The case study in cancer
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The Case Study in Cancer
Rachel Candelaria BIO 111
Part I
Ann is a 27-year-old nurse working at the local hospital in surgery. She had worked hard to
move into the specialty, and she was enjoying her career, friends, and family. She and her partner had been living together for about a year, and she was content. As a nurse, Ann knew the importance of doing breast self-exams, and did them regularly. In the shower one morning, she felt a lump she wasn’t familiar with. Ann was a bit worried, even though there
was no history of breast cancer in her family, so she made an appointment with her doctor. 1.
If Ann has a tumor in her breast, is it necessarily cancerous? Differentiate between a benign tumor and cancer at the cellular level. No, if Ann has a tumor in her breast, it is not necessarily cancerous. A benign tumor refers to an abnormal growth of cells that do not invade nearby tissues and do not spread to other parts of the body. In contrast, cancer refers to the presence of malignant cells that can invade nearby tissues and spread to other parts of the body.
At the cellular level, benign tumors typically consist of well-differentiated cells that resemble the normal cells of the tissue they originated from and have a more organized growth pattern. On the other hand, cancer cells are often less differentiated, have abnormal nuclei, and display uncontrolled growth and invasion capabilities (American Cancer Society, n.d.).
Part II
Ann’s doctor is worried enough to send her to a breast cancer specialist, just to be safe. Ann
makes an appointment and is referred for a mammogram, which will image the soft tissue in the breast. After the mammogram and an exam, she meets with the surgeon, Dr. Hernandez. Dr. Hernandez is also concerned, as she felt and has images from the mammogram of a small tumor. She recommends a biopsy of the tumor as soon as possible. Ann goes in the same day for the quick surgical procedure where a needle is inserted and part of the tumor is taken for analysis. The tumor will be analyzed by a pathologist, a specialist in looking for disease in tissue samples. 1.
The pathologist examines the cells taken from the tumor, particularly the number of cells in mitosis. Below are the results. In normal breast cells, one would expect 0-4 cells per 10 high-powered field of view (microscopy) undergoing mitosis.
Cell Cycle Stage
Number of Tumor Cells in 10 High-Power Fields
Interphase
120
Prophase
7
Metaphase
2
Anaphase
10
Telophase
0
Based on the above results, what can you conclude about the tumor cells? Can you say definitively that they are cancerous? Be sure to support your answer with the data above. Based on the results provided, it can be concluded that the tumor cells are cancerous. The number of tumor cells in mitosis is significantly higher than what would be expected in normal breast cells. In normal breast cells, one would expect 0-4 cells per 10 high-powered field of view undergoing mitosis, but in this case, there are 19 cells undergoing mitosis out of 140 cells observed. This higher mitotic index indicates increased cell division and is a characteristic feature of cancer cells 2.
The pathologist also looks for three receptors on the tumor cells: estrogen receptors, progesterone receptors, and HER2 receptors.
a.
What type of macromolecule class are cell receptors? What is the monomer? a. Cell receptors are classified as proteins and are considered a macromolecule class. The monomers of proteins are amino acids.
b.
What is the role of cell receptors in cellular function? Cell receptors play a crucial role in cellular function by acting as molecular switches that transmit signals from the external environment to the inside of the cell. They are involved in various cellular processes, including growth, division, differentiation, and response to external stimuli (Alberts et al., 2002).
c.
Ann’s tumor was positive for estrogen and progesterone receptors, but negative for the HER2 receptor. What is the role of estrogen receptors on a cell? Remember to cite your sources using APA Style. The role of estrogen receptors on a cell is to bind estrogen and mediate the cellular effects of estrogen signal transduction. When estrogen binds to its receptor, it can regulate gene expression and influence cell proliferation, differentiation, and survival (Zhao & Dahlman-Wright, 2010).
Part III
Dr. Hernandez sits down with Ann and her partner. The doctor is sorry to report that Ann has breast cancer; however, because it was caught early and responds to estrogen and progesterone, the prognosis is good. At this point it looks like the cancer is stage 1. However, as Ann is young, the doctor wants to perform a couple tests. The first test is a genetic sequencing test for BRCA1 and BRCA2, as well as testing for other genes known to increase the risk of cancer. The other test is an Oncotype DX test on the tumor cells. This is a gene expression test, where the results correlate with how aggressive the cancer cells are.
Ann is overwhelmed, but wants to do everything she can to get rid of this disease. 1.
As a result of your discussions, you know that mutations in BRCA1 and BRCA2 increase the risk of breast cancer. Because of this, a positive test for these mutations would mean different treatment for Ann, including removal of both her breasts
(bilateral mastectomy) as well as her ovaries to prevent ovarian cancer. Ann decides
to have the test done, but she is a little hazy on the biology of DNA.
a.
Describe the basic structure and function of a gene. A gene is a segment of DNA that contains the instructions for the synthesis of
a specific protein or RNA molecule. It consists of coding sequences (exons) that are transcribed and translated into functional proteins and non-coding sequences (introns and regulatory regions) that play a role in gene regulation (Alberts et al., 2002).
b.
At the molecular level, what is a mutation? Are all mutations harmful? What type of mutation does not lead to a change in protein structure? At the molecular level, a mutation refers to a change in the DNA sequence of a
gene. Not all mutations are harmful, as some can have no effect or even produce beneficial changes. Silent mutations are mutations that do not lead to a change in the protein structure because they occur in non-coding regions
or result in the same amino acid sequence due to the redundancy of the genetic code (Genetics Home Reference, 2021).
c.
The polymerase chain reaction (PCR) is a method that can be used to detect mutations. It uses machinery similar to your cells to replicate a specific DNA sequence, which in this case would be only the mutated gene. Describe the basic process of DNA replication in a cell. DNA replication in a cell involves several steps. It starts with the unwinding of the DNA double helix and the separation of the strands. DNA polymerase then synthesizes two new strands by adding complementary nucleotides to each separated strand. This process is semi-conservative, meaning each new DNA molecule contains one old strand and one new strand (Alberts et al., 2002).
2.
Also, as a result of your discussion, you know that the expression of genes can change in cancerous cells versus noncancerous cells. The Oncotype test will look at the expression levels of several genes in her tumor cells by looking at the mRNA produced. a.
What role does mRNA play in the flow of information in the cell? (
Hint
: Remember the central dogma of molecular biology.) Please include the basic flow of information in the cell. a. mRNA (messenger RNA) plays a crucial role in the flow of genetic information in the cell. It carries the genetic code from DNA to the ribosomes in the cytoplasm, where it serves as a template for protein synthesis. This process is known as transcription. The flow of information in the cell is described by the central dogma of molecular biology, which states that DNA is transcribed into mRNA, and mRNA is translated into protein (Alberts et al., 2002).
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