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Neoplasia

NRS 233 - Pathophysiology II
by

Katrina Dielman

on 1 May 2016

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Transcript of Neoplasia

Neoplasia
Development of Cancer
Principle #4:
Cancer develops from abnormalities at the DNA level
Response to Cancer
General Systemic Effects of Cancer
Anorexia
Cachexia
Fatigue
Clotting abnormalities
Hypercalcemia
SIADH
Pain
Neoplasm Terminology
Principle #1:
Names of neoplasms often describe the site of origin of the cancerous cells, and if it is benign vs. malignant (e.g., -oma vs. carcinoma/sarcoma)
Characteristics of
Benign & Malignant Neoplasms
How to Blow a Chance at Apoptosis
Benign
Cells well-differentiated
Grow slowly
Do not invade surrounding tissue
Have a capsule
Do not metastasize
Little vascularity
Rarely demonstrate necrosis or ulceration
Do not have systemic effects
Kevin Jasper, age 17, has been diagnosed with a
benign brain tumor
. His mother says, "I just do not understand. Since it is not cancer, why do they have to operate? I am worried sick at the thought of them cutting open his head, if it is not cancer!"
Reply as if you are talking directly to her.
NRS 233 - Pathophysiology II
Principle #2:
Neoplasms can cause obstruction & destroy organ function
Mr. Hobb was diagnosed with
osteosarcoma
. His teenaged daughter says, "I know Dad has cancer, but what exactly does that long word mean?"

Reply as if you are talking directly to her.
uab.edu
scielo.br
Differentiation:
The acquisition of specific cell functions
Proliferation:
Reproduction of new cells through cell division -
mitosis
(develop or replace lost or damaged normal tissues) &
meiosis
(eggs & sperm)

Replication:
The most fundamental aspect of
cell cycle control
is the regulation of
entry
&
exit
Terms used to describe detailed aspects of cellular reproduction & growth:
Most common sites of cancer origin in USA - 2012
Estimated
new cases
Estimated
deaths
neurosurgery.ucla.edu
Malignant
Cells poorly differentiated/immature - "
anaplastic
"
Grow rapidly
Invade adjacent tissue (
invasion
) & spread to distant sites (
metastasis
)
No capsule
Metastasize to LN and distant tissues
Demonstrate necrosis & ulceration
Have systemic effects
Principle #3:
Benign & malignant neoplasms have different characteristics
Tumor
Grading

vs.

Staging
Grading:

How poorly differentiated the cells are -
"Degree of Anaplasia"
Staging:

The location and pattern of spread of a tumor
Grading System of the
American Joint Committee on Cancer
GX
- Grade cannot be assessed
G1
- Well differentiated (low grade)
G2
- Moderately differentiated (intermediate grade)
G3
- Poorly differentiated (high grade)
G4
- Undifferentiated (high grade)
Tumor Staging:
TNM Classification System
T = Size of tumor
The higher the T number, the larger the tumor and/or the more it has grown into nearby tissue
N = Lymph node involvement
The larger the N number, the more extensive the lymph node involvement

M = Metastasis
The higher the M number, the more extensive the metastasis
nytimes.com
Overactive
Proto-oncogenes
Underactive
Tumor Suppressor Genes
Major Signaling Pathways for Cancer
Cell Cycle
Phases of the Cell Cycle
G0 (Resting state)
-
The cell must leave this resting state to enter the cell cycle
G1 (Gap 1)
S (Synthesis)
G2 (Gap 2)
M (Mitosis)
Overactive
Underactive
Cells can become trapped in any stage of the cell cycle, but they do not reverse the process and go back to G0
Entry!
Exit!
Theories of Carcinogenesis
Additional mutations = malignancy
Anchorage independence
Activation of telomerase gene
Cancer cells are considered immortal
Carcinogens
Assisted by
Infection
Hormones
Response to Diagnosis & Treatment
Emotional, relational, financial
Chemotherapy & radiation
Meningioma
References
Copstead, L. & Banasik, J. (2013).
Pathophysiology
(5th ed.). St. Louis, MO: Elsevier.

Felver, L. (2013). Online Materials:
PROP- Pathophysiology online.
Retrieved from https://evolve.elsevier.com/

Giddens, J. (2013).
Concepts for nursing practice
(1st ed.). St. Louis, MO: Elsevier Mosby.

YouTube videos from Kahn Academy embedded on some slides.
Talk to a Family Member
Talk to the Mom
Kahn Academy
Full transcript