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Cancer the second leading cause of death in the U.S. 66% of deaths are in people age 65 and older no single cause (can be caused by cellular, molecular, and genetic factors and external environment factors) Cancer Risk Factors genetic mutation heredity obesity tobacco - single greatest lifestyle risk foods age environment -oma benign tumor -carcinoma malignant, epithelial tissue -sarcoma malignant, mesenchymal tissue Cancer Characteristics abnormal cell differentiation abnormal cell growth chaotic cell division Proliferation normal process of cell division Differentiation process of specialization of cell types Apoptosis cell suicide Cell Growth Rate = cell death rate Abnormal Growth growth in the absence of growth signal and unlimited replication Proto-oncogenes "before cancer" normal direct cell growth-activating pathways overactivity increases proliferation have normal cell to cell communication functions Oncogenes "after mutation" abnormal transmit abnormal cell growth signals cause a large increase in proliferation leads to new growth Normal Tumor Suppressor Genes inhibit cell proliferation ex. Rb gene, P53 gene, BRCA 1 and BRCA 2 Abnormal Tumor Suppressor Genes the absence of tumor suppression function P53 Gene the most common tumor suppression defect if present and functional, the tumor is more likely to respond to chemo Benign Tumors slow, progressive growth growth may stop expansive growth unable to spread well-differentiated cells Malignant Tumors rapid, widespread growth possible mortality compresses vessels and can outgrow their blood supply steals nutrients liberates toxins and enzymes that destroy tumor and normal tissue Ways of Cancer Spread direct invasion and extention deposit of cancer cells in cavities metastasis via blood/lymph system Tumor Grading r/t histology (degree of abnormality) not universal ranking - each body system has own higher number and letter = higher malignancy potential Anaplasia lack of differentiated features in a cancer cell Tumor Staging r/t clinical spread T(tumor): Tx - can't be assessed, Tis - carcinoma in situ, T1-4 N(node): Nx - can't be assessed, No - no evidence, N1-4 - nodes involved M(metastasis): Mx - can't be assessed, Mo - no evidence, M1-4 - metastasis present Cancer S/S pain altered tissue integrity (necrosis, bleeding, hemorrhage, compressed blood vessels, ulceration) immune deficiency malnutrition bone marrow suppression (anemia, leukopenia, thrombocytopenia) Cachexia unintentional weight loss weight loss, muscle and fat wasting, anorexia, anemia, weakness Metastasis cell penetrate basement membrane of blood/lymph vessels and are picked up to be circulated and deposited in other tissues Forms of Tumor Detection surgery (accidental/planned) radiography computed tomography mri Paraneoplastic Syndromes inappropriate hormone release release of factors that damage skin, nervous system, and blood system widespread immune dysfunction Forms of Cancer Therapy surgery radiation chemotherapy immunotherapy gene therapy stem cell transplant