Pharm-Cancer

-What must a patients WBC be before they will receive Chemotherapy? -What is normal WBC?

-3 thousand -4-10 thousand

What are the characteristics of Abnormal cells?

-Abnormal, serve no purpose -Rapid and continuous cell division -Anaplastic morphology -Large nuclear to cytoplasmic ratio -Lose their differentiated function (cell started as kidney cell but had some alteration and does not work as kidney cell anymore) -Adhere loosely -Migrate -Grow by invasion or metastasis

What are the major common SE for chemotherapy?

-Alopecia: Hair follicles rapidly divide just like CA cells. Chemo targets rapidly dividing cells -Nausea and Vomiting -Bone Marrow depression -Diarrhea -Stomatitis -Anorexia -Extravasation and infiltration

What are the clinical manifestations of Leukemia?

-Anemia (causes fatigue, malaise) -Bleeding (nose bleeds, bruising d/t decreased platelets -Weight loss (unexplained=not good! Metabolic demands of body are increased) -Bone pain (it's in bone marrow) -Liver, spleen, and lymph nodes enlarged (accumulation of cells in lymphatic) -Hyperuricemia (increased with cell breakdown) -Infection

Multiple Myeloma: -____ are the origin of myeloma -Characterized by ______ -Higher incidence in _____.

-B lymphocytes (such as hematopoietic stem cells in the bone marrow) -multiple malignant tumor masses of plasma cells scattered throughout the skeletal system an in the soft tissue -blacks than whites

What are the effects of Neoplasm's on Host?

-Benign growth can be trivial or lethal: Brain vs GI tract -Malignant growth can be the same but usually more aggressive, destructive -Cancer cells are known to secrete substances that suppress the immune system -Pain is usually due to invasion of metastatic cells into organs or bones -Leukopenia due to malignant invasion of bone marrow, or chemotherapy -Infection, hemorrhage, and organ failure are the primary causes of cancer death -The failure of cancer ridden organs such as the liver, kidney, brain, and lung results in the loss of life-sustaining functions

Cancer Treatment: Immunotherapy: -Also called ____ therapy. Given to a patient with cancer to ___________. 1. ___- naturally occurring proteins with complex anticancer actions. Active against a variety of solid tumors and hematologic malignancies 2. ___-Proleukin has decreased tumor size with metastatic renal cancer and melanoma 3. ___- highly specific antibodies derived from cloned cells. They block CA cell growth

-Biological Response Modifier (BRM); stimulate their immune systems to more effectively recognize and attack CA cells. 1. Interferons 2. Interleukins 3. Monoclonal antibodies

Radiation: Others -_______:Administered via IV or central line -_____:Combines a drug and a specific type of light to kill cancer cells -_____:Stop the process of new blood vessel growth -_____:Experimental, involves introducing genetic material into a person's cells to fight or prevent cancer; A gene can be delivered to a cell via a "vector". Most common "vector" is a virus. Viruses used for gene therapy are altered to make them safe -______:Body tissue exposed to high temperatures (up to 113 degrees F) to damage and kill CA cells

-Bone Marrow transplant and Peripheral Blood Stem Cell transplant -Photodynamic therapy -Angiogenesis Inhibitors -Gene Therapy -Hyperthermia

Cancer Treatment: Surgery: -Local treatment, success dependent on: ____, ____, and ____. -Generally _____ are removed. -Risk for _____. (Why physicians often prescribe adjuvant therapy after surgery or neo-adjuvant (before surgery)

-Can the cancer be completely removed, Can a border of healthy tissue be removed with the cancer, and Has the cancer already spread at the time of surgery -the main lymphatic vessels and lymph nodes nearest to the caner or organ -micrometastases

What are the major organ toxicity's associated with chemotherapy?

-Cardiac: CHF, arrhythmia's, MI, cardiomegaly -Pulmonary: pulmonary edema, SOB, resp. alkalosis -Nephrotoxicity -Neurotoxicity: CNS & ANS

What are the characteristics of benign neoplasms?

