CHAPTER 20 CANCER IS WHAT THIS CLASS IS GONNA GIVE ME AUAUAUGH

Oncologists

who are physicians who specialize in the diagnosis and treatment of patients with cancer. There are many subspecialties of oncologists, including medical oncologists, surgical oncologists, pediatric oncologists, and radiation oncologists; their titles are self-explanatory

Oncology clinical nurse specialists

who are registered nurses with advanced clinical practice in the care of cancer patients

Oncology social workers

who have master’s degrees in medical social work and provide for the social and emotional needs of cancer patients and their families.

Cancer (CA)

a class of malignant diseases characterized by uncontrolled cell division. The basic cause of this uncontrolled growth is damage to the cells’ DNA. This damage produces mutations to the genes that control cell division. These mutations, which can be inherited or acquired, lead to the uncontrolled cell division and malignant tumor formation. Thus, all of it is genetic; that is, it develops because something in a cell’s genes has changed (mutated).

neoplasms

these tumors formed when cells multiply more quickly than cells die. malignant if they rapidly produces. Benign if they do not spread.

oncology

The study of tumors

The cells of malignant tumors

Have unlimited, unregulated growth potential.

Grow directly into adjacent tissues (invasion or infiltration).

Invade the lymphatic system and are carried to local and distant lymph nodes

Invade the bloodstream and are carried to other distant organs and tissues (metastasis)

The cells of benign tumor

Grow slowly.

Are surrounded by a connective tissue capsule.

Do not invade or infiltrate adjacent tissues.

Do not spread to other organs (metastasize) or to lymph nodes.

Can compress surrounding tissues, causing functional problems.

benign

denoting the nonmalignant character of a neoplasm or illness

cancer

general term of a malignant neoplasm

cancerous

pertaining to a malignant neoplasm

infiltrate

to penetrate and invade a tissue or cell

infiltration

the invasion into a tissue or cell

malignant

capable of invading surrounding tissues and metastasizing to distant organs

malignancy

tumor that invades surrounding tissues and metastasizes to distant organs

metastasis

spread of disease from one part of the body to another

metastases

metastasis plural

metastatic

able to metastasize

mutation

a change in the chemistry of a gene that is continued in subsequent division of the cell

mutagen

agent that produces a mutation in a gene

neoplasm

a new growth, either in benign or a malignant tumor

neoplastic

pertaining to a neoplasm

oncology

the science dealing with cancer

oncologist

medical specialist in oncology

proliferate

to increase in number through reproduction

tumor

any abnormal swelling

carcinoma in situ (CIS)

describes an early form of carcinoma in which there is no invasion of surrounding tissues. In many instances, it is a precursor that will transform into an invasive or malignant cancer.

Carcinoma originates from

Epithelial cells

Sarcoma originates from

connective tissue, bone, cartilage, muscle cells

leukemia originates from

blood-forming tissues cells

lymphoma originates from

lymph nodes

melanoma originates from

melanocytes (pigment producing skin cells)

Carcinoma examples

Cervical cancer, stomach cancer, squamous cell skin cancer, lung cancer

Sarcoma examples

Osteosarcoma, chondrosarcoma, rhabdomyosarcoma

leukemia examples

Acute lymphocytic leukemia, chronic myelogenous leukemia

lymphoma examples

Hodgkin disease, non-Hodgkin lymphoma

melanoma examples

Malignant melanoma

Non–small cell lung cancer

accounts for 85% of cases, and 80% of patients die within 5 years of diagnosis.

Squamous cell carcinoma

arising from round cells that have replaced damaged cells in the epithelial lining cells of a major bronchus. It accounts for 25% to 40% of lung cancers.

Adenocarcinoma

arising from the mucus-producing cells in the bronchi. It accounts for between 30% and 50% of lung cancers. It is the most common lung cancer in women, and its incidence is increasing.

Large cell carcinoma

which includes cancers that cannot be identified under the microscope as squamous cell or adenocarcinoma. It accounts for 10% to 20% of lung cancers

Small cell lung cancer

like squamous cell carcinoma, is derived from the epithelial cells of the bronchi but replicates at a faster rate, producing smaller cells. It accounts for 14% of all lung cancers; most patients die within 18 months of diagnosis

Mesothelioma

a rare tumor arising from the cells lining the pleura and is associated with asbestosis

adenocarcinoma

a cancer arising from glandular epithelia cells

carcinoma

a malignant and invasive epithelial tumor

carcinoma in situ (CIS)

carcinoma that has not invaded surrounding tissues

chondrosarcoma

cancer arising from cartilage cells

leukemia

disease in which the blood is taken over by white blood cells and their precursors

melanoma

malignant neoplasm formed from cells that produce melanin

mesothelioma

cancer arising from cells lining the pleura or peritoneum

osteosarcoma

cancer arising in bone-forming cells

rhabdomyosarcoma

cancer derived from skeletal muscle

sarcoma

a malignant tumor originating in connective tissue

Carcinogenesis

literally the creation of cancer, is the abnormal rate of cell division as a result of damaged DNA causing gene mutation.

