cd_GIT Part I

8/14/2019 cd_GIT Part I

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Oncology Nursing: An

Introduction

Prepared By: Kristina Sevilla, RN

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Cancer Statistics

All Sites of Cancer

Estimated new Cancer 1,479,350

Male - 766,130

Female - 713,220

Estimated Deaths 562,340

Male - 292,540

Female - 269,800


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2009 Estimated US Cancer the act of deviatingfrom the ordinary, usual, or normal typeDeaths*

Lung & bronchus 30%

Prostate 9%

Colon & rectum 9%

Pancreas 6%

Leukemia 4%

Liver & intrahepatic 4%bile duct

Esophagus 4%

Urinary bladder 3%

Non-Hodgkin 3%

lymphoma

Kidney & renal pelvis3%

All other sites 25%

2009, American Cancer Society, Inc.

Men

292,540

Women

269,800 26% Lung & bronchus

15% Breast

9% Colon & rectum

6% Pancreas

5% Ovary

4% Non-Hodgkinlymphoma

3% Leukemia

3% Uterine corpus

2% Liver & intrahepaticbile duct

2% Brain/ONS

25% All other sites


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Mortality, 2006 Rank cause of Death

1. Heart Diseases 631,636 26.0

2. Cancer 559,888 23.1

3. Cerebrovascular diseases 137,119 5.7

4. Chronic lower respiratory diseases 124,583 5.1

5. Accidents (unintentional injuries) 121,599 5.0

6. Diabetes mellitus 72,449 3.0

7. Alzheimer disease 72,432 3.0

8. Influenza & pneumonia 56,326 2.3

9. Nephritis* 45,344 1.9

10. Septicemia 34,234 1. 4

2009, American Cancer Society, Inc.


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Incident


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History

Greek Word

Karkinoma for Crab


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CANCER

A group of more than 270 different diseases

characterized by:

Proliferation

Invasion and Metastasis

Loss of Differentiated Function Mutations


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The Precise

Etiology of Canceris UNKNOWN


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How does Cancer Develop

Initiation

Promotion

Progressio

n


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Defect in Cellular Proliferation

Under normal situations there is control ofthe number of cells in the body.

Balance between cellular proliferation and

cellular death. Contact inhibition

If something goes wrong in the control

mechanism, it can result in rapidproliferation of immature cells.


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Normal Cells

VS.Malignant Cells


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MITOTIC CELL DIVISION

Normal Cells Malignant Cells

Leads to two daughter cell Leads to multiple daughtercells that may or may not

resemble the present.


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APPEARANCE

Normal Cells Malignant Cells1. Cells of the same type,

homogenous in size,shape, and growth.

2. Cells cohesive, formregular pattern expansion.3. Uniform size to nucleus.4. Have characteristics

pattern of organization.

1. Cells larger and grow morerapidly than normal.

2. Cells not as cohesive,irregular patterns ofexpansion.

3. Larger more prominentnucleus.

4. Lack characteristic patternof organization of hostcells.


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GROWTH PATTERN

Normal Cells Malignant Cells

1. Do not invade adjacenttissues

2. Proliferate In response tospecific stimuli

3. Grow in ideal condition

1. Invade adjacent tissues

2. Proliferate in response toabnormal stimuli

3. Grow in adverse condition

such as lack of nutrients.


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GROWTH PATTERN

Normal Cells Malignant Cella

1. Exhibit Contact Inhibition

2. Cell birth equals Cell death

3. Stable Cell Membrane

Do not exhibit ContactInhibition

Cell birth exceeds Cell Death

Loss of Cell Control as aresult of cell membranechanges


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GROWTH PATTERN

Normal Cell Malignant Cell

1. Constant or Predictablegrowth rate

2. Cannot grow outsidespecific environment

1. Growth rate erratic

2. Able to break off cells andmigrate.

May grow in the other sites.


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Normal Cells Cancer Cells

Reproduce themselves exactlyStop reproducing at the right time

Stick together in the right place

Self destruct if they are damaged

Become specialized or 'mature

Cells communicate well

Cancer cells don't stop reproducing

Cancer cells don't stick together

May self destruct more slowly thanthey reproduce

Cancer cells don't specialize, butstay immature

Cancer cells don't obey signals fromother cells


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Reactive and Neoplastic Growth Process

Atrophy

Hypertrophy

Hyperplasia


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Reactive & Neoplastic Growth Process

Metaplasia cell type conversion

Dysplasia maturation Abnormality

Anaplasia DeDifferentiation

Neoplasia abnormal Proliferation


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What is Neoplasm?

is an abnormal proliferation of tissues,

usually caused by genetic mutations.

