Neoplasms - VO

Chapter 20: Neoplasms and Cancer

  • Author: Jennie Bergen, EdD, RNC-OB, CNE

    • Institution: Clayton State University

Understanding Neoplasms

  • Neoplasia: Refers to cancer; involves non-adaptive, abnormal cell growth.

    • Characteristics:

      • Loss of apoptosis (programmed cell death).

      • Abnormal differentiation leads to cells that no longer resemble parent cells and serve no functional purpose.

      • Utilizes body resources to perpetuate growth.

Types of Neoplasia

  • Benign Neoplasia:

    • Stays localized; generally does not metastasize.

    • Grows slowly in size.

  • Malignant Neoplasia:

    • Capable of metastasis (spreading to distant sites).

    • Exhibits invasive properties; characterized by uncontrolled growth.

Characteristics of Tumors

Table 20-2: Benign vs. Malignant Tumors

  • Benign Tumors:

    • Cells similar to normal cells.

    • Relatively slow growth; often encapsulated.

    • Remain localized with rare systemic effects.

    • Malignant Tumors:

      • Cells are often undifferentiated with varied sizes and shapes.

      • Rapid growth; invasive; lack a protective capsule.

      • Can metastasize through blood and lymph.

Warning Signs of Cancer

  1. Unusual bleeding or discharge from any body area.

  2. Changes in bowel or bladder habits (e.g., prolonged diarrhea).

  3. Alterations in the appearance of a wart or mole (e.g., color, size, shape).

  4. Non-healing sore, whether on the skin or oral mucosa.

  5. Unexplained weight loss.

  6. Anemia or persistent fatigue.

  7. Unexplained cough or hoarseness.

  8. Painless solid lump in breast, testes, or elsewhere.

Local Effects of Tumors

  • Pain: Typically absent in early stages; can become severe as the tumor progresses.

  • Obstruction: Tumors may block ducts or passageways, reducing blood supply and causing dysfunction (e.g., digestive tract obstruction).

  • Tissue Necrosis and Ulceration: May lead to localized bleeding or infection around tumors.

Systemic Effects of Malignant Tumors

  • Weight Loss and Cachexia: Result from increased energy demands of tumor cells, coupled with anorexia and psychological stress.

  • Anemia: May be due to blood loss at tumor sites or nutritional deficits affecting hemoglobin production.

  • Severe Fatigue: Linked to anemia, cachexia, and psychological stress from treatment.

  • Inflammation and Infection: Occur as body resistance declines.

  • Bleeding: Can result from tumor erosion of blood vessels.

  • Paraneoplastic Syndrome: Certain tumors may produce substances affecting neurological and hormonal functions.

Diagnostic Tests for Cancer

  • Routine Screening: Critical for early detection and monitoring after treatment.

  • Self-Examinations: Important for early identification; focus on breast, testicular, and skin exams.

  • Blood Tests: Used to monitor blood cell levels during treatments and detect tumor markers (e.g., PSA for prostate cancer).

  • Imaging Techniques: Includes radiographic methods, ultrasound, MRI, and CT scans for visualizing tissue or organ changes.

  • Cytological Tests: Involves biopsy or cell sampling for histological examination, aiding in tumor classification and treatment sensitivity.

Spread of Malignant Tumors

  • Invasion: Local spread of tumor cells into adjacent tissues (e.g., uterine carcinoma invading the vagina).

  • Metastasis: Distant spread via blood or lymphatic systems (e.g., colon carcinoma spreading to the liver).

Staging Cancer

  • Aids in standardizing the assessment of treatment outcomes and estimating prognosis.

  • Commonly uses TMN System:

    • T: Size of primary tumor.

    • N: Involvement of regional lymph nodes.

    • M: Presence of metastasis.

Carcinogenesis

  • The process of normal cells transforming into cancer cells, which can vary significantly in duration and factors involved.

  • Multifactorial Disease: Influenced by environmental factors, genetic changes, and infections (e.g., HPV in cervical cancer).

  • Well-established risk factors exist for certain cancers.

Risk Factors for Cancer

  • Genetics: Oncogenes regulate cell growth and can contribute to cancer development.

  • Infections: Oncoviruses can alter the DNA of host cells.

  • Radiation Exposure: Increases risk, particularly ultraviolet, X-rays, and gamma rays; risk accumulates with higher dosages.

Cancer Incidence

  • Most Common Types in Men:

    • Prostate Cancer

    • Lung Cancer

    • Colorectal Cancer

  • Most Common Types in Women:

    • Breast Cancer

    • Lung Cancer

    • Colorectal Cancer

Intracellular Accumulations

  • The buildup of substances within cells; can be reversible if the harmful stimulus is removed, but potentially lethal otherwise.

  • Accumulations can occur in the cytoplasm or nucleus and manifest in varying conditions, including liver and kidney diseases.

Specific Types of Cellular Accumulations

  • Water Accumulation: Resulting from Na+ ion pump failure; can lead to cellular swelling.

  • Lipid Accumulation: Commonly occurs in the liver; may result from excessive intake or impaired metabolism.

  • Other Accumulations: Include carbohydrates, proteins, pigments, calcium, and urate deposits.

Conclusion

  • Understanding neoplasms and their impact on health is crucial for early detection, effective treatment, and prognosis of cancer.