Apoptosis/ Programmed cell death PCD

programed cell death

Protooncogenes

are healthy genes that promote normal cell growth.

Mutated oncogenes

cause malfunctions in the normal growth mechanisms.

Tumor suppressor (TS) genes

normally suppress mitosis and are activated by DNA damage. Their function is to stop cell division so that the abnormal genetic structure cannot be passed on to daughter cells.

Mutated TS genes

the abnormal cells can divide and proliferate. A mutated TS gene called p53 is present in half of all cancers and is associated with a poor prognosis and resistance to chemotherapy

mutagens

Agents that cause these mutations.

carcinogens

agents that cause mutation that leads to cancer

environmental tobacco smoke (ETS)

secondhand smoke. contains the same chemicals and carcinogens as those inhaled by smokers. It is responsible for 3,000 lung cancer cases each year in America. The genetic mutations caused by the carcinogens are probably similar to those in the subset of smokers discussed earlier, even though exposure to the carcinogens is much less than that for smokers.

apoptosis

programmed normal cell death

carcinogen

cancer-producing agent

carcinogenic

causing cancer

carcinogenesis

origin and development of cancer

different

not alike

differentiate

to change from generalized to specialized

oncogene

one of a family gene involved in cell growth that work in concert to cause cancer

oncogenic

capable of producing a neoplasm

protooncogene

a normal gene involved in normal cell growth

Radon

a radioactive gas that you cannot see or smell, is the second leading cause of lung cancer (after smoking). It is produced by decaying uranium and is found in nearly all soils.

Air pollution

may be the cause of the 10% to 40% increase in lung cancer mortality between urban and rural areas

Particulate matter

very small particles, includes soot; organic material such as hydrocarbons; and metals such as arsenic, chromium, and nickel—all of which are known mutagens and carcinogens.

Chemical toxins

are estimated to cause more than 75% of all cancers. Some 77,000 chemicals are used in this country. Over 3,000 are added to our food, and most Americans have between 400 and 800 chemicals stored in their bodies, mostly in fat cells

Chlorine

Used in drinking water, chlorine produces carcinogenic compounds. Cancer risk among people drinking chlorinated water is 93% higher than that of people not drinking chlorinated water.

Lead

Found in lead-based paint and contaminated air, water, and soil, lead poisoning can severely affect mental and physical development, particularly in children younger than 6. In 2014, over 100,000 residents of Flint, Michigan, including 12,000 children, were exposed to high levels of lead in their drinking water. The lead came from the polluted river source of water and from lead pipes used to supply the water.

Polychlorinated biphenyls (PCBs)

These were banned years ago but still persist in the environment, and are found in farmed salmon.

Pesticides

, 60% of herbicides, 90% of fungicides, and 30% of insecticides are known to be carcinogenic (Figure 20.6). Farmers using pesticides have a 14% greater risk for developing prostate cancer than do organic farmers.

Dioxins

These are chemical compounds produced by combustion processes from waste incineration and from burning fuels like wood, coal, and oil.

Asbestos

This insulating material was used in the 1950s to 1970s on floors, ceilings, water pipes, and heating ducts. When the material becomes old and crumbly, it releases fibers into the air. Inhalation of the fibers is the cause of mesothelioma

Arsenic

This is used by insecticide and herbicide sprayers and oil refinery workers

OSHA

Occupational Safety and Health Administration

Obesity

is said to be linked to about 10% of breast and colorectal cancers and up to 40% of kidney, esophageal, and endometrial cancers

chlorine

a toxic agent used as a disinfectant and bleaching agent

dioxin

carcinogenic contaminant in pesticides

environment

all the external conditions affecting the life of an organism

environmental

pertaining to the environment

particle

a small piece of matter

particulate

relating to a fine particle

pesticide

agent for destroying files. mosquitoes, and other pests

pollution

condition that is unclean, impure, and a danger to health

radon

colorless, tasteless, and odorless gas that can cause lung cancer

uranium

radioactive metallic element

Breast Cancer Screening

Examination and palpation.

Self-examination of the breast following a period.

Mammograms

Digital mammography

Computer-aided mammography

Ultrasound

Magnetic resonance imaging (MRI)

Ductal lavage

Biopsy

Mammograms

to record images of the breast on x-ray film.

Digital mammography

to record images in computer code

Computer-aided mammography

using a laser beam to produce a digital signal that can be processed by a computer to highlight suspicious areas.

Ultrasound

using sound waves to make a computer image of the inside of the breast, particularly to see changes in women with dense breast tissue and to tell the difference between benign fluid-filled cysts and a possibly malignant solid mass.

Magnetic resonance imaging (MRI)

creating detailed images of the breast in different planes.