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CELLULAR ABERRATIONS

1LT MA DIOCITA A SARVIDA NC Headnurse, Ward 7C 14 August 2012

The

process of Cell Cycle Definition of Cancer Explain the Mechanism of Carcinogenesis and malignant neoplasia
Classification

of cancer Causes of Cancer

Cancer

Signs Common Test and Tumor Markers Nursing Management Prevention Grading and Staging of cancer

Curriculum for Oncology Nursing, 4th Edition by Joanne K Itano and Karen Taoka (2005) Manual of Cancer Nursing by Breanda Shelton and Mikaela M Olsen (2004) Oncology Nursing Advisor (A comprehensive Guide to Clinical Practice)t Hickey (2010) Susan Newton and margare www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001911 www.mayoclinic.com/health/cancer/DS00038
Core

1. Gap 1 (G1) 2. S phase (Synthesis) 3. Gap 2 (Gap 2) 4. Mitosis (M phase) 5. Gap 0 (G0)

Latin

word for crab (karkinoma) Malignant cells. the uncontrolled growth of abnormal cells in the body. A large group of diseases characterized by uncontrolled growth and spread of abnormal cells

is

a complex of diseases which occurs when normal cells mutate into abnormal cells that take over normal tissue, eventually harming and destroying the host 3rd in leading causes of morbidity and mortality in the Philippines. 2nd leading cause of mortality (1.2 million) in America.

All

cancers begin in cells. The body is made up of many types of cells. These cells grow and divide in a controlled way to produce more cells as they are needed to keep the body healthy. However, sometimes this orderly process goes wrong. The extra cells may form a mass of tissue called a tumor.

New growth of cells in the body. CLASSIFICATIONS Benign = (non-cancerous) Malignant = (cancerous) Metastasis the movement of cancer cells through the body. Due to this some forms of cancer spread quickly.

Benign
Grow slowly Well-defined capsule Not invasive Well differentiated Low mitotic index Do not metastasize

Malignant
Grow rapidly Not encapsulated Invasive Poorly differentiated High mitotic index Can spread distantly (metastasis)

The

process by which normal cells become cancer cells called malignant transformation. A multistep process that may take years to complete, and it is governed by a series of genetic or epigenetic changes.

Responsible

for the development of Cancer

ONCOGENES- a gene that, when mutated or expressed at high levels, helps turn a normal cell into a tumor cell.

TUMOR SUPPPRESSOR GENESdesigned to limit cell division, promote apoptosis.

1. 2.

3.

Initiation Promotion Progression

1. Carcinomas - arise from epithelial tissue.

2. Sarcomas - arise from connective or muscle tissue.


3. Lymphomas - cancer of lymphatic tissue

4. Leukemias - cancer that arises from blood-forming tissues.


5. Adenomas - are cancers that arise in the thyroid, the pituitary gland, the adrenal gland, and other glandular tissues. 6. Melanomas -cancerous growths of melanocytes

Age Gender Tobacco Physical

Activity Genetics Environmental factors Unsafe sex Sun exposure Radiation Viruses

C A U T I O N U S

- change in bowel habits - a soar or cut that does not heal - unusual bleeding or discharge - thickening or lump in the breast or anywhere in the body - indigestion or difficulty in swallowing - obvious change in mole or wart - nagging cough or hoarseness - unexplained anemia - sudden weight loss

Blood

test

X-ray
UTZ Biopsy Pleural

Biopsy Bone marrow Aspiration Mammography Colonoscopy

Sigmoidoscopy Bronchoscopy

Endoscopic

esophageal ultrasound (EUS) with biopsy CT scan MRI scan Bone scan Positron emission tomography (PET) scan

Sputum

cytology test to look for cancer cells Pulmonary function test Liver enzymes (liver function tests) Gallium scan cholangiopancreatography (ERCP) Calcitonin blood test Upper GI series Intravenous pyelogram (IVP)

TSH,

FT4 Serum alpha fetoprotein Barium swallow Esophagogastroduodenoscopy (EGD) with biopsy

MARKER
Alpha fetoprotein (AFP)

CLINICAL SIGNIFICANCE
Testicle cancer

Carcinoembryonic antigen (CEA) Prostate specific antigen (PSA) CA 15-3 CA 125 HCG

Colon cancer
Prostate cancer Breast cancer Ovarian Gestational trophoblastic disease

Surgery

Radiation

Therapy Chemotherapy Hormone therapy Gene therapy Bone marrow peripheral stem cell transplantation Complementary and Alternative medicine

Aimed towards: CURE -free of disease after treatment normal life Control -Goal for chronic cancers Palliative Care: Quality of life maintained at highest level for the longest possible time.

