Med Surg 8: Oncology

Class 8: Cancer

 

Hyperplasia: proliferation of cells that are still organised

dysplasia: proliferation of cells that are becoming disorganized.

situ: in the normal location.

  • so if there is dysplasia in situ this means that the cancer is not yet invasive to other tissues.

 

Proto – oncogene: allows apoptosis to occur.

  • oncogene: a protooncogene that has been damaged and can no longer signal apoptosis at the right time or at all.

 

Tumor suppressor gene:

 

Immune system

  • T lymphocytes: deal with INtracellular foreign substances
  • B lymphocytes: deal with EXtracellular foreign substances
  • Immunologic escape: the process where the cancer can avoid our immune system safeguards.
  • Oncofetal antigens: in tumor cells as well as fetal cells
    • are not well differentiated

 

mutations in genes:

  • Primary cancer related genes: Oncogenes, tumor suppressor genes, DNA repair genes

 

screening

  • self exams
  • cervical
  • breast
  • prostate – do not run psa on everyone any more no
  • ovarian – no general test
  • colon – at and after 50

 

biopsy will allow us to see the differentiation in the cell types

  • styles: Needle aspiration, Core or incisional, and excisional
  • all of these will give us a tissue sample of the cancer.

 

Stages – the extent of the disease and how invasive it is

  • 0 – situ (precancer, some dysplastic cells)
  • 1 – local tumor
  • 2 – limited local (lymph nodes)
  • 3 – extensive spread
  • 4 – metastasis

TNM classification

  • T = tumor size T1-T4
  • N = spread in the lymph nodes N0 – N3
  • M = metastasis 0 or 1

 

Grades – the differentiation of the cell types

 

Karnofsky scale 100% is perfect, and 0% is death

 

ECOG – eastern cooperative oncology group

  • 0 full active, 4 completely disabled, 5 death

 

hysterectomy types

  • Subtotal – remove uterus
  • total – and cervix
  • total and bilateral salpingo oophorectomy – and fallopian tubes and ovaries
  • Radical – and upper vagina, other tissue, and lymph nodes

 

palliation – comfort and symptom management

 

drug therapy – the goal is to combine drugs to minimize s/s and maximize the cancer killing effectiveness

  • chemo is an adjuvant to surgery (meaning that it is supportive therapy after the surgery to clean up the excess
  • only chemo certified RNs can give chemo.
  • be careful with waste/spills
  • special protocol for extravasation of IV
  • Ask when the last dose of chemo was and what was it?

Study tips:

  • Potential complications of dxs
  • what would I will
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