HS200_2302A_Unit_6_Assignment_AutumnRodriguez
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Unit 6 Assignment
For this assignment, you will review several case studies on various types of cancers. You will then answer the following questions for each of the case studies:
●
Are there any signs and symptoms of this cancer?
●
Are there any risk factors which may be genetic and/or lifestyle related? Any possible preventive measure?
●
Is there any recommended screening procedure and appropriate diagnosis for cancer?
●
What are the traditional treatment options? Any side effects?
●
Are there any recommendations for complementary and alternative medicine treatment options for the cancer that may help ease side effects and improve patient’s quality of life?
In addition, you will also answer one question in each case study, posed by the patient, as if you are that patient’s physician. At least four professional references must be included
. All internet sources must be original articles or government resources (
NIH.gov
,
CDC.gov
,
medlineplus.gov
) or from websites of medical Institutes (
mayo.edu
,
mdanderson.org
,
dana-farber.org
) or American Cancer Society (
Cancer.org
). Wikipedia or other non-peer reviewed resources are not acceptable
.
Be sure to put your references in APA format
. Here is the link for
Academic Writer
.
Case Study #1
Jennifer is a 28-year-old Caucasian woman who works as a legal assistant in a law firm. While showering one morning she notices a lump in her right breast. Jennifer knows her mother had a harmful mutation in the BRCA1 gene, and her mother died of breast cancer. Jennifer has also had a history of early menstruation. She has never been pregnant, although would like to have children one
day. Concerned, Jennifer sees her primary physician, who sends her to have a mammogram. The mammogram shows that she does
indeed have breast cancer. Her doctor discusses treatment options with her. Complete the table below. Each blank is worth 3.5 points. Breast Cancer
Signs and Symptoms
Pain, discharge or pulling in of the nipple or nipple area. Changes in size or shape. Red or flaky skin on
the breast or nipple area. A new lump anywhere in the breast or armpit. Changes in how you skin looks
or feels on the breast.
Risk factors
Women aged 55 or older. If any of your close relatives have or have had breast cancer. Tobacco use. Drinking alcoholic beverages. If you have inherited genetic mutations such as BRCA1 and BRCA2. If you are severely overweight or obese. Exposure to radiation vie prior medical procedures, exposure through work, etc. If you use hormone replacement therapy.
Screening/diagnosis
You can be diagnosed through a breast biopsy, ultrasound, genetic testing, immunohistochemistry, or MRI of the breast. Immunohistochemistry is a test used to check for hormone receptors.
Preventive measures
Eat a healthy diet and maintain a healthy weight. Regular exercise. Getting screened regularly. Avoiding drinks that contain alcohol and doing regular self-exams. Can also get genetic screening or taking medications that can lower the risk of breast cancer.
Traditional treatment options and side effects
Chemotherapy, radiation, targeted therapy, hormone therapy, immunotherapy. As well as a mastectomy, breast reconstruction, or lumpectomy.
CAM options
Acupuncture, shiatsu, acupressure, touch therapies, massages, energy therapies, reflexology, aromatherapy, hypnotherapy, meditation, mindfulness, yoga, tai chi, cannabis and CBD, herbal medicines, mistletoe extract medicines, echinacea, St John’s wort. (American Cancer Society, 2022), (Centers for Disease Control and Prevention, 2023), (Cleveland Clinic, 2023),
(Susan G. Komen, 2023)
Imagine you are Jennifer’s physician, and provide your response to her question: “How will these treatments affect my fertility?” (3 points)
There are some treatments for breast cancer that may affect your fertility. Chemotherapy poses the risk of damaging your ovaries which can lead to infertility immediately, or later. However, these effects are not necessarily permanent. Many women are still able to
conceive after treatment. Case Study #2
John is a 40-year-old, 6-foot-tall African American male with a BMI of 30. He is in the real estate business and likes to have a drink after work to unwind. He also enjoys going out with friends to a bar on weekends. John has approximately 20 drinks per week. At the doctor’s office during a regular checkup, he reports feeling tired at work, a change of bowel habits over the past 2 months, and occasionally has blood in his stool. He has a family history of colon cancer; his father had colon cancer but has managed it through
treatment and is alive and doing well. The physician sends him for a colonoscopy after a sigmoidoscopy. He is told after the procedure that a suspicious mass is detected and a biopsy and CT scan are needed to confirm the diagnosis. Complete the table below. Each blank is worth 3.5 points. Colon Cancer
Signs and Symptoms
Blood in stool, rectal bleeding, weakness, tiredness, sudden loss of weight (without trying), change in bowel movements, discomfort in the abdominal area.
