BADNAP NP III 2535 Module 2 Cancer

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Oklahoma City Community College *

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Biology

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Jan 9, 2024

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BADNAP NP III 2535 Module 2 Cancer Directed Assignment: This module is to be utilized as part of the directed readings and assignments for theory. It is designed to aid the student in preparing for class. The module is to be completed by the individual student. No group work is permitted. Ten (10) points will be given for complete work. Incomplete work will result in lost points. 1. Differentiate among the three stages of cancer development. Stage 1 is the cancer initiation stage. Genetic mutation takes place. Stage 2 of cancer growth is the promotion, reversibility of the altered cells. Stage 3 is the proregression, there is increased growth rate of tumor, increased invasiveness, and metastasis. 2. Describe the role of the immune system related to cancer. The infiltration of immune cells into the primary tumor can have positive or negative effects on the patient’s prognosis. Tumors not only actively escape from the immune system, but they can also co-opt certain immune processes. A major mediator of this co-opting process by the tumor is through modification of the tumor stroma. The stroma consists of several cell types that contribute to tissue homeostasis, including fibroblasts, endothelial cells, nerve cells, immune cells, and the extracellular matrix (ECM). Normally, it provides tissue homeostasis by controlling the balance between cell proliferation and cell death through interactions with the extracellular matrix (ECM) and fibroblasts. However, in cancer, fibroblasts often induce tumor progression by stimulating the proliferation and invasive phenotype of cancer cells, increasing their metastatic potential. In pancreatic cancer, the dense fibrosis (desmoplasia) has been postulated to play either an inhibitory role constraining tumor growth or a protective role by providing survival signals and possibly impeding drug delivery to the cancer cells. Tumor stroma can also promote the formation of new blood vessels, a process called angiogenesis. Without angiogenesis, a solid tumor will be limited in size and in its ability to access the blood stream for dissemination, an essential aspect to metastasis. 3. Identify the major classifications of chemotherapy agents. (a) Alkylating agents Nitrogen mustard-Bendamustine platinum analogs carboplatin (b) Antimetabolites Cytidine analogs-azacitidine Folate antagonist-methotrexate. (c) Antimicrotubular agents

Topoisomerase inhibitor 1- Irinotecan (d) Antibiotics Actinomycin D (e) Miscellaneous Hydroxyurea. (f) Pant alkaloids (Mitotic inhibitors) 4. Differentiate between teletherapy (external beam radiation) and brachytherapy (internal radiation). External beam radiation (Teletherapy) Radiation delivered from a distant source, from outside the body and directed at the patient's cancer site. Systems which produce different types of radiation for external beam therapy include orthovoltage x-ray machines, Cobalt-60 machines, linear accelerators, proton beam machines, and neutron beam machines. A radiation oncologist makes decisions regarding the type of system that is best suited to treat a specific cancer patient. External beam therapy is the radiation therapy treatment option used for most cancer patients. It is used to treat many types of tumors including cancers of the head and neck area, breast, lung, colon, and prostate. Internal Radiation Therapy (Brachytherapy) Brachytherapy involves placing radiation sources as close as possible to the tumor site. Sometimes, they may be inserted directly into the tumor. The radioactive sources or isotopes are in the form of wires, seeds (or molds), or rods. This technique is particularly effective in treating cancers of the cervix, uterus, vagina, rectum, eye, and certain head and neck cancers. It is also occasionally used to treat cancers of the breast, brain, skin, anus, esophagus, lung, bladder, and prostate. In some instances, brachytherapy may be used in conjunction with external beam therapy. When both forms are employed, the external beam radiation is intended to destroy cancerous cells in a

large area surrounding the tumor, while the brachytherapy delivers a boost, or higher dose of radiation, to help destroy the main concentrated mass of tumor cells. 5. Describe the effects of radiation therapy and chemotherapy on normal tissues. Acute radiation damage predominantly involves rapidly proliferating cells, e.g., epithelial surfaces of the skin or digestive tract. Radiation damages the stem cells, which manifests when tissues are lost as part of normal cell turnover, but there is inadequate replacement by stem cells due to radiation damage. This results in a break in the protective barrier - commonly in the skin, oral mucosa, and gastrointestinal tract, especially 1-5 years within the completion of radiotherapy. Subsequently, compensatory hyperplasia within stem cells results in recovery. Therefore, symptoms resolve over a few weeks. When acute damage fails to heal completely and persists into the late period, such lesions are consequential late effects. Such effects are more commonly seen in regimens that involve chemotherapy in combination with radiotherapy, where tissues fail to repair due to concomitant cytotoxic effects from chemotherapy. 6. Identify three (3) complications associated with advanced cancer. a. Leucocyte adhesion to damaged endothelial cells results in the formation of thrombi and subsequent distal ischemia, which results in distal atrophy and necrosis. b. Late complications occur in tissues with slow turnover, e.g., brain, kidney, liver, the wall of the intestine, subcutaneous tissue, fatty tissue, and muscle. Consequences of radiation in such tissues include fibrosis, atrophy, necrosis, and vascular damage - telangiectasia and carcinogenesis. c. Loss of weight and appetite 7. Describe one additional concept that you learned while completing this module: The early detection of cancer is an important factor in the prognosis. The earlier cancer is detected, the better the outcome and vice versa.

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References Janssen M.E. Louise et all. The immune system in cancer metastasis: Friend or foe? Copyright © 2023 BMJ Publishing Group Ltd & Society for Immunotherapy of Cancer Muhammad T. Amjad; Anusha Chidharla; Anup Kasi. Cancer Chemotherapy. National Library of Medicine.nih.gov. National Cancer Institute. Types of Radiation of Therapy. https://training.seer.cancer.gov/treatment/radiation/types.html. Hafsa Majeed; Vikas Gupta. Adverse Effect of Radiation. National Library of Medicine. nih.gov. Updated August 14,2023. https://www.ncbi.nlm.nih.gov/books/NBK563259/

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