CANCER (NEOPLASIA)
I. Definition
Cancer is a group of diseases characterized by uncontrolled, abnormal cell growth with the
ability to invade nearby tissues and metastasize (spread) to distant organs.
• Also called malignant neoplasm
• Normal cells → regulated growth
• Cancer cells → unregulated growth
II. Key Terms (EXAM MUST-KNOW)
Term Meaning
Neoplasm New abnormal growth of tissue
Benign tumor Non-cancerous, localized, slow growing
Malignant tumor Cancerous, invasive, metastatic
Metastasis Spread of cancer to distant organs
Carcinogenesis Process of cancer development
Oncogene Gene that promotes cancer growth
Tumor suppressor gene Gene that inhibits cell division (e.g., p53)
Apoptosis Programmed cell death (lost in cancer)
III. Difference: Benign vs Malignant Tumors
Feature Benign Malignant
Growth rate Slow Rapid
Capsule Present Absent
Invasion No Yes
Metastasis No Yes
Recurrence Rare Common
IV. Pathophysiology (How Cancer Develops)
A. Carcinogenesis (3 Stages)
1. Initiation
o DNA damage occurs
o Caused by carcinogens (chemicals, radiation, viruses)
2. Promotion
o Mutated cells begin to multiply
o Reversible stage
3. Progression
o Tumor becomes malignant
o Invasion and metastasis occur
B. Hallmarks of Cancer (Very High-Yield)
• Uncontrolled cell proliferation
• Loss of apoptosis
• Sustained angiogenesis (new blood vessels)
• Tissue invasion and metastasis
• Immune evasion
V. Causes & Risk Factors
A. Non-Modifiable
• Age
• Genetics / family history
• Gender
B. Modifiable
• Smoking 🚬
• Alcohol
• Obesity
• Poor diet
• Sedentary lifestyle
• Radiation exposure
• Occupational hazards
C. Infectious Agents
Virus Associated Cancer
HPV Cervical cancer
Virus Associated Cancer
Hepatitis B & C Liver cancer
EBV Lymphoma
HIV Kaposi sarcoma
VI. Classification of Cancer
A. By Tissue Origin
Type Origin Example
Carcinoma Epithelial cells Breast, lung
Sarcoma Connective tissue Bone cancer
Leukemia Blood-forming tissues ALL
Lymphoma Lymphatic system Hodgkin’s
Melanoma Melanocytes Skin cancer
VII. Signs & Symptoms (CAUTION SIGNS)
CAUTION Mnemonic:
• C – Change in bowel or bladder habits
• A – A sore that does not heal
• U – Unusual bleeding or discharge
• T – Thickening or lump
• I – Indigestion or difficulty swallowing
• O – Obvious change in wart or mole
• N – Nagging cough or hoarseness
General Symptoms
• Unexplained weight loss
• Fatigue
• Pain
• Anemia
• Fever
VIII. Diagnostic Tests
A. Screening Tests
• Pap smear (cervical)
• Mammography (breast)
• Colonoscopy (colon)
• PSA (prostate)
B. Definitive Diagnosis
✅ Biopsy – GOLD STANDARD
C. Other Tests
• CT scan
• MRI
• PET scan
• Tumor markers (CA-125, AFP, CEA)
IX. Staging of Cancer (TNM System)
Component Meaning
T Tumor size
N Lymph node involvement
M Metastasis
Stages:
• Stage 0 – In situ
• Stage I – Localized
• Stage II–III – Regional spread
• Stage IV – Distant metastasis
X. Cancer Treatment Modalities
1. Surgery
• Remove tumor
• Curative or palliative
2. Chemotherapy
• Kills rapidly dividing cells
• Side effects:
o Bone marrow suppression
o Nausea/vomiting
o Alopecia
o Mucositis
3. Radiation Therapy
• Localized destruction of cancer cells
• Skin irritation, fatigue
4. Immunotherapy
• Boosts immune response
5. Targeted Therapy
• Attacks specific cancer pathways
6. Hormonal Therapy
• Breast & prostate cancer
XI. Complications of Cancer
• Metastasis
• Cachexia (severe weight loss)
• Anemia
• Infections
• Pain
• Spinal cord compression
• Superior vena cava syndrome
XII. Oncologic Emergencies (EXAM FAVORITE ⚠️)
• Tumor lysis syndrome
• Spinal cord compression
• Superior vena cava syndrome
• Hypercalcemia of malignancy
• Febrile neutropenia
XIII. Nursing Management of Cancer Patients
A. Assessment
• Pain
• Nutritional status
• Skin integrity
• Signs of infection
• Emotional status
B. Nursing Interventions
• Pain management
• Infection prevention
• Nutrition support
• Patient education
• Psychosocial support
C. Patient Education
• Treatment side effects
• Medication adherence
• Infection precautions
• Lifestyle modifications
XIV. Cancer Prevention
Primary Prevention
• Smoking cessation
• Healthy diet
• Exercise
• Vaccination (HPV, Hep B)
Secondary Prevention
• Screening & early detection
Tertiary Prevention
• Rehabilitation
• Palliative care
XV. Palliative & End-of-Life Care
• Focus on comfort
• Pain and symptom control
• Emotional and spiritual support
• Family involvement
🧠 QUICK EXAM TIP:
• Biopsy = definitive diagnosis
• Metastasis = hallmark of malignancy
• TNM = staging system
• CAUTION = warning signs