Risk factors
Smoking, consumption of alcohol, obesity, not exercising, a diet that consists of too much red meat or processed food, history of inflammatory diseases, African American ethnicity, if you have a history of polyps or colorectal cancer, if you have an inherited syndrome, American Indian or Alaskan Native peoples, people over the age of 50.
Screening/diagnosis
A biopsy of tissue from the colon, a colonoscopy, fecal test, blood tests, a CMP (comprehensive metabolic panel), x-rays, ultrasound, PET scan, MRI, CT scan, and CEA (carcinoembryonic antigen assay).
Preventive measures
Maintain a healthy diet and weight, reduce intake of alcohol, not using tobacco, get colon cancer screenings tracking your family medical history.
Traditional treatment options and side effects
Surgical resection with colostomy, polypectomy partial colectomy, chemotherapy, targeted therapy, CAM options
Ayurveda, herbal medicines, tai chi, yoga, reiki, meditation, massage, imagery, foot reflexology, aromatherapy, acupuncture acupressure, CBD, medical marijuana.
(American Cancer Society, 2020), (Cleveland Clinic, 2022), (Fight Colorectal Cancer, n.d.), (Mayo Clinic, 2023)
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Imagine you are John’s physician and respond to the concerns he expresses: “I’m nervous, Doctor. If the results come back indicating I have cancer, then what is my prognosis? What treatment options are there? (3 points)
The prognosis will depend on the stage of your colon cancer, however around 90% of people who have been treated for early-stage colon cancer survive. There are several treatment options available and if we caught it early, the odds are better. Surgery is an option where we remove a part of the colon, and it may be necessary to do a colostomy which can be temporary or permanent. There is also the option of laparoscopic surgery that isn’t as invasive and removes the polyps from the intestine. Additionally, there is a polypectomy where we remove the polyps that are on the inner wall of the intestine. Then we have chemotherapy and targeted therapy (Mayo Clinic, 2023). However, it is important that you significantly reduce your consumption of alcohol, as this puts you at higher risk of developing colon cancer. Case Study #3
Sofia, a 65-year-old woman, visits her doctor, complaining of a 4-week history of right sided chest pain. She describes the pain as dull and intermittent and has not changed over the last few weeks. She has also lost about 7 pounds in the last few months. After a series of tests and procedures such as chest X-ray, CT scan, sputum cytology, and biopsy of the lung tissue, Sofia is diagnosed with non-small cell lung cancer (NSCLC). She used to smoke but quit 10 years ago at age 55. She had started smoking at age 16. Her father was also a smoker and died of lung cancer. She is informed about other tests and procedures that may be used in the staging process, such as magnetic resonance imaging (MRI), positron emission tomography (PET) scan, and pulmonary function tests (PFTs). Sofia is terribly anxious and asks her doctor about the prognosis. Complete the table below. Each blank is worth 3.5 points. Lung Cancer
Signs and Symptoms
Persistent cough, shortness of breath, chest pain, coughing blood, bone pain, headache, sudden loss of weight, hoarseness, wheezing, always feeling tired, loss of appetite, repeating bouts of bronchitis or pneumonia.
Risk factors
Smoking (including exposure to secondhand smoke), exposure to radon gas, asbestos, uranium, arsenic, chromium, and some silica. Previous radiation therapy, a family history of lung cancer.
Screening/diagnosis
Imaging tests such as a CT scan, a biopsy, a PET scan, blood tests, chest x-rays, sputum cytology,
and then staging tests.
Preventive measures
Don’t smoke or stop smoking and avoid secondhand smoke. Maintain a healthy diet, avoiding carcinogens (especially at work), exercise regularly, and get your home tested for radon.
Traditional treatment options and side effects
Surgery (wedge resection, lobectomy, etc.), chemotherapy, targeted therapy, radiation therapy, immunotherapy, palliative care.
CAM options
Yoga, meditation, herbs, special diets, vitamins, massage, reflexology, reiki, tai chi, naturopathic medicine, ayurvedic medicine.
