ONCOLOGY 1

ALARA – As Low As Reasonably Achievable 7. LYSOSOMES

- Applicable in chemotherapy  Lysozymes
- Begin w/ low dose o Digestive enzymes
- Pt. may die if high dose o Digestive System
o Pancreatic secretions/BILE alkalize
Cancer- must be regarded as a group of disease entities the lower GI
w/ different causes, manifestations, treatments & o HCL acidify the stomach
prognoses. The basic disease process begins when
normal cells undergo change and begin to proliferate in
an abnormal manner. 8. PEROXISOMES – produces non-specific
 Growing of abnormal cell w/o physiologic subtances that contributes to immunologic
demands response
 ENDOGENOUS – Synthetic, Kill bacteria
Benign – Deteriorating effect  EXOGENOUS – Hydrogen Peroxide (Agua
 If cells can’t communicate -> there is Oxigenada)
development of Cancer  An oxidizing agent
 Oxidizing means removal of
BIOLOGY OF THE CELL charges resulting to death
 CATALASE – substance
Chambers/Organelles found in blood, non specific
1. CELL MEMBRANE
 The skin of cells 9. MITOCHONDRIA
 Separate external and internal  Power house of the cell
 Contains lipids, cholesterol and fats  Generates ATP
 ADEK (fat soluble)  Cassava causes CYANIDE POISONING –
 Selectively permeable damages mitochondria
 Gated- insulin will be the key in order for the o Do not eat cassava during warm/dry
glucose to enter the cell season
o Cassava contains cyanide
 WHY FAT = One way of protecting the cell
 Glucose is a water soluble nutrient MITOSIS (PMAT)
 Carbohydrates : Glucose, fructose, galactose  Cell division
 ACIDOSIS – Due to lactose intolerant  Mother cells split into two identical daughter
--There is no conversion to glucose cells

Glucose (Cytoplasm) Pyruvic Acid (Mitochondira) Prophase

ATP <Energy/heat> <Calorigenic>  Intact Nuclear Cell Membrane
Fats and Proteins are reserved  Contains nucleus, centrioles, chromatids,
spindle fibers
 Spindle Fibers –draws chromosomes
2. NUCLEUS  CHROMOSOME – fundamental unit of heredity
 Brain of the cell
 Command center Early Prophase: Visible chromosomes
Late Prophase: Centrioles are now at opposite poles
 DNA is the blueprint of instruction
Metaphase
3. CYTOPLASM - Detox  Alignment of chromosomes

4. ENDOPLASMIC RETICULUM (smooth and Anaphase

rough)  Early Anaphase: <V-shaped>
 Manufacture many things  Late Anaphase: Cleavage furrow
 Not mature (will go to the GOLGI
APPARATUS to mature) Telophase
 Furrow
 Electrolytes – charges / action  Making sure equal and identical

INTERPHASE
5. RIBOSOMES  Not included
 For protein synthesis  Preparing for prophase

6. GOLGI COMPLEX  CYTOKINESIS – cytoplasmic separation

ONCOLOGY 1
 Mitotic division – wound heals, like fetal  Biologic Agents (bacteria and
organogenesis virus)
 First trimester – most dangerous for pregnancy,
prone to virus PROMOTION
 Why mitosis? = Even abnormal cells have o Repeated exposure to promoting agents
mitosis o Dose of promoter
o Innate characteristics & genetic stability
PHASES OF CELL CYCLE target cells

G1 PHASE PROGRESSION
 8-10 hours o Total genetic mutation
 Actively dividing o Cellular oncogene
 Duplicate Organelles o Cellular proto-oncogenes
 Protein formation  EGFR - Epidermal Growth Factor
Receptor – for skin problems
S PHASE  C-Myc <CHROMOSOME 8> ; for
 8 Hourse possible colon, pancreatic, lung
 DNA Synthesis cancer; promising target for cancer
 Interphase cells
 Cell signaling proteins = Kristen
G2 PHASE Ras (KRAS/KRAS2)
 4-6 Hours <CHROMOSOME 12>
 Creates enzymes and proteins
TP53 / p53 GENES – cancer suppressor gene
MITOTIC PHASE (PMAT)  Oncovirus
 Lack means mutation
G0 PHASE  Cellular mutation mean there is genetic change
 Nondividing cells
 Exit from cell cycle TOP 10 CAUSES OF MORTALITY
 BONE MARROW – no G0 phase 1. HEART DISEASE
 RBC – 100-120 days 2. CANCER
 Chemotherapy <Rapidly dividing cells> 3. VASCULAR DISEASE
4. ACCIDENT
SUMMARY OF EVENTS OF THE CELL CYCLE IN 5. PNEUMONIA
SOMATIC CELLS
TOP 10 CANCER
 SOMATIC CELLS – BODY CELLS 1. PROSTATE
 WARBURG EFFECT – The use of glucose even 2. BREAST
in the presence of oxygen 3. LUNG & BRONCHUS
4. COLON & RECTUM
CELLULAR ABERRATION 5. CORPUS & UTERUS
 Cellular proliferation – cells are actively dividing
 Loss of contact inhibition – <no trespassing TABLE 311 (READ)
effect>
 Cell Biology
 The cancer cells are synthesizing protein MAJOR DYSFUNCTION IN THE CELL
and glucose
 Nuclei of cancer cells are abnormally large Pathophysiology of Cancer
 Proliferation Pattern
When growth hormones take effect? SLEEPING AND  Characteristics of malignant cells
RESTING HOURSE o Tumor-Specific Antigen (TSA)
 Prostate-Specific Antigen &
Carcinoembryonic Antigen
 Invasion & Metastasis
o Lymphatic & hematogenous Spread
CARCINOGENESIS: MOLECULAR PROCESS o Angiogenesis