-Encapsulated by connective tissue -Well Differentiated (look like regular tissue) -Slow-growing -May cause problems depending on site (Ex: wart, mole, brain tumor)

What are the clinical S&S of Hodgkin Dx?

-Enlarged painless lymph node(s) in neck cervical, axillary, inguinal and/or retroperitoneal nodes commonly -Possible asymptomatic mediastinal mass on Xray -Intermittent fever without infection, drenching night sweats -Weight loss -Anemia

What are the clinical manifestations of multiple myeloma?

-Evidence of diffuse destructive bone lesions (weak bones) -Bones affected in decrease order: Vertebrae, ribs, skull, pelvis, femur, clavicle and scapula..C/o Back Pain -Destroys cortical bone: Pain, pathological fx. -Hypercalcemia (leaving bone): confusion, lethargy, weakness -Repeated infections: D/t suppressed humoral immune response -Renal insufficiency and failure

-Most common type of radiation -Generally outpatient, similar to having an Xray -____: is a form of external radiation that is given during surgery after the tumor is removed. Most often used for thyroid, colorectal and gynecological cancers -____: external radiation given to the brain when the primary site has a high risk of spreading to the brain, ie: small cell lung CA

-External radiation: Teletherapy -Intraoperative radiation therapy (IORT) -Prophylactic cranial irradiation (PCI)

Phases of the Cell Cycle: -To ensure that every cell in the body has similar genetic information, cell reproduction occurs by a precise division process comprised of phases: ____

-G0 Phase: Resting -G1 Phase: Period between the M phase and the start of DNA synthesis -S Phase: (Synthesis) DNA is synthesized in the cell nucleus -G2 Phase: Period between the completion of DNA synthesis and the next phase -M Phase: Mitosis (nuclear division) & Cytokinesis (cytoplasmic division)

-Histopathology: Tumor Grading? -Poorly differentiated tumors are ____ responsive to treatment.

-Grade I-well differentiated -Grade II- moderately well-differentiated -Grade III-poorly to very poorly differentiated -Grade IV-very poorly differentiated -less

What are the 3 major functions of BRM's?

-Initiate, modify or restore the immune response -Have direct antitumor activity, or -Have other biologic effects, such as affecting differentiation of cells or ability to metastasize

Tumors are spread by: -____: the growth of the PRIMARY tumor into surrounding tissues -____: the dissemination or spread of malignant cells from the primary site to other parts of the body (break loose, travels somewhere else, plants, divides) -___% of diagnosed tumors already have mets by the time they are clinically detectable -75% of pt.s who die have mets to the ____.

-Invasion -Metastasis -50 -liver

What are the characteristics of malignant neoplasms (CA)?

-Invasive (Local invasion) -Poorly Differentiated (Not like the normal cells of origin) -Often rapid growing and metastatic -As a general rule, malignant tumors have the potential to kill the host if left untreated

What are the characteristics of Normal cells?

-Limited cell division -Specific morphology -Small nuclear-cytoplasmic ratio -Perform differentiated function (cells going to perform one function, can't go to another organ to work; kidney cells cant go work in lungs-only kidneys) -Adhere tightly together -Non-migratory -Grow in a well regulated manner

What are CA diagnostic methods?

-Radiology/imaging/endoscopic examinations -Pap smear -Tissue biopsy -Tumor markers: antigens that are expressed on the surface of tumor cells or substances released from normal cells in response to the presence of tumor: used for prognosis, treatment and detection.

Overview of S&S of Cancer:______

-Specific to the area of cancer or organ affected -Pain - little to none in early stages; tumors create pain b/c of invasion, compression of nerve endings, or stretching of organs -Fatigue - most common, Cachexia, anorexia, early satiety, weight loss, anemia; all contribute to wasting -Anemia - associated with malignancy -Leukopenia and thrombocytopenia -Infection

What are the factors affecting response to chemotherapy?

