Med-Surg Immune System, part 8: Cancer - Signs, Symptoms, Diagnosis and Treatment

by Cathy Parkes October 05, 2020 1 Comment

In this article, we give a general overview of cancer. There are, of course, many cancers, and specific ones you will need to know about, but it is important to have a foundational understanding of what cancer really is. This article covers the definition, pathophysiology, three stages, risk factors, signs and symptoms, treatments, and complications. You can check out these videos below for more information on specific cancers, treatments, and complications

Cancer is covered in our Medical-Surgical flashcards (Immune system), and Cathy’s videos follow along with the cards.

Definition of cancer

Cancer is a disease characterized by DNA damage that causes abnormal cell growth and development.

Pathophysiology of cancer

Cancer comprises three main processes: initiation, then promotion, then progression.

Initiation

During initiation, damage or mutation to the DNA causes excessive cell division because of excessive oncogene function and decreased suppressor gene function.

It’s helpful to think of this like a car. If you are driving a car, the gas is the oncogene, because it makes you go faster. Your brakes are the suppressor gene. With cancer initiation, your gas is basically stuck to the floor and your brake doesn’t work. Oncogene function is in overdrive and there is little suppressor gene function.

Promotion

During the promotion stage of cancer, mutated cells are exposed to promoters that enhance their growth. Estrogen is one example of a promoter that will promote the further development of certain types of cancer (like endometrial cancer).

Progression

During the progression stage of cancer, tumor cells acquire additional mutations, and their growth rate increases. This allows them to metastasize (spread) throughout the body and makes them resistant to therapy.

Cancer risk factors

Risk factors that place an individual at high risk for cancer include advanced age, genetics, immunosuppression (like the immune-system-suppressing drugs taken by organ transplant recipients), viruses, smoking, sun exposure, and a high-fat, low-fiber diet.

Cancer signs & symptoms

Signs and symptoms of cancer will vary greatly based on the type of cancer but the generalized signs and symptoms of cancer can include unexplained weight loss, fatigue, pain, infection and bleeding.

Cancer diagnosis

A biopsy is considered the gold standard for diagnosing cancer. A biopsy is when tissue is removed from the body and tested for cancerous cells. Other diagnostic tools can include MRI, CT scan, and ultrasound, and these tools are used to visualize abnormalities inside the body.

Learn how to classify tumors

Cancer treatment

There are a variety of treatments for different types of cancer, including medications, radiation, surgical treatments, and other procedures.

Medications for cancer

Depending on the type of cancer, sometimes medications can be given. Examples of this include hormonal therapy and immunotherapy.

Procedures to treat cancer

Chemotherapy is a medication used to destroy rapidly-dividing cells and is administered through an implanted port or through a central line.

Radiation is when high-radiation beams are pointed at tumors, causing them to shrink or die.

A patient can undergo surgeries to remove cancerous tumors; this type of surgery is known as a tumor excision.

Cancer & cancer treatment complications

Complications are unfortunately very common with cancer. There are complications that come from the cancer itself, and some that come from the treatment of cancer. Because cancer can be aggressive, treatments are also aggressive and can cause collateral damage in the body.

Potential and common complications include malnutrition, infection, mucositis (inflammation and ulceration of the mouth), anemia, thrombocytopenia, and alopecia (loss of hair).

These complications are covered in more detail in the rest of this series and in our Medical-Surgical nursing flashcards.

Cathy’s teaching on HIV/AIDS is intended to help prepare you for Medical-Surgical nursing exams. The Medical-Surgical Nursing video series is intended to help RN and PN nursing students study for nursing school exams, including the ATI, HESI and NCLEX.


Full Transcript

Alright! In this video, I'm going to start talking about cancer. If you are following along with cards, I'm on card 18 [in the Immune System section of our Medical-Surgical Nursing Flashcards].

And in this video, I'm going to talk about cancer in general. So I'll discuss the pathophysiology behind cancer. I'll discuss the risk factors, the signs and symptoms, the diagnosis, treatment, and complications associated with cancer in general. Then in my subsequent videos, I will go into more details about specific cancers.

Cancer is a disease characterized by DNA damage that causes abnormal cell growth and development.

The pathophysiology behind cancer, it really involves three processes. The first is initiation, then promotion, then progression.

During initiation, damage or mutation to the DNA causes excessive cell division. And this is because we have excessive oncogene function but decreased suppressor gene function. So I'll use a car analogy. So if you're driving a car and your gas is the oncogene, so it makes you go faster, and then your brake is your suppressor gene. So with cancer, your gas is basically stuck to the floor and your brake doesn't work. So oncogene function is getting crazy and there's no break. So there's limited suppressor gene function, and that's what happens during initiation.

Then, we have promotion. So during promotion, mutated cells are exposed to promoters that enhance their growth. So, estrogen is an example of a promoter that will promote the further development of certain types of cancer.

Then we have progression. So with progression, tumor cells acquire additional mutations, and their growth rate increases. This allows them to metastasize, so basically, spread throughout the body and makes them resistant to therapy.

Risk factors that place an individual at high risk for cancer include older age, genetics, immunosuppression, viruses, smoking, sun exposure, and a high-fat, low-fiber diet.

Signs and symptoms, so general signs and symptoms of cancer can include unexplained weight loss, fatigue, pain, infection, and bleeding.

As far as diagnosis of cancer, a biopsy is going to be our gold standard for diagnosing cancer. Other diagnostic tools can include MRI, CT scan, and ultrasound as well.

For treatment, in terms of medications, we can use chemotherapy, which is used to destroy rapidly dividing cells. It's administered through an implanted port or through a central line. We can also give the patient hormonal therapy and immunotherapy as well.

And then, other procedures that can be used include radiation and then surgery to remove the tumor, so tumor excision.

Complications are very common with cancer and the treatment of cancer. So potential and common complications include malnutrition, infection, mucositis, which is inflammation and ulceration of the mucosa in the mouth, anemia, thrombocytopenia, and alopecia. Alopecia is loss of hair.

So we will talk through nursing care of most of those complications in my subsequent videos. So in the next video, we will dig into tumor classification. So hang in there with me and I'll see you soon!


1 Response

Rosalinda
Rosalinda

April 06, 2021

Brief concise lecture 👌

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