasia is linked to higher incidence of malignancy
Look @ Ipad for malignancy verses benign tumors
Carcinogenesis or malignant transformation is a three step process: initiation, promotion, and
progression. Agents that initiate malignant transformation are known as carcinogens
o Initiation: carcinogens cause mutations in DNA -> usually apoptosis occurs or DNA repair
takes ahold, but, cells can easily escape these protective mechanisms with permanent
cellular mutations occurring
o Promotion: repeated exposure to promoting agents causes increased expansion or
manifestation of abnormal genetic information. This phase usually results in benign
lesions
o Progression: increasing malignant behavior and development of angiogenesis to invade
adjacent tissue and metastasize. Proto-oncogenes turn on cellular growth and cancer
suppressor genes turn them off -> leads to controlled cell proliferation
Cancerous cells are described as malignant neoplasms demonstrate uncontrolled cell growth with
no physiologic demand
Carcinogens include viruses, bacteria, physical agents, chemicals, genetic or familial factors,
lifestyle factors and hormones
o Viruses that can cause cancer include HPV, HBV, and Epstein-Barr virus (EBV)
o H. pylroi is a bacteria that can cause gastric cancer
o Physical factors include exposure to sunlight, radiation, chronic irritation or
inflammation, tobacco, industrial chemicals
o Tobacco smoke is the most lethal chemical carcinogen and related to 1/3 of cancer related
deaths
o Risk factors for familial cancer are cancer in two or more first degree relatives, onset
younger than 50 years old, same type in many family members, rare cancer in one or more
family members
o Lifestyle risk factors include obesity, diet and insufficient activity. Diet that increases risk
of cancer includes fats, alcohol; salt cured or cooked meats, nitrate containing food, red
and processed meats and heavy alcohol use. Sedentary lifestyle and lack of regular
exercise are also linked
o Tumor growth can also be linked to hormonal balance either by endogenous or exogenous
hormones. Ex. women using combination hormonal therapy for menopause have a higher
risk for ovarian cancer.
Before growth becomes uncontrolled the immune system can surveillance and stop the abnormal
growth -> when this fails then risk for tumor development becomes apparent
Those who are immunocompromised have an increased risk for cancer
Those who receive immunosuppressant therapy such as transplant patients also have higher
incidence
AIDs and treatment for one cancer can both lead to another or secondary type of cancer
Normal Immune Responses: Tumor associated antigens or TAAs are found on the membrane of
many cancerous cells -> they are processed by antigen presenting cells or APCs (macrophages and
dendritic cells) and are presenting to T lymphocytes that recognize the antigen-bearing cells as
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