INITIATION o Seeding – tipak/ slough off

o Carcinogens
 Chemical (Noodles,
Canned Foods) Page 338 – Characteristics of Benign & Malignant
 Physical Neoplasm (READ)
ONCOLOGY 1
 Differentiated/Encapsulated CHEMICAL AGENTS
 Dye
Tumor (NEOPLASM)  Asbestos – colorless, odorless
 Benign – encapsulated  Pesticides and Formaldehydes
 Malignant  Arsenic, Soot and Tars
o Vascular System  Benzene
o Lymphatic System  Cadmium
o Implantation  Smoke
o Seeding
GENETIC PREDISPOSITION
Destructive enzymes of Malignant Cells  Hereditary Cancer Syndrome
 Proteinases o Syndrome – cluster of symptoms
 Collagenases o Two or more first or second degree
 Plasminogen Activators relatives
 Lysosomal Hydrolases o Early onset of cancer in family members
younger than 50 years
How do malignant survives? = They make their own o Same type of cancer in several family
When can malignant cell implant? = Ming sangit siya sa members
other parts o Individual family member with more than
one type of cancer
CANCER CLASSIFICATION o Rare cancer in one or more family
 Solid Tumor members
 Hematological Cancer o Evidence of an autosomal dominant
inheritance pattern of cancers affecting
Pwede ma malignant ang benign if immune system fails several generations of a family
o Hereditary Syndrome
ROUTE OF METASTASIS  BRCA 1 – Chromosome 17
 Local Seeding  BRCA 2 – Chromosome 11
 Blood borne metastasis  MEN 1
 Lymphatic Spread  MEN 2

Metastatic effect
Increase ICP FAMILIAL FACTOR – disease within the family
 Headache  Owing to genetics
 Compression of the optic nerve (Papilledema)  Shared environment
 Nausea & Vomiting  Cultural or Lifestyle Factors
 Or by chance alone

COMMON SITES FOR METASTASIS DIETARY FACTOR (Long term)

1. Brain  Fats and oils from animal sources
2. Liver  Alcoholic beverages
3. Lungs  Salt cured
4. Spinal Cord  Smoked meats
5. Bones  Nitrate & Nitrite containing foods

HORMONAL AGENTS
EPIDEMIOLOGY & ETIOLOGY  Prolonged Estrogen replacement therapy (ERT)
 Epidemiology – how to stop, how it is make = To prevent osteoporosis
 Etiology - Cause o Menopause use ERT
o Prone to osteoporosis – Menopause
MICROBIAL AGENTS  DES (Diethystilbestrol) for vaginal carcinoma
 Bacteria  Oral contaceptives
 Protozoan
 Fungi IDIOPATHIC/ Unknown cause
 Viruses 1. Breast
2. Colon
PHYSICAL AGENTS 3. Rectal
 Chronic irritation & inflammation 4. Lymphatic
 Radiation 5. Bone Marrow
 Over exposure to sunlight 6. Pancreas cancer arise spontaneously
 Tobacco/ Cigar Use
ONCOLOGY 1

LEVELS OF PREVENTION o Carrier: Female

PRIMARY SECONDARY TERTIARY o Manifest: Male
1. Health 1. Early Diagnosis 1. Intent is to how
Promotion and Prompt the AGAMMAGLOBULINEMIA
2. Health treatment disease/injury  No or zero immunoglobulin
Education 2. Case finding process & assist  X-linked
3. Genetic measures the person in
Screening 3. Individual and obtaining an
4. Marriage mass screening optimal health
Counseling survey status
5. Use of specific 4. Prevent 2. Maximize use of PRIMARY is the combination of
immunization complication remaining personal behavior and health
6. Attention to and sequel capacities Health promotion is to influence people
personal 5. Shorten period 3. Restoration and in ways of reducing risks.
hygiene of disability rehabilitation
7. Avoidance of 6. Disability 4. Monitor for and
allergens limitations preventing the
8. Protection recurrence of
from the primary
carcinogens cancer

9 WARNING SIGNS OF CANCER (CAUUTIONS)

(CAU2TIONS)
1. Change in bowel or bladder habits
2. Any sore throat does not heal
3. Unusual bleeding or discharge
4. Unexplained anemia
5. Thickening or lump in breast or elsewhere
6. Indigestion
7. Obvious change in wart or mole (Precancerous)
8. Nagging cough or hoarseness
9. Sudden weight loss

THE ROLE OF THE IMMUNE SYSTEM

NORMAL IMMUNE RESPONSES – free from cancer

 T-lymphocyte – recognize TAA’s
 B-lymphocytes
o Macrophage

Lymphokines – produce by lymphs, destroy

Natural Killer Cells - defense to cancer

IMMUNE SYTEM EVASION

 Tumor-Associated Antigen
o (a.k.a tumor cell antigen)
o Deceive immune system
o Failure to recognize foreign or
nonforeign

 Tumor Antigen-Antibody Complexes

o Prevent production of antibodies

Tumor Specific Antigen – Directly to specific organ

Tumor Associated Antigen – Associated organ

HYPOGAMMAGLOBULINEMIA – a genetic disorder of

decreased immunoglobulin
 Low production of immunoglobulin
 Prone to infection
 Indicative sign: DIARRHEA
 X-linked