NR 507 Week 1: Altered Immune System and Altered Inflammatory Response - Discussion Part 3

Week 1: Altered Immune System and Altered Inflammatory Response - Discussion Part Three Loading... This week's graded topics relate to the following Course Outcomes (COs). 1 Analyze pathophysiologic mechanisms assoc ...

Week 1: Altered Immune System and Altered Inflammatory Response - Discussion Part Three Loading... This week's graded topics relate to the following Course Outcomes (COs). 1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1) 2 Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1) 3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7) 6 Distinguish risk factors associated with selected disease states. (PO 1) 5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1) 6 Distinguish risk factors associated with selected disease states. (PO 1) 7 Explore age-specific and developmental alterations in physiologic and disease states. (PO 1, 4) Discussion A 44-year-old patient presents with lump in the chest of approximately 2 cm in diameter. There is a slight dimple over the location of the lump and when the lump is manipulated it seems to be attached to the surrounding tissue. A lumpectomy is performed and the mass is sent to pathology. The pathology report comes back and the mass is confirmed to be an estrogen receptor negative, a progesterone receptor negative and a her2/neu receptor positive breast cancer. What are some of the risk factors for breast cancer? What tumor suppressor genes are associated with breast cancer? What tumor oncogenes are associated with breast cancer? Compare and contrast tumor suppressor genes from oncogenes? Discussion Part Three (graded) Responses Lorna Durfee 5/4/2016 5:25:16 PM Discussion Part 3 A 44-year-old patient presents with a lump in the chest of approximately 2 cm in diameter. There is a slight dimple over the location of the lump and when the lump is manipulated it seems to be attached to the surrounding tissue. A lumpectomy is performed, and the mass is sent to pathology. The pathology report comes back, and the mass is confirmed to be an estrogen receptor negative, a progesterone receptor negative and a her2/neu receptor positive breast cancer. Doctor Brown and Class: What are some of the risk factors for breast cancer? The National Cancer Institute (2014) outline risk factors for breast cancer. They state that increasing age, history of benign breast disease or breast cancer, menstruation beginning early, menopause late, and not ever having been pregnant of having first pregnancy after 30 as risk factors. The use of oral contraceptives and a family history of breast cancer can add to the risk. There is also the presence of genetic changes that are inherited, a history of any radiation therapy to the chest, and long-term use of hormone therapy. Other risk factors include the use of diethylstilbestrol (DES), dense breasts, alcohol use/ abuse, and being obese after menopause (National Cancer Institute, 2014). Also, being overweight after menopause, not getting regular exercise and drinking alcohol, more than one drink per day (Centers for Disease Control and Prevention, 2014). Mutations in BRCA1 and BRCA2 are risk factors (National Cancer Institute, 2014). What tumor suppressor genes are associated with breast cancer? BRCA1 and BRCA2 are two genