WK 5: Lung Cancer & End of Life Flashcards
Patho of cancer
· Initiation – a mutation occurs in a cell’s DNA leading to activation of oncogenes (genes that promote cell growth) or inactivation of tumor suppressor genes (genes that inhibit cell growth)
· Promotion – mutated cells undergo continual, unregulated proliferation forming a small cluster of abnormal cells
· Progression – abnormal cells continue to divide and grow forming a tumor
Oncogenes VS tumor suppressor genes
· Oncogenes - genes that promote cell growth
· Tumor suppressor genes - genes that inhibit cell growth
Characteristics of benign VS malignant neoplasms
· Benign
○ Well-differentiated
○ Usually encapsulated
○ Expansive mode of growth
○ Metastasis absent
○ Rarely recur
· Malignant
○ Usually undifferentiated Able to metastasize Infiltrative and expansive growth
○ Frequent recurrence
○ Moderate to marked vascularity
○ Rarely encapsulated
○ Becomes less like parent cell
Poorly differentiated VS well-differentiated tumors
Poorly differentiated tumours have a worse prognosis than those closer in appearance to normal cells.
Factors that may lead to the development of cancer
· Genetic
· Chemical
· Environmental
· Viral or immunological
· From causes not yet identified
What is TNM staging
The anatomical extent of disease is based on three parameters
○ Tumour size and invasiveness (T)
○ Spread to lymph nodes (N)
○ Metastasis (M)
Clinical manifestations for lung cancer
· Cough, or change in chronic cough Dyspnea
· Blood-tinged sputum
· Recurrent chest infections Wheezing
· Chest or shoulder pain- late manifestation
· Sometimes recurrent fever is an early symptom – infection in an area near tumour
· Tumour in adjacent structures: Hoareness, dysphagia head and neck edema, pleural effusion
· Palpable lymph nodes
· Common metastases- lymph nodes, bone, brain, contralateral lung, adrenal glands, liver
· Nonspecific symptoms: weakness, anorexia, weight loss, night sweats
Diagnostic tests used to evaluate lung cancer
· Chest X-RAY
· CT scan
· Sputum cytology
· Bronchoscopy- bronchial washes, biopsy
· Needle Aspiration- under CT
· Scans for metastases-Positron emission tomography ( PET) scan, MRI
Preop if surgery a treatment – pulmonary function tests ABG’s
What is chemotherapy
Chemotherapy is a drug treatment that uses powerful chemicals to kill fast-growing cells in your body.
What is chemotherapies effect on cells?
inhibit the synthesis of cellular enzymes, hinder DNA replication, and/or induce cell damage and apoptosis
Side effects of chemotherapy
chemo is less likely to damage cells at rest but can kill/slow growth of healthy cells that grow and divide quickly (i.e., cells that line mouth, and intestines, cause hair growth, bone marrow)
What is nadir
is a term for the lowest point in white blood cells that a person reaches following each chemotherapy cycle = maximal immunosuppression
Nursing management for cancer/palliative symptoms
· Nausea and vomiting
○ Antiemetics – olanzapine, ondansetron
· Lifestyle management
○ Encourage the patient to eat foods they feel like eating
○ Avoid strong smells
○ Avoid warm foods
○ Eat smaller meals every 2-3 hours
○ Drink fluids between meals