-Tumor burden: The sum of cancer cells present in the body -# cell mutations: Better response when tissues have a high growth fraction, usually have more blood supply -Drug resistance: decreased uptake of drug -Dose intensity -Pt specific factors

Cancer Treatment: Radiation: -Explain how it works. -About half of all people with cancer are treated with radiation, either alone or in combination. -Useful for almost every type of ____. Can also be used for ___ and ____. -Radiotherapy can be ____, ____, or _____.

-Uses ionizing radiation to kill cancer cells and shrink tumors. -solid tumor; leukemia and lymphoma -external, internal, or systematic

Carcinogenic Agents during the Initiation phase-Phase 1: ____

-Viruses -Exposure to sun, radiation -Environmental: asbestos, tobacco -Accidental transplantation during surgery (if one cancer cell is left it can infect other parts of the body) -Diet: colorectal cancer (high protein & high fat diet) -Genetics/Heredity -Chemicals

Explain the Nadir phase of Cancer.

-With most anticancer drugs, onset of neutropenia is rapid and recovery develops relatively quickly. Neutropenia begins to develop a few days after dosing and generally the lowest neutrophil count, (Nadir), occurs by 10-14 days after chemo. -Pts. are at high risk during Nadir for.....Infection

Altered expression of cellular genes: -Every cells carries a set of ___ for every function it performs. Different genes are active in different cells, which is why brain cell carries out many different activities from a muscle cell. -The growth and division of normal cells is ___ controlled by the activity of ___. -Normally genes help to prevent Cancer, but when genes are faulty or become damaged they can cause _____ that is out of normal cellular control. -One its own, one damaged gene does not generally make cells cancerous. Normally ___ different genes have to be damaged before cell becomes cancerous. -Example: Inherited damaged genes BRCA1 and BRCA2 increase risk of ___ cancer by 5-7 times.

-coded instructions -tightly; genes -growth and division of cells -2-3 -breast

Immune Response to Cancer: -Immune system is believed to play an important role in _____ of cancer cells. -Consider: People who are _____ have a greater incidence of cancer. -The body must be able to recognize cancer cells as ____ and mediate their _____.

-detection and eradication -immunocompromised -non-self; destruction

Further obstacles to chemotherapy: -Toxicity to normal cells is _____. -Cure requires ___% cell kill-just one remaining cell can proliferate. -Failure of ____ (large tumors and solid tumors have less blood supply) -Less receptive to therapies

-dose limiting -100 -early detection

Classification of Leukemias - Acute: proliferation of ______ - Chronic: proliferation of _____

-immature WBCs with rapid development of the disease -more mature WBCs

Classification of Leukemia's: -Lymphocytic: arise from ______ -Myelogenous: arise from ______

-lymphocytes -myeloid tissue (granulocytes, myelocytes, myeloblasts)

What are the clinical manifestations associated with Non-Hodgkin Lymphoma?

-may be local or generalized lymphadenopathy, similar to HD -Painless, superficial lymmphadenopathy of head/neck region

What is the prognosis for Non-Hodgkin Lymphoma?

-poorer diagnosis that Hodgkin's lymphoma. Dependent on Stage

Radiation: -___ deliver their radiation mainly around the area of the implant, so the whole patient's body is not radioactive but the general area is -_____ uses unsealed radiation that travels thru out the body. Some of this is excreted in the saliva, sweat, and urine before it decays. -Generally hospitalized for ___ and _____.

-sealed sources -systemic radiation -internal and systemic

-Our cells grow and divide ____ and under very tight control so that each tissue in our body stays the same. -Cancer begins when ______

-slowly -one cell changes and starts growing and dividing rapidly and out of control, to the detriment of the host.

-What is the #1 preventable carcinogenic cause of Cancer? -What is a co-carciniogenic to it? -What are dietary carcinogens? -Why is increasing age (especially >60) the #1 risk for Cancer?

