NUR 2392 Exam 1 (Version 1) Study Guide

NUR 2392 Exam 1 (Version 1) Study Guide • WHAT INFLUENCES CANCER GROWTH? ○ Exposure to carcinogens (tobacco, radiation, chemo, hormone drugs, pollution) ○ Genetic predisposition (BRCA gene, family history) ○ Immunity ○ Factors that cause cancer can be divided into: ■ External: chemical, physical, viral ■ Personal: immunity, age, genetic risk ● WHAT IS INCIDENCE? ○ The number of new cases reported by the American Cancer Society ■ Women have the highest incidence of breast cancer ■ Men have the highest incidence of prostate cancer ■ 2nd highest for both men and women is lung cancer ■ 3rd highest for both is colon and rectal cancer ● THREE CONTRIBUTING FACTORS TO INCIDENCE ○ Hereditary ■ 10-15% of cancers are inherited (breast, ovarian, colon, prostate, Wilm’s, retinoblastoma) ○ Environment ■ Air pollutants (vinyl chloride, lead insecticides) ■ Work environment (welders, chrome platers, leather tanners) ■ Water pollutants ■ Bacteria, viruses, asbestos, medical drugs, hormones ■ Radiation (UV, sun, x-ray, radioactive chemicals) ○ Lifestyle ■ Cigarettes, red meat, fat, estrogen, obesity, radiation, viruses, drugs, etc. ● Biochemical research: ○ Identify prevention ○ Screening ○ Treatments (chemo and radiation) ○ Management of symptoms ● RISK FACTORS FOR CANCER (Opposite = prevention) ○ Smoking ○ Poor nutrition ○ Excessive weight ○ Sedentary lifestyle ○ Exposure to environmental carcinogens ○ Genetics ● PREVENTION ○ Primary goal: to reduce the risk for cancer development ■ Sunscreen, vaccinations, elimination of tobacco, modification of diet, etc. ○ Secondary goal: early detection; participation in screening ■ Routine screenings ○ Tertiary goal: prevention of recurrence through chemo-preventive agents - Prevention strategies in order to lower chance of developing cancer: - Maintain a healthy lifestyle - Reduce exposure to cancer-causing substances - Adhere to medication regimen - Routine screenings - Vaccinations ● CANCER WARNING SIGNS (C.A.U.T.I.O.N) ○ Change in bladder/bowel habits ○ A sore that does not heal ○ Unusual bleeding or discharge of any body orifice ○ Thickening or presence of lump ○ Indigestion or difficulty swallowing ○ Obvious change in wart or mole (color, size, texture) ○ Nagging cough or hoarseness that is prolonged ● BENIGN ○ Harmless, does not usually require intervention ○ Slowx, steady growth ○ Remains localized ○ Smooth, well defined, and moveable when palpated ○ Resembles parent tissue ○ Ex: adenomas, fibroids, hemangiomas, lipomas ● MALIGNANT ○ Indicates cancer ○ Has migrated ○ Fatal without intervention ○ Usually rapid growth ○ Rarely contained within a capsule ○ Irregular, immobile when palpated ○ Little resemblance to parent tissue (anaplasia) ○ May come back after removal ○ Ex: carcinomas, sarcomas, lymphoma/leukemia, blastomas ● SLNB PROCEDURE ○ Sentinel node is identified, removed, and examined for the type of cancer cells present ○ It is used in people who have already been diagnosed with cancer ● LEUKEMIA ○ Arise from organs that form the blood and invade the production of normal blood cells ● LYMPHOMA ○ Affect the lymphocytes, which fight infections and produce enlarged lymph nodes in the armpits, chest, abdomen, and groin ● CARCINOMAS ○ Originate in the epithelial cells of the skin, lungs, liver, kidneys, stomach, breast, prostate, and thyroid ■ Are likely to metastasize ● SARCOMAS ○ Originate in the soft tissues such as the muscles, blood vessels, bone, and connective tissue ● STEPS OF CARCINOGENESIS ○ INITIATION : 1st step, changes in gene expression caused by anything that can damage cellular DNA, leading to loss of cellular regulation; normal cells become damage, which is irreversible and leads to cancer development ○ PROMOTION : Enhanced growth of and initiated cell by substances known to cause cancer, this is when it becomes a tumor; repeat exposure enhances cell growth which leads to mutation ○ PROGRESSION : 1cm tumor has billion of cells and contains its own blood supply; increase in the production of malignant cells ○ METASTASIS : Occurs when cancer cells move from primary location to other location; EX: Liver cancer (Primary) metastasis to the stomach (secondary); movement of cells from the primary site ● PRIMARY/ SECONDARY TUMORS ○ Primary : Identified by the tissue from which it arose (Parent tissue) ○ Secondary : Cancer cells move from primary location (Additional tumor) ■ Metastatic ● DIAGNOSTIC TESTING: ○ Lab tests: ■ CBC (Complete blood count) ■ Blood protein testing