(American Cancer Society, 2023), (American Lung Association, 2022), (Centers for Disease Control and Prevention, 2023), (Cleveland Clinic, 2022), (Mayo Clinic, 2022)
Imagine you are Sofia’s physician, and provide your response to her question: “What is the prognosis? How long do I have to live?” (3 points)
Your prognosis will depend on the stage of cancer you are at. However, 63% of people who have been diagnosed with early-stage NSCLC are still alive five years later. There is no easy answer as to how long you have to live, and it depends on whether the cancer
has metastasized (Cleveland Clinic, 2022). The good news is that NSCLC is curable especially when detected early and there are several treatment options. It will be especially important in your case to avoid tobacco use. Case Study #4
Andrew is 48 years old, works in a health insurance company, and is single. Through discussion with colleagues, he becomes aware of the prostate specific antigen (PSA) test. He knows his father was diagnosed with prostate cancer at an early age. Andrew decides to go for the PSA screening test. His higher-than-normal PSA blood test and digital rectum exam (DRE) test suggest he might have prostate cancer. A biopsy is done at his doctor’s office, and samples are sent to a lab. The pathologist confirmed the presence of cancer cells in the samples and provided a Gleason score which is quite high.
Complete the table below. Each blank is worth 3.5 points. Prostate Cancer
Signs and Symptoms
Erectile dysfunction, bone pain, sudden loss of weight, blood in semen or urine trouble urinating, diminished strength of urine stream, loss of bladder of bowel control, feeling week or tired, numbness or weakness in legs or feet, pain or burning sensation when urinating, excessive urinating at night.
Risk factors
People (men) over the age of 50, Black persons at higher risk, obesity, a family history of prostate cancer, diet, smoking, exposure to certain chemicals (i.e., Agent Orange), if you have inherited a mutated gene.
Screening/diagnosis
PSA (prostate specific antigen) test, DRE (digital rectal examination), biopsy, imaging tests such as MRI or ultrasound.
Preventive measures
Maintain a healthy diet, regular exercise, maintain a healthy weight, know your family medical history, taking 5-alpha reductase inhibitors, regular prostate screenings not smoking or quitting smoking, Traditional treatment options and side effects
Surgery to remove prostate, surgery, radiation, ablative therapy, cryotherapy, hormone therapy, chemotherapy, immunotherapy, targeted drug therapy.
CAM options
Music therapy, exercise, dance/movement therapy, relaxation techniques, art therapy, spirituality, meditation, herbal remedies, vitamins.
(American Cancer Society, 2023), (Centers for Disease Control and Prevention, 2023), (Cleveland Clinic, 2023), (Mayo Clinic, 2022)
Imagine you are Andrew’s physician, and provide your response to his question: “Should I put my sperm in a sperm bank before undergoing treatment? How will the surgery affect my regular life?” (3 points)
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Yes Andrew, I would recommend freezing your sperm, as it will be your best chance to conceive a child after undergoing treatment. After surgery, it will become nearly impossible to conceive a child via sexual intercourse (Johns Hopkins Medicine, 2021). The surgery poses very little risk of damaging the rectum meaning you might notice bowel changes as your body adjusts after surgery, but they should return to normal (Johns Hopkins Medicine, 2021). There is a small chance that you might experience urinary leakage
or loss of control of urination after surgery for a while, but many patients recover from this (Johns Hopkins Medicine, 2021).
Case Study #5
Larry, a 45-year-old marathon runner, visits his primary physician for a routine physical checkup. During the checkup, a suspicious looking mole is detected at the back of his left hand. The lesion has an appearance suggestive of melanoma. Larry informs his doctor
that the mole has gotten larger over the past two years. Larry has a light complexion. He typically goes for a 5-6 mile run every day and spends time gardening and biking. He is not sure whether any of his relatives have or have had skin cancer. He is referred to a dermatologist, who believes the mole looks like skin cancer. The mole is surgically excised and sent to pathology lab for histologic analysis. Larry is diagnosed with malignant melanoma. As further treatment, Larry’s physician wants to remove his left axillary mass and do histologic examination to ascertain whether or not Larry’s melanoma has metastasized. Complete the table below. Each blank is worth 3.5 points. Skin Cancer
Signs and Symptoms
Basal cell carcinoma: a sore that bleeds and then heals but returns, flat, flesh-colored laceration, brownish scar-like laceration.
Squamous cell carcinoma: A flat laceration that is scaly and has a crusted surface, a red nodule on the
skin that is firm.