The

primary method of treatment of most solid malignancies. Most common treatment approach. 90% of patient with cancer have some type of surgical procedure for diagnosis, treatment, or management of the disease. Best chance of cure and provides histologic information for prognosis.

the

movement of energy through a space or medium It causes damage or changes to the cells A major cancer treatment that can be used alone or in combination with other therapies to cure, control or palliative disease

is

the use of various chemical agents that interfere with the replication and other normal functions of cancer cells, resulting in cell death. Provides systemic approach to the treatment of cancer Goal of chemotherapy (Cure, control and palliation)

is

designed to alter hormone production in the body so that cancer cells stop growing or are killed completely

is

to replace damaged genes with ones that work to address a root cause of cancer: damage to DNA further damaging cancer cell DNA to the point where the cell commits suicide.

Procedures

that restore stem cells that were destroyed by high doses of chemotherapy and/or radiation therapy. Aspiring bone marrow cells from compatible donor and infusing theminto the recipient. A tandem transplant involves two sequential courses of high-dose chemotherapy and stem cell transplant.

is

a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine

1. Promote

measures that relieve pain and discomfort. 2.Promote measures to maintain intact skin integrity. 3.Promote measures that maintain oral mucosa. 4.Promote measures to prevent injury from abnormal bleeding. 5. Monitor platelet count and complete blood count.

6. Promote measures that identify and

prevent infection 7. Help decrease the clients fatigue and increase his activity level. 8.Promote measures that ensure adequate nutritional intake. ( High protein, high calorie diet) 9. Ensure adequate fluid and electrolyte balance. 10.Promote measures to enhance body image.

11. Take an honest gentle, caring approach; encourage client to express and verbalize feelings 12. Promote measures that address preventing complications of cancer therapy 13. Instruct client and family about the disease process and treatments; provide necessary information for self-care. 14.Help client and family cope effectively. 15.Promote measures to reduce social isolation.

Eating

a healthy diet Exercise regularly Limit alcohol Maintain a healthy weight Minimize exposure to radiation and toxic chemicals Not smoking or chewing tobacco Reduce sun exposure, especially if you burn easily

Grade I: Cells differ slightly from normal cells and are well differentiated (mild dysplasia). Grade II: cells are more abnormal and are moderately differentiated ( moderate dysplasia) Grade III: cells are very abnormal and are poorly differentiated(severe dysplasia) Grade IV: cells are immature (anaplasia) & undifferentiated

Stage 0: carcinoma in situ Stage I: tumor limited to the tissue of origin, localized tumor growth (in primary site but has not spread) Stage II: Limited local spread (spread to nearby area but still in primary site) Stage III: Extensive local and regional spread (spread throughout nearby area) Stage IV: Metastasis (spread to close or distant organs)

TNM SYSTEM
one

of the most widely used staging systems International Union Against Cancer (UICC) and the American Joint Committee on Cancer (AJCC).

Most

medical facilities use the TNM system as their main method for cancer reporting. PDQ, NCIs comprehensive cancer information database, also uses the TNM system.

T - It is based on the extent of the tumor N- the extent of spread to the lymph nodes. M - the presence of distant metastasis

A number is added to each letter to indicate the size or extent of the primary tumor and the extent of cancer spread.

TX - Primary tumor cannot be evaluated T0 - No evidence of primary tumor Tis - Carcinoma in situ (CIS; abnormal cells are present but have not spread to neighboring tissue; although not cancer, CIS may become cancer and sometimes called pre invasive cancer) T1, T2, T3, T4- Size and/or extent of the primary tumor

NX

- Regional lymph nodes cannot be evaluated N0 - No regional lymph node involvement N1, N2, N3- Involvement of regional lymph nodes (number of lymph nodes and/or extent of spread)

MX

M0 M1

- Distant metastasis cannot be evaluated - No distant metastasis - Distant metastasis is present

1.
2. 3. 4. 5.

6.

Lung Cancer Breast Cancer Prostate Cancer Colorectal Cancer Lymphoma Leukemia

7. Pancreatic Cancer 8. Thyroid Cancer 9. Liver Cancer 10. Nasopharyngeal Cancer 11. Gastric Cancer 12. Ovarian Cancer 13. Renal Cell Carcinoma

Thank you and good day!