-smoking -alcohol -coke, preservatives, additives, anything that keeps food good, black part from BBQ, low fiber diet (preservatives stay in body longer) -lung cancer; decrease in immune system; exposed more

Cancer is classified by the: -___ or ____ where it originates - Types:____

-tissues or blood cells - 1. Hematologic malignancies -Hematopoietic and Lymphoid Neoplasms 2. Solid tumors-Malignant tumors of the epithelial tissue (lines internal and external surfaces and body cavities) -Sarcomas -Carcinomas: Compromise 80% of human cancers -Bastomas

-Neoplasms resemble ___ tissue. the less a tumor resembles normal tissue, the ___ undifferentiated or anaplastic the tumor is.

-undifferentiated; more (the longer cancer is growing, the less likely it looks like its host)

Leukemia: -Begins when ____. It divides uncontrollable and overrides the body's normal restrictions on cell division. -Over time the marrow becomes crowded with cancerous cells, all of the descendants of the ____ abnormal cell. The malignant cells accumulate in the patient's __, ___ and ____. -In people with leukemia, the bone marrow produces a large number of _____. -At the time of diagnosis, up to a trillion ___ may be present in the body.

-when an immature blood cell in the bone marrow (Progenitor cell), becomes cancerous -first; lymph nodes, spleen and elsewhere. -abnormal white blood cells, which don't function properly -leukemic cells

What are the types of Leukemia?

1. ALL -Acute Lymphoblastic Leukemia -Most common childhood cancer, M>F -Prognosis less favorable when it occurs in adults 2. AML -Acute Myelogenous Leukemia -More common in adults, particularly after age 65 3. CLL -Chronic Lymphocytic Leukemia -More common in adults 4. CML -Chronic Myelocytic Leukemia -Adults

Why does CA occur? A number of factors, some controllable and some uncontrollable: ______

1. Altered expression of cellular genes-gene mutations -Over 1600 potential cancer causing genes identified to date 2. Chromosomal abnormalities 3. Virus associated with CA -HPV (genital warts) assoc. with CA of cervix -Epstein-Barr virus (mono) assoc. with Burkitt's lymphoma 4. Increased oncogene expression (promote cell division) 5. Reduction in Tumor Suppressor genes -Defective Tp53: without tumor suppressor genes, oncogenes would be continuously overexpressed--> uncontrolled cell division 6. Diseases or drug that affect the immune system -AIDS- increased risk of Karposi's sarcoma and lymphomas (dark spots on skin) 7. Carcinogens- often controllable

What are the 7 different drug therapies used for cancer treatment?

1. Antimetabolites 2. Alkylating Agents & Platinum Cmpds. 3. Mitotic Inhibitors 4. Antineoplastic Antibiotics 5. Nitrosureas 6. Hormones/Hormone Antagonists 7. Radioactive Drugs

2 key properties of CA Cell Differentiation: 1. ____= (altered function) cancer cells independent from normal cellular controls. 2. ____= (altered structure) loss of differentiation; "without form." As cancer cell becomes less differentiated you have more replication. -Undifferentiated cells (____cells) are not totally committed to a specific function.

1. Autonomy 2. Anaplasia -stem

What are the different tumor markers and what does each indicate?

1. CA-125 = tumor marker for detection, extent of disease and tx. of ovarian cancer 2. PSA = prostrate-specific antigen -increased in benign prostatic hypertrophy and prostatic cancer; used along with rectal exam -must be collected before rectal exam (which can cause it to elevate) 3. CEA = carcinoembryonic antigen -used to aid diagnosis (not diagnostic alone) for colon & GI cancer; more for monitoring treatment; may be elevated for many other reasons

Chemotherapy and the Cell-cycle: 1. _____ (work best in a specific cell cycle) -Most effective against rapidly growing CA Cells -Examples: ___________ 2. ______ (may work in more than one phase of cell cycle or any phase) -Examples: __________

