NUR 502 Module 1 Discussion
University:
St. Thomas University
NUR 502 Module 1 Discussion
Paper Instructions
J.C is an 82-year-old white man who was evaluated by GI specialist due to abdominal discomfort, loss of appetite, weight lost, weakness and occasional nausea.
Past Medical History (PMH)
Patient is Diabetic, controlled with Metformin 500 mg by mouth twice a day, Lantus 15 units SC bedtime. Hypertensive, controlled with Olmesartan 20 mg by mouth once a day. Atrial Fibrillation, controlled with Rivaroxaban 15 mg by mouth once a day and bisoprolol 10 mg by mouth once a day.
Labs
Hb 12.7 g/dl; Hct 38.8% WBC 8.2; Glycemia 74mg/dl; Creatinine 0.8 mg/dl; BUN 9.8 mg/dl; AST 21 U/L ALT 17 U/L; Bil T 1.90 mg/dl; Ind 0.69 mg/dl; Dir 1.21 mg/dl.
Diagnostic test
- Endoscopic Ultrasound of the Pancreas
Solid mass in the head of pancreas 4 cms, infiltrating Wirsung duct. The solid mass impress to infiltrate the superior mesenteric vein. Perilesional node is detected, 1.5 cms, metastatic aspect.
- Fine needle aspiration (FNA) biopsy Ductal adenocarcinoma.
Case study questions
- Please name the potential most common sites for metastasis on J.C and why?
- What are tumor cell markers and why tumor cell markers are ordered for a patient with pancreatic cancer?
- Based on the case study described, proceed to classify the tumor based on the TNM Stage classification. Why this classification important?
Discussed characteristic of malignant tumors regarding it cells, growth and ability to spread.
- Describe the carcinogenesis phase when a tumor metastasizes.
- Choose the tissue level that is affected on the patient discussed above Epithelial, Connective, Muscle or Neural. Support your answer.
Submission Instructions
Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.) Must have intext citation and one reference, and 150 words.
All replies must be constructive and use literature. MUST be done on a SEPARATE day from the initial post.
Please post your initial post by 11 59 PM ET Thursday, and comment on the posts of two classmates by 11 59 PM ET Sunday.
You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.
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Sample Answer
Thank you so much for your response. I agree with you that the most common sites of metastasis include the liver, lungs, and bones (Ayres Pereira & Chio, 2019; Tan et al., 2021; Rosen & Sapra, 2023). I discovered from my research that the metastasis to these sites is due to the extravasation of the cancerous cells into the circulatory system and via the lymph nodes. Tumor marker cells are indeed products of cancer cells.
The body also produces them in response to the presence of cancer cells. Besides giving information on the cancer type, healthcare providers can determine the aggressiveness of the cancer based on tumor marker cells (Storz & Crawford, 2020). I agree with you that the TNM staging of cancer helps practitioners determine the aggressiveness of cancer and treatment modalities. It also acts as a method of communication among the different providers involved in cancer treatment.
I agree with your description of malignant tumors that have uncontrolled, rapid cell cycle and low differentiation (Klein, 2020). The tissue level that is affected in the client is epithelial tissue. I think the most appropriate stage for the ductal adenocarcinoma would be stage IV.
References
- Ayres Pereira, M., & Chio, I. I. C. (2019). Metastasis in Pancreatic Ductal Adenocarcinoma Current Standing and Methodologies. Genes, 11(1), 6. https //doi.org/10.3390/genes11010006
- Klein, C. A. (2020). Cancer progression and the invisible phase of metastatic colonization. Nature Reviews Cancer, 20(11), Article 11. https //doi.org/10.1038/s41568-020-00300-6
- Rosen, R. D., & Sapra, A. (2023). TNM Classification. In StatPearls. StatPearls Publishing. http //www.ncbi.nlm.nih.gov/books/NBK553187/
- Storz, P., & Crawford, H. C. (2020). Carcinogenesis of Pancreatic Ductal Adenocarcinoma. Gastroenterology, 158(8), 2072–2081. https //doi.org/10.1053/j.gastro.2020.02.059
- Tan, Z., Xue, H., Sun, Y., Zhang, C., Song, Y., & Qi, Y. (2021). The Role of Tumor Inflammatory Microenvironment in Lung Cancer. Frontiers in Pharmacology, 12. https //www.frontiersin.org/articles/10.3389/fphar.2021.688625
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