Any overgrowth of tissue can form a

TUMOR.

Either Benign or malignant.


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BENIGN NEOPLASM MALIGNANT NEOPLASM

1. Composed of cells that look like

the tissue origin2. Usually encapsulated3. Grow slowly and by expansion4. Do not recur and metastasize

5. Do not destroy tissue generally6. Do not cause systemic

symptoms or death generally.

1. Composed of Undifferentiated

Cells2. Little semblance to tissue of

origin3. Grows rapidly4. Expands at Periphery and

Invades and destroyssurrounding tissue

5. It Spreads by way of lymph andblood to distant parts of the body

6. Causes systemic signs and maycause death


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What is TUMOR?

is the name for a swelling or lesion formedby an abnormal growth of cells (termed

neoplastic).

Tumor is not synonymous with cancer. A tumor can be benign or malignant.

C


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Cancer Types

Carcinoma- a tumor derived from epithelial

cells, those cells that line the surface of our skin

and organs.

This is the most common cancer type and

represents about 80-90% of all cancer casesreported.

Sarcoma- a tumor derived from muscle, bone,cartilage, fat or connective tissues.


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Leukemia- a cancer derived from white blood

cells or their precursors.

Lymphoma- a cancer of bone marrow derived

cells that affects the lymphatic system.

Myelomas- a cancer involving the white blood

cells responsible for the production of antibodies


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Where Cancers Spread Locally?

tumors grow along the

path of least resistance.


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How Cancer Spreads?

The cancer that grows where it first started

in the body is called the 'primary cancer'.

The place a cancer spreads to and then

starts growing is called the 'secondary

cancer' or 'metastasis'.


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How Cancer Spreads?


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Three main ways a cancer spreads.

Local spread

Through the blood

circulation

Through the

lymphatic system


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GENES andMUTATIONS


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Normal Genes Mutated Genes

1. proto-oncogene

A gene that has functions topromote cell division.are responsible for providing thepositive signals that lead to celldivision. Some proto-oncogeneswork to regulate cell death

2. Tumor SuppressorA gene that functions in the controlof cell division.These genes work to limit celldivision and may be contrasted withoncogenes

1. Oncogenes

A defective gene that is involvedin triggering cancer cell growth can cause a cell to divide in an

unregulated manner.

2. The loss of function of thesegenes leads to abnormal cellularbehavior


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FACTS:

All cancers demonstratealterations in one or more

tumor suppressorsand oncogenes


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Hallmarks of Cancer

1. Tissue Invasion and Metastasis

2. Failure to Respond to STOP Signals

3. Evading Apoptisis4. Growth without GO Signals

5. Unlimited Number of Cell Divisions

6. Continued Angiogenesis


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Risk Factors of Cancer

Non Controllable

Gender M> F

Age

Race

Controllable

Stress

Diet

Occupation

Infection

Lifestyle

Drugs


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Etiology/ Causative Factor

Extrinsic Factor Viruses and bacteria

Chemical Carcinogens

Radiation Carcinogens

Iatrogenic Chemical

agents

Intrinsic Factor

Hormonal Factor

Genetic Factor Physical Stressor

Dietary Factors

A Vi d B t i


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A. Viruses and Bacteria

Vi d B t i


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Viruses and Bacteria


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Chemical Agents

Industrial wastes, pesticides, cigarette

smoking, asbestos, phenol

Natural body substance in body: Bile acids

Food Additives: Sodium Saccharine, Nitrites

Drugs and Hormone


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Physical Agents: Radiation

-Radiation (both solar and ionizing), and

radon, nuclear radiation.

Hereditar Factors


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Hereditary Factors

C Ni W i Si


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Cancers Nine Warning Signs

Change in bowel or bladder habits

A sore that does not heal

U nusual bleeding or discharge

T hickening or lump in breast or elsewhere I ndigestion or difficulty in swallowing

Obvious change in wart or mode

N agging cough or hoarseness U nexplained anemia

S sudden loss of weight


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Levels of Cancer

Prevention and Control


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1. Primary Prevention

Focus on eliminating the conditions that

cause cancer to develop.

Cancer not yet develop or is in pre-

cancerous stage.


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2. Secondary Prevention

Refers to early detection coupled with

effective therapy.

Cancer maybe curablein early stage.


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3. Tertiary Prevention

Refers to te prevention of cancer

recurrences, symptoms and

complications.

It involves supportive care, Rehabilitation

and Pain Relief.


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Thank You!

Documents

cd_GIT Part I