Case Studies -Week 3 Cancer by Mélanie Filion https://padlet.com/melanie_filion/cancer_monday Monday class en-us 2018-02-02 19:52:19 UTC 2020-01-20 19:43:15 UTC hello@padlet.com 1) Mary is concerned about a possible hereditary risk factor in her diagnosis, what can you explain to Mary about "breast cancer genes" https://padlet.com/melanie_filion/cancer_monday/wish/433677966 Mutation in BRCA1, BRCA2 genes, risk of developing breast/ovarian cancer is very high with a mutation in either gene, but tends to be higher with BRCA1
Current estimate are that 1% of general population have mutation in either of BRCA genes
10-15% of woman diagnosed with breast cancer have BRCA mutations
In families with 4 or more cases of breast cancer diagnosed before age 60, chance of hereditary breast and ovarian cancer syndrome is approximately 80%
- Lifetime risk of breast cancer 50-85%
-Lifetime risk of ovarian cancer with BRCA1: 25-50%, BRCA2: 15-30%]]> 2020-01-20 15:30:05 UTC https://padlet.com/melanie_filion/cancer_monday/wish/433677966 1) The physicians say they would need to do a biopsy to determine if the tumor is benign or malignant. What does this mean? https://padlet.com/melanie_filion/cancer_monday/wish/433679660 Benign means; Grow slowly,
Well-defined capsule, Not invasive, Well differentiated, Low mitotic index and Do not metastasize. I would like result in watching while 
Malignant means grow rapidly, Not encapsulated, invasive, Poorly differentiated, High mitotic index, Can spread distantly (metastasis) intervention would likely be needed. 
]]> 2020-01-20 15:35:54 UTC https://padlet.com/melanie_filion/cancer_monday/wish/433679660 2) Mary complains of pain and fatigue. Explain these clinical manifestations https://padlet.com/melanie_filion/cancer_monday/wish/433680207 Pain: little or no pain is associated with early stages of cancer, it is influenced by fear, anxiety, sleep loss, fatigue, overall physical deterioration 
Fatigue: most frequent symptom, tiredness, weakness, lack of energy, lethargy ]]> 2020-01-20 15:37:39 UTC https://padlet.com/melanie_filion/cancer_monday/wish/433680207 1. The physicians say they would need to do a biopsy to determine if the tumor is benign or malignant. What does this mean? https://padlet.com/melanie_filion/cancer_monday/wish/433680510 Determining whether a tumor is benign or malignant will confirm whether the tumor is cancerous or not, and help in developing a  treatment plan for the patient. In cases where a biopsy reveals the presence of cancer, the biopsy results will include a discussion of the type of cancer, its size, its location, and its margins. 
Benign - noncancerous (slow growth, will possibly be monitored over years to assess the tumors possibility for progression to cancer)
Malignant - cancerous (rapid growth) 

]]> 2020-01-20 15:38:27 UTC https://padlet.com/melanie_filion/cancer_monday/wish/433680510 #4 What are 3 main treatment modalities for cancer? what are the links to patho? brooke_whitteker12 https://padlet.com/melanie_filion/cancer_monday/wish/433680939 1 - surgery: first resort, for localized cancers
2 - chemo: for metastasis cancers
3 - radiation: for specific cancerous cell targeting ]]> 2020-01-20 15:39:54 UTC https://padlet.com/melanie_filion/cancer_monday/wish/433680939 7. What does his staging and grading indicate? what is the TNM system? https://padlet.com/melanie_filion/cancer_monday/wish/433683352 stage I- localized tumor growth; limited to the tissue of origin
grade II- Cells are more abnormal and moderately differentiated. 
it is not spreading

*T-primary tumor site
N- lymph node involvement
M-metastatic spread]]> 2020-01-20 15:48:17 UTC https://padlet.com/melanie_filion/cancer_monday/wish/433683352 2. Why did the physician test for Prostate Specific Antigen (PSA)? https://padlet.com/melanie_filion/cancer_monday/wish/433683479 The physician most likely tested for PSA using a blood test to either confirm the presence of prostate cancer (though previously diagnosed with a prostate tumor) or to monitor treatment for prostate cancer. PSA is made by the prostate gland, therefore the blood test will measure the level of PSA in your blood. The higher the level of PSA, the more likely you are to have or to develop cancer. ]]> 2020-01-20 15:48:47 UTC https://padlet.com/melanie_filion/cancer_monday/wish/433683479 3. How does a cancer cell differ from a regular cell? https://padlet.com/melanie_filion/cancer_monday/wish/433684874 Cancer cells:
-Have changes on their surface
-Are able to turn off signals over time which allow them to grow rapidly over time and become invasive
-Not as specialized (distinct)
-Vary in size and shape
-Grow in clusters without a boundary
-Do not interact with other cells
-Remain immature (undifferentiated) and do not mature because of rapid growth
-May not be functional