Melanoma: Any dark lesions on the palms, soles, fingers, toes, or the lining around the nose, mouth, anus or vagina, a mole that changes in appearance or bleeds, a large brown spot accompanied with darker speckles, a lesion that is painful and itches or burns. Risk factors
Extreme sun exposure, fair skin, having a history of sunburns, moles, climates with a lot of sun or high-
altitude, family history of skin cancer, exposure to radiation, if you personally have had skin cancer, precancerous lacerations on the skin, weakened immune systems, exposure to certain chemicals, having blond or red hair, having blue or green eyes, older age.
Screening/diagnosis
Conducting regular self-examinations of your body, getting a total body examination by your doctor, a skin biopsy of the suspicious part of the skin, imaging tests for melanoma, Merkel cell carcinoma, or melanoma.
Preventive measures
Avoiding sun exposure – especially during the middle of the day, always wearing sunscreen (one that is broad-spectrum) and year-round, wearing clothing that protects from sun exposure, avoiding tanning
beds, being mindful of medications that can cause sun-sensitizing, regularly examining your skin and reporting any changes to your doctor.
Traditional treatment options and side effects
Cryosurgery, excisional surgery, Mohs surgery, radiation, chemotherapy, curettage and electrodessication, biological therapy, photodynamic therapy, CAM options
Herbal remedies, CBD, phytochemicals, botanical agents, yoga, meditation, maintaining good tradition,
acupuncture, homeopathy. (Centers for Disease Control and Prevention, 2023), (Hidalgo et al., 2022), (Mayo Clinic, 2022)
Imagine you are Larry’s physician, and provide your response to his question: “Can I still spend time outdoors? Is there anything special I’ll have to do in order to stay outside as often as I’d like?” (3 points)
Yes, you can still spend time outdoors, but it is vital that you practice safe sun exposure. Wear protective clothing such as long sleeves, long pants, hats, scarves, and sunglasses. Also ensure that you are applying broad-spectrum sunscreen with an SPF of 30 or more every day and reapplying every two hours. If you are sweating or getting wet, apply sunscreen more often. Try to avoid being
in the sun between 10 a.m. and 2 p.m. every day and of course avoid artificial UV radiation such as tanning beds (Centers for Disease Control and Prevention, 2023) (Mayo Clinic, 2022).
Case Study # 6 - Student’s Choice
Choose one more form of cancer that you are interested in and complete the table below for that cancer. Complete the table below. Each blank is worth 3.5 points. Ovarian Cancer
Signs and Symptoms
Fatigue, back pain, frequent urination, sudden loss of weight, swelling or bloating od abdomen, feeling full quickly when eating, changes in bowel habits, discomfort in pelvic area, vaginal discharge.
Risk factors
Older age (over 60), family history of ovarian cancer, if you have inherited genes that an cause ovarian
cancer, being overweight, endometriosis, if you have never been pregnant, postmenopausal HRT. Screening/diagnosis
MRI, CT scan, PET scan, pelvic ultrasound, blood tests, laparoscopy, pelvic exam.
Preventive measures
Taking birth control and if you have a family history, consider genetic testing. Traditional treatment options and side effects
Surgery (hysterectomy, oophorectomy, etc.), chemotherapy, targeted therapy, radiation, hormone therapy, CAM options
Acupuncture, herbal remedies, spirituality, yoga, meditation, vitamins.
(American Cancer Society, 2020), (Cleveland Clinic, 2022), (Mayo Clinic, 2023)
Anticipate a question that a patient who was recently diagnosed with the cancer you have chosen to research. Type that question below, and then provide an answer as if you are the patient’s physician. (6 points)
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How will this affect my fertility? What are my options if I want to have a child?
Unfortunately, if we conduct a hysterectomy or oophorectomy, you will no longer be able to conceive a child. If the cancer is only affecting one ovary, we will remove that one ovary and you still have a chance of conceiving. I would suggest freezing your eggs so that if we have to remove both ovaries but not your uterus, you may still be able to become pregnant with those frozen eggs or embryos. Another option here would be to use eggs from a donor (American Cancer Society, 2020).