1. CCS-Cell Cycle Specific -Antimetabolites, Mitotic Inhibitors 2. CCNS-Cell Cycle Non-specific -Alkylating agents & Platinum compounds, Hormones, Steroids, Most antibiotic antitumor drugs

1. _____ is the process whereby proliferating cells are transformed into different and more specialized types. As cells mature, they differentiate to perform the specific functions of the tissue they constitute. -In normal growth and development, cells become more _____ to a particular pathway of differentiation -As cells mature, they differentiate to perform the specific functions of the ___ they constitute. -The more differentiated: the _____ ability to replicate. *The cancer cell looses its ability to ____ and ____.

1. Cell Differentiation -specialized or "committed" -tissue -less *function normally & to control its growth & development

Cancer is a group of many disease of multiple causes that can arise in cell of the body capable of evading regulatory control over: 1. ______ 2. ______ -Most cancers originate due to damage to the ____ inside cells.

1. Cellular Proliferation, and/or 2. Cellular Differentiation ("makes kidney cell look like kidney cell") -DNA

What are the treatment goals for CA?

1. Cure 2. Control the growth of cancer cells 3. Palliation: Comfort and relief of symptoms

1.____: classification of tumor cells; refers to cell differentiation 2. ____: represents the progression and degree of origin involvement; size of tumor and the presence of mets (clinical spread of disease) -____ system

1. Grading 2. Staging -TNM (tumor, nodes, metastasis)

1.___: ratio if dividing cells to resting cells, or the total % of dividing cells. 2.___: time it takes for a tumor to double in size -1cm tumor represents ___ doubling times from the initial cancer cell and contains over a billion cancer cells. (tumor must be at least 1cm to be detected) 3. Increased GF = __ doubling time -As tumors enlarge the GF ____ and the time it takes for the tumor to enlarge is _____ (___ doubling time)

1. Growth fraction 2. Doubling time (Growth rate) -30 3. decreased -decreased; longer (increased)

Development of Cancer: -Orderly process of three stages: ____

1. Initiation: Initiators alter the DNA causing permanent mutation changes 2. Promotion: Alter initiation, promoting factors stimulate replication of the DNA-damaged cells 3. Progression: Increased malignant behavior, invasion and metastasis

Types of Cancer: -Hematopoietic and Lymphoid Neoplasms 1. ____: a chronic or acute disease of unregulated proliferation of the stem cells of the blood-forming tissues. These cells are unable to mature normally. Can be myeloid or lymphoid. 2. ____: Solid tumor of the lymphorecticular system that can have its origin in any lymphoid tissue, usually begins in the lymph nodes. 3. ____: A neoplastic disease characterized by the infiltration of bone and bone marrow myeloma cells. It is a B cell cancer. -Solid tumors

1. Leukemia 2. Lymphoma (Hodgkin's Disease) 3. Multiple Myeloma

What are the Modalities of Cancer Treatment?

1. Surgery 2. Immunotherapy - involves stimulating the host 3. Hormone and Antihormone Therapy 4. Radiation - to eradicate cells or for palliative treatment -Adverse effects are dose specific (anorexia, N/V, bone marrow depression) 5. Chemotherapy - palliative, primary, or to decrease tumor size 6. Others

Immune System: Anti-Cancer: 1. ____ recognize cancer cells and stimulate the production of Killer T-cells and other cytotoxins 2. The immune system recognizes the foreign molecules of cancer as: _____ or _____. (Both of these are expressed by cancer cells, not normal cells) 3. ____ is the body's natural anti-viral. It has anti-tumor characteristics

1. T-cells 2. Tumor specific antigens (TSAs) or Tumor-associated antigens (TAAs) 3. Interferon

Explain the TNM Classification System.