Normal cells:
-Mature into very distinct cell types with specific functions, size, shape
-Growth with boundary's  
-Interact with other cells (i.e. knowing when to stop growing)
-Perform normal function ]]> 2020-01-20 15:54:21 UTC https://padlet.com/melanie_filion/cancer_monday/wish/433684874 3. Mary's B/W demonstrated hypercalcemia. Explain the link to her cancer. https://padlet.com/melanie_filion/cancer_monday/wish/433685375 Breast cancer is the commonest malignancy associated with hypercalcemia; the detection of hypercalcemia in these patients usually signifies metastatic disease and is associated with a poor prognosis. ]]> 2020-01-20 15:56:16 UTC https://padlet.com/melanie_filion/cancer_monday/wish/433685375 4. How does a regular cell transform into a cancer cell? https://padlet.com/melanie_filion/cancer_monday/wish/433688160 Normal cells become cancerous when a series of mutations leads the cell to continue to grow and divide out of control, and, in a way, a cancer cell is a cell that has achieved a sort of immortality.]]> 2020-01-20 16:07:35 UTC https://padlet.com/melanie_filion/cancer_monday/wish/433688160 5. Besides a mutation, what can influence the development of cancer? https://padlet.com/melanie_filion/cancer_monday/wish/433688743 The development of cancer can be influenced by a patients age, weight, exposure to carcinogens, and genetics. These factors can increase the patients risk of developing cancer.]]> 2020-01-20 16:10:00 UTC https://padlet.com/melanie_filion/cancer_monday/wish/433688743 1. What are Mary's risk factors for breast cancer? https://padlet.com/melanie_filion/cancer_monday/wish/433733893 - Over the age of 60 (62y)
- Family history of breast cancer (mother died at age 54)
- Early menarche (8y)
- Female
- Hormone replacement therapy 
- Weight 
- North America (environmental exposure, diet, or lifestyle)
- No children ]]> 2020-01-20 19:19:56 UTC https://padlet.com/melanie_filion/cancer_monday/wish/433733893 2. What are the main clinical manifestations of breast cancer? https://padlet.com/melanie_filion/cancer_monday/wish/433734648 - Lump or mammographic abnormality detected in the breast (most often in upper, outer quadrant)
- Dense with glandular tissue
- Rate of lesion growth varies
- Slow-growing lesions associated with lower mortality rates
- Hard, irregular, poorly delineated, non-mobile, and non-tender
- Small percentage cause nipple discharge
- Usually unilateral and clear or bloody
- Nipple retraction may occur
- Peau d’orange 
- Infiltration, induration, dimpling of overlying skin in large cancers
- Breast asymmetry
- Correlation with menstrual cycle
- Recurrence of cancer


]]> 2020-01-20 19:23:07 UTC https://padlet.com/melanie_filion/cancer_monday/wish/433734648 #6 abnormal findings for this patient? brooke_whitteker12 https://padlet.com/melanie_filion/cancer_monday/wish/433736517 - 8/10 pain in right breast
- swollen right arm
- dry mouth
- difficulty swallowing
- mouth sores
- nausea/vomiting/diarrhea
- low platelets 
- low WBC
- low neutrophils
- low Na
- low K
- high creatinine 
- low protein
ABGs:
- high pH
- high HCO3
- Reddish orange urine]]> 2020-01-20 19:29:46 UTC https://padlet.com/melanie_filion/cancer_monday/wish/433736517 #3 TMN and survival rate for classification brooke_whitteker12 https://padlet.com/melanie_filion/cancer_monday/wish/433736976 T - 1 cm, N - no, M - no

Stage 1 or 2: 100-93%]]> 2020-01-20 19:32:11 UTC https://padlet.com/melanie_filion/cancer_monday/wish/433736976