REFERENCES: (properly formatted references are a requirement for this assignment)
American Cancer Society. (2020). Colorectal cancer
. https://www.cancer.org/cancer/types/colon-rectal-cancer.html
American Cancer Society. (2020). How cancer and cancer treatment can affect fertility in females
. https://www.cancer.org/cancer/managing-cancer/side-effects/fertility-and-sexual-side-effects/fertility-
and-women-with-cancer/how-cancer-treatments-affect-fertility.html
American Cancer Society. (2022, January 5). Pregnancy and breastfeeding after breast cancer
. https://www.cancer.org/cancer/types/breast-cancer/living-as-a-breast-cancer-survivor/pregnancy-after-
breast-cancer.html#:~:text=breast%20cancer%20treatment.-,Can%20I%20have%20a%20baby%20after
%20having%20breast%20cancer%3F,to%20become%20pregnant%20after%20treatment
American Cancer Society. (2023). Lung cancer
. https://www.cancer.org/cancer/types/lung-cancer.html
American Cancer Society. (2023). Prostate cancer
. https://www.cancer.org/cancer/types/prostate-cancer.html
American Lung Association. (2022, November 17). Complementary and alternative therapies for lung cancer
. https://www.lung.org/lung-
health-diseases/lung-disease-lookup/lung-cancer/treatment/types-of-treatment/complementary-and-
alternative
Centers for Disease Control and Prevention. (2023, July 25). Basic information about breast cancer
. https://www.cdc.gov/cancer/breast/basic_info/index.htm
Centers for Disease Control and Prevention. (2023, August 1). Basic information about lung cancer
. https://www.cdc.gov/cancer/lung/basic_info/
Centers for Disease Control and Prevention. (2023, July 17). Basic information about prostate cancer
. https://www.cdc.gov/cancer/prostate/basic_info/
Centers for Disease Control and Prevention. (2023, April 18). Basic information about skin cancer
. https://www.cdc.gov/cancer/skin/basic_info/index.htm
Cleveland Clinic. (2022). Colon cancer (Colorectal cancer)
. https://my.clevelandclinic.org/health/diseases/14501-colorectal-
colon-cancer
Cleveland Clinic. (2022). Lung cancer: Types, stages, symptoms, diagnosis & treatment
. https://my.clevelandclinic.org/health/diseases/4375-lung-cancer#symptoms-and-causes
Cleveland Clinic. (2022). Ovarian cancer: Symptoms, diagnosis & treatment
. https://my.clevelandclinic.org/health/diseases/4447-
ovarian-cancer#prevention
Cleveland Clinic. (2023, September 25). Breast cancer
. https://my.clevelandclinic.org/health/diseases/3986-breast-
cancer#symptoms-and-causes
Cleveland Clinic. (2023). Prostate cancer: Symptoms, causes & treatment
. https://my.clevelandclinic.org/health/diseases/8634-
prostate-cancer#overview
Fight Colorectal Cancer. (n.d.). Complementary and Alternative Medicine for Colon Cancer
. https://fightcolorectalcancer.org/cam/
Hidalgo, L., Saldias-Fuentes, C., Carrasco, K., Halpern, A. C., Mao, J. J., & Navarette-Dechent, C. (2022, November). Complementary and alternative therapies in skin cancer a literature review of biologically active compounds
. PubMed. https://pubmed.ncbi.nlm.nih.gov/36124923/
Johns Hopkins Medicine. (2021, August 8). Bowel dysfunction after prostate cancer treatment
. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/bowel-dysfunction-after-
prostate-cancer-treatment
Johns Hopkins Medicine. (2021, August 8). Fertility after prostate cancer treatment
. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/fertility-after-prostate-
cancer-treatment
Johns Hopkins Medicine. (2021, August 8). Urinary dysfunction after prostate cancer treatment
. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/urinary-dysfunction-after-
prostate-cancer-treatment
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Mayo Clinic. (2022, March 22). Lung cancer - Symptoms and causes
. https://www.mayoclinic.org/diseases-conditions/lung-
cancer/symptoms-causes/syc-20374620
Mayo Clinic. (2022, December 14). Prostate cancer - Symptoms and causes
. https://www.mayoclinic.org/diseases-conditions/prostate-cancer/symptoms-causes/syc-20353087
Mayo Clinic. (2022, December 6). Skin cancer - Symptoms and causes
. https://www.mayoclinic.org/diseases-conditions/skin-
cancer/symptoms-causes/syc-20377605
Mayo Clinic. (2023, July 27). Colon cancer - Symptoms and causes
. https://www.mayoclinic.org/diseases-conditions/colon-cancer/
symptoms-causes/syc-20353669
Mayo Clinic. (2023, May 9). Ovarian cancer - Symptoms and causes
. https://www.mayoclinic.org/diseases-conditions/ovarian-
cancer/symptoms-causes/syc-20375941
Susan G. Komen®. (2023, December 28). Complementary therapies - Integrative therapies
. https://www.komen.org/breast-cancer/survivorship/complementary-therapies/