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Pathophysiology
Chapter 11-13: Cancer
37
Nursing
Undergraduate 3
09/11/2011

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Term
Carcinoma
Definition
Cancer arising in epithelial tissue
Term
adenocarcinomas
Definition
arise from or form ductal or glandular structures
Term
Sarcoma
Definition
Cancer arising from connective tissues
Term
Lymphoma
Definition
cancers of lymphatic tissue
Term
Leukemia
Definition
cancers of blood forming cells
Term
Carcinoma in situ
Definition
Preinvasive epithelial malignant tumors of glandular or squamous cell origin
Term
Characteristics of Benign Tumors
Definition
Grow slowly, have a well defined capsule, not invasive, well differentiated - looks like the tissue from which it arose, have low mitotic index, do not metastasize
Term
Characteristics of Malignant Tumors
Definition
Grow Rapidly, not encapsulated, invade local structures and tissues, poorly differentiated, high mitotic index, can spread distantly through blood cells and lymphatics.
Term
Anaplasia
Definition
Absence of differentiation. Marked by loss of organization and a marked increase in nuclear size with  evidence of ongoing proliferation. Variable size and shape. More anaplastic = more malignant.
Term
Tumor Markers
Definition
substances produced by cancer cells that are found either in or on the cancer cells or in the blood, spinal fluid or urine
Term
Alpha fetoprotein (AFP)
Definition
Secreted by liver and germ cell tumors
Term
Prostrate Specific Antigen (PSA)
Definition
secreted by prostate tumors
Term
Function of tumor markers
Definition
Can be used to screen and identify individuals at high risk for cancer, to help diagnose the specific type of tumor, follow the clinical course of cancer. Cannot be used as a definitive diagnostic test though because benign tumors may also produce markers.
Term
Apoptosis
Definition
Programmed cell death
Term
Oncogenes
Definition
mutant genes that in their normal state (proto-oncogene)direct synthesis of proteins that positively regulate proliferation
Term
tumor-suppressor gene
Definition
encode proteins that in their normal state negatively regulate (ie stop) proliferation
Term
Chromosome Translocation
Definition
A piece of one chromosome is translocated to another chromosome and can activate oncogenes. Translocation may cause excess and inappropriate production of proliferation factor : Burkitt lymphoma.
Term
Point Mutation
Definition
alteration of one or a few nucleotide base pairs. Can change a regulated proto-oncogene to an unregulated oncogene. Found in many cancers
Term
Chromosome Fusion
Definition
Type of translocation that can lead to production of novel proteins with growth promoting properties : CML (leukemia) fuses bcr on chromosome 9 to abl on chromosome 22, promotes growth of myeloid cells. Chemotherapy that targets this mutation has been used successfully.
Term
Cancer and Inflammation
Definition
Chronic inflammation has been recognized for 150 years as being an important factor in the development of cancer. Inflammatory cells release cytokines and growth/survival factors that lead to cell proliferation and blood vessel growth. Ex: Hep C virus often leads to liver cancer
Term
Viral causes of cancer
Definition
A number of viruses have been associated with cancer. Hepatitis B and C, Epstein-Barr virus, Kaposi sarcoma herpesvirus, human papillomavirus
Term
Bacterial causes of cancer
Definition
Chronic infection with Helicobacter pylori (peptic ulcer) is strongly associated with gastric carcinoma
Term
Common sites of metastasis
Definition

Lung→multiple organs, brain

Colorectal→Liver, lungs

Testicular →lungs, liver, brain

Prostate→Bones

Ovarian→Peritoneal surfaces, diaphragm, liver

Sarcoma (extremity)→Lungs

Melanoma→lymphatics, lung, liver, brain, GI tract

Term
Staging of Cancer
Definition

Stage 1: confined to organ of origin

Stage 2: locally invasive

Stage 3: has spread to regional structures (lymphatics)

Stage 4: has spread to distant sites

Term
Chemotherapy
Definition

Induction chemotherapy: seeks to cause shrinkage or disapearance of tumors

Adjuvant chemotherapy: given after surgery to eliminate micrometastases

Neoadjuvant chemotherapy: given prior to localized (surg. or rad.) treatment of cancer

Term
Brachytherapy
Definition
iodine capsules that are temporarily placed in body cavities, useful in cervical and prostate cancers.
Term
Environmental Risk Factors for Cancer
Definition
Tobacco use, obesity, sun exposure, ionizing radiation, viruses, bacteria, occupational exposures (asbestos), excessive alcohol consumption, poor diet
Term
Compnents of a Cancer-Prevention diet
Definition
Fruits and Veggies, Fiber, Foods containing Vitamin A, C, E, D, Vitamin B6, Vitamin D, Vitamin C, Foods containing folate, Spices, whole grains, lycopene, legumes and nuts
Term
Components of Cancer-risk diet
Definition
Fat, High glycemic index carbohydrates, foods with high amounts of preservatives, alcohol, blackened foods, fried foods, high levels of calcium, refined grain products
Term
Ionizing Radiation Risk
Definition

2 points of view

1) No dose of radiation considered safe

2) health risks of diagnostic doses are not measurable and may be nonexistent.

Term

 

Transgeneration Effects

Definition
The progeny of the irradiated cells have an increased rate at which genetic mutations arise
Term
Bystander Effects
Definition
Radiation induced genomic instability occurs in the descendant cells of the irradiated cell after several generations of cell division
Term

 

Mesodermal germ layer

Definition
embryonic layer that gives rise to connective tissue, blood, blood vessels, kindney and lymphatics. Origin of most childhood cancers.
Term
Cancer Rates in Children
Definition

2% of all invasive cancers

80% have distant metastases at diagnosis

10-25% more common in white than black children

More common in boys than girls

Term
Multifactorial Etiology
Definition
The interaction of many factors to produce cancer
Term

 

Prognosis for Childhood Cancer

Definition
More than 70% are cured. Especially for children under 15. Slower increases in cure rate for those from 15-24. Probably due to greater participation in clinical trials among the younger set.
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