1. T: primary tumor/tumor spread -T0: no evidence of primary tumor, in sutu (no actual tumor but detection in change) -T1, 2, 3, 4: Progressive increase in tumor size or involvement 2. N: extent of node involvement -N0: regional lymph nodes normal -Progressive # means increasing degrees of abnormalities of regional lymph nodes 3. M: presence of distant metastasis -M0: no known mets -M1, 2, 3, 4: Extent of metastasis of distant sites

What is the goal of chemotherapy?

1. To eradicate as many cancer cells as possible with as little damage to normal cells as possible -Very hard to accomplish -At any one time, only a portion of the total # of tumor cells will be in a cell cycle stage that is susceptible to chemotherapy. Therefore several courses of chemotherapy are generally necessary to ensure that all tumor cells have been erradicated.

Cancer-Definition: -Cells that have obtained the ability to grow uncontrolled and damage normal tissue. Cancer is characterized by what three things?

1. Uncontrolled cellular growth 2. Local tissue involvement 3. Distant metastasis (spreading)

Extravasation and Infiltration: 1. ______: causing blisters, tissue sloughing. ie: Necrosis 2. Stay with patients receiving vesicant therapy 3. What do you do if it extravasates? 4. Extravasation Protocols 5. _____: Usually administered first, no severe tissue distruction 6. ____: Causes cellulitis, thrombophlebitis, possible necrosis

1. Vesicant 3. stop the infusions and ice (constricts vessels to keep it there) 5. Nonvesicant 6. Irritant

Cell Proliferation: 1. In the normal cell cycle cellular: Proliferation occurs so that the # cells ____ = # cells ____. -State of _____ -Cellular ____= Cellular ______ 2. In neoplasms, cells continue to grow at the expense of the ____. -In most cases CA cells proliferate at the same rate as normal cells. The difference is _______.

1. dividing; dying -equilibrium -proliferation; degeneration 2. host -their proliferation is indiscriminate and continuous (Don't have control over growth)

Cancer Treatment: Hormonal Therapies: 1. Corticosteroid Hormones: Used to _____. -Examples:_____ 2. Most hormones are used to _______. -Examples: ______

1. increase the effectiveness of Chemotherapy by slowing CA cell growth -Prednisone, Dexamethasone 2. slow the growth of breast, prostate and endometrial cancers, which often grow in response to hormone levels in the body -Tamoxifen (anti-estrogen) -Effective for estrogen receptor positive tumors *estrogen sometimes makes cancer grow. A breast CA pt. would take tamoxifen to make them go through menopause. (only if breast CA is positive for receptors)

Tumor Growth: -In early stages, growth is exponential (tumor takes a constant amount of time to double in size) and depends on three factors: _______

1. number cells actively dividing 2. duration of cell cycle 3. number of cells lost compared to new cells

Explain the dosing for chemotherapy.

1.Intermittent dosing to allow normal cells to repopulate 2.Different drug deliveries: -Intrathecal - because most do not cross blood brain barrier 3.Combination therapy -Most are treated with 2 or more drugs

What are the different routes metastasis can occur by?

1.Vascular channels -spread through the blood stream, the cells escape the basement membrane of the tissue of origin, move thru the extracellular space, & penetrate the basement of the vessel -Angiogenesis: new capillary growth stimulated by the tumor to meet needs for nutrients and O2. Tumors release hormone-like molecules that cause nearby vessels to start growing and branch to the tumor. (tumor can't grow and divide without blood. sometimes use anti-angiogenesis drugs to treat) 2. Lymphatic Spread: cancer cells can travel via the lymphatic system (breast/axilla nodes) 3. Seeding: tumor spread through a natural cavity (i.e. peritoneal cavity) 4. Transplantation: transported during sugery

-Work directly on DNA to prevent CA cell replication -Not Phase Specific, work in all phases of the cell cycle -Active against chronic leukemias, Non-Hodkin and Hodgkin's lymphoma, multiple myeloma, certain cancers of the lung breast and ovaries -Examples: ________

