Clients reaction to cancer Pain, Death Families reaction to cancer grief stress supportive financial role change Nurses reaction to cancer mine? be supportive to patient and families Epidemiology of cancer gender site age race geographic factors Why is incidence of cancer in men > women? Men have a weaker immune system Leading cause of Cancer deaths in men Lung Prostate Colorectal Leading cause of Cancer deaths in women Lung Breast Colorectal At what age is cancer highest? > 65 yrs of age In US why is mortality rate > in African Americans? Because it is seen in a later stage maybe due to not having ins or seeking help Primary prevention interventions Avoid known potential carcinogens Modify associated factors / behaviors Remove at risk tissue Chemoprevention Secondary prevention Screeening programs Genetic testing Gene therapy 75% of all cancers are related to? environment Name some primary preventative measures sunblock smoking cessation changes in diet removing at risk tissue due to gene (braca) Chemoprevention- hormone therapy to prevent from getting cancer Name some known potential carcinogens smoking drinking pesticides asbestos Name some secondary preventative measures screening mammogram > 40 - unless have family history, when younger need to have MRI to diagnose breast cancer colonoscopy > 40 unless have family history, do every 10 yrs if clear psa - blood work that cks prostate > 40 or 50 Signs and symptoms of colon cancer rectal bleeding polyps When should you have your first pap smear? When you become sexually active or start having periods After 30 if never had an abnormal one can do every 3 yrs Risk factors and carcinogens (viruses) CMV EBV - Ebstein Barr-mono-lymphoma HPV HIV - decreased immune system Risk factors and carcinogens ( bacteria) H-pylori (risk for colon cancer or stomach cancer) Risk factors and carcinogens (host factors) genetics hormonal immunologic mechanisms - immune system cannot fight off Risk factors and Carcinogens ( environmental factors) Physical agents Chemical carcinogens Radiation Lifestyle Risk factors and carcinogens ( dietary ) the more fat you eat the more estrogen and that causes lots of cancers red meat and processed meat char on meat when grilled natural (fresh) is best Organizations involved in cancer education (Support groups) American Cancer Society (ACS) National Hospice and Palliative Care Organization (NHPCO) How many days do red blood cells live? 120 days What cells are not replaced? brain cells and neurons Labile cells ( multiply constantly through life ) skin Cell Differentiation (orderly process) Proliferating cells transformed Specialization structure and function How often are platelets replaced? Every few hours Movement through cell cycle is controlled by: proteins Why is cell cycle used in cancer treatment? Because more cycles that can be hit the better the treatment What is the best cell cycle phase to hit during treatment? S phase (synthesis) Euploid normal DNA 23 chromosomes Abnormal cell growth (Cellular changes) Atrophy- down tone Hypertrophy- up tone Hyperplasia- up in # of cells Metaplasia- scaring Dysplasia- can be precancerous Anaplasia Neoplasia- can be benign or cancerous Characteristics of normal cells limited cell division specific morphology small nuclear-cytopasmic ratio perform specific differentiated functions adhere tightly together non-migratory growth orderly, well-regulated manner contact inhibited euploid-normal DNA What is Neoplasm? tumor Carcinogenesis Initiation- exposure (cigarettes kills off cilia) Promotion- keep smoking (promotes change) Progression- keeps getting bigger and bigger Benign Not cancerous wont spread to other areas Malignant cancer Malignant cell Anaplastic (big nucleus) What does cancer of unknown origin mean? can't tell what kind of cell / very hard to treat because we don't know where it came from Benign cell characteristics Inappropriate cell growth Specific morphology Well differentiated Encapsulated Adhere tightly together Non-migratory Grow in an orderly manner Euploid Malignant cell characteristics Rapid or continuous cell division Unlimited life span Anaplastic morphology Large nuclear-cytoplasmic ratio Lose some or all differentiated functions Adhere loosely together Able to migrate Grow by invasion Not contact inhibited Aneuploid- chromosomes not normal Radical getting rid of everything around it Define in very simple language the cause of cancer: Cancer begins when an abnormal cell, after being transformed by the genetic mutation of DNA, forms a clone and begins to proliferate abnormally The single most lethal chemical carcinogen is ________ Tobacco smoke (it accounts for at least 30% of cancer deaths) # Cruciferous vegetables that appear to reduce cancer risk are _________, __________, & ___________