Alkylating Agents -Cisplatin -Chlorambucil

-Intefere with DNA and RNA growth -Work during the "S" Phase -Used to treat chronic leukemias, cancers of the breast, ovary and GI tract -Examples: _______

Antimetabolites -5-fluorouracil -Methotrexate

-Intefere with DNA -Work in all phases of the cell cycle -Widely used for a variety of cancers -Examples: _______

Antineoplastic Antibiotics -Adriamycin; Severe Cadiotoxic Side Effects (need ECG before tx.) -Dactinomycin -Mitoxantrone

Internal Radiation: ______ -Sealed in the form of: ______ -____ is implanted in the tissues at or near the site, ie: head/neck cancers -____ is inserted into the body with an applicator, ie: uterine

Brachytherapy -wires, catheters, ribbons, capsules, seeds or a small holder (implant) -Interstitial -Intracavity or intraluminal

What are the cancer warning signs?

CAUTION C - Changes in bowel or bladder habits A - A sore that does not heal U - Unusual bleeding or discharge T - Thickening or lump in breast or elsewhere I - Indigestion, chronic O - Obvious change in wart or mole N - Nagging cough or hoarseness

-Administration of cytotoxic (carcinogenic agents) drugs to intervene and interrupt the cell cycle -- also causes some degree of injury to normal cells -Can be cell-cycle specific or non-specific (Review figure for phases: G0, G1, G2, S, M)

Chemotherapy

Cancer Treatment: Immunotherapy: -______: - for chemotherapy induced anemia - Epoetin alfa -**Not approved for pts. with leukemias and other myeloid malignancies---Can stimulate proliferation of these cancers. Use with caution and not if Hgb >12 -Stimulates production of blood cells; don't give to those with blood CA (leukemias)- it will produce malignant blood cells.

Erythropoietin-Stimulating Agents

-Arises in a single node of a chain of nodes and spreads -Staged I-IV -Reed-Sternberg (RS) cells are the distinguishing feature, they represent malignant transformed cells -Higher in males than females -Higher in whites than blacks -On the decline, currently accounts for only 1% of all cancers

Hodgkin Lymphoma

Diverse groups of malignant neoplasms that develop from the proliferation of lymphocytes, histiocytes, and their precursor in the lymphoid tissues.

Malignant Lymphomas

What are the most curable forms of CA? What are the two classes?

Malignant Lymphomas, Hodgkin disease (presence of Reed-Sternberg cells) & Non-Hodgkin disease

-Can inhibit or stop mitosis, and work during the M Phase of the cell cycle -Examples: ______

Mitotic Inhibitors -Vinblastine -Vincristine -Paclitaxel

-New, abnormal cell growths (tumors) can be categorized as benign or malignant. -____: "new formation" Refers to altered cell differentiation and growth: abnormal mass of proliferating cells. Often used interchangeably with the word "tumor"

Neoplasm

-Act similar to alkylating agents, not phase specific -Interfere with enzymes that help repair DNA -Useful for cancers that travel to the brain, ie: lymphomas, malignant melanoma -Examples:______

Nitrosureas -Carmustine -Lomustine

-Generic term for a wide spectrum of disorders characterized by the malignant transformation of B and T cells and the lymphoid system. -Does not have Reed Sternberg cells -Seen with increasing frequency in persons with AIDS.

Non-Hodgkin Lymphoma

What is Hodgkin Lymphoma Prognosis?

Overall good, but dependent on Stage (Stage 1 80% cure rate, Stage 4 50% cure rate)

-Internal radiation taken orally or injected. -Useful for non-Hodgkins and thyroid cancers -Usually out of the system within 48 hours

Systemic internal radiation

Phase 3 of Development of Cancer: Progression: -Final stage, characterized by ____

increased growth rate of the tumor, as well as increase invasiveness and metastasis

Phase 2 of Development of Cancer: Promotion: -Characterized by ____

the proliferation of altered cells

can a patient be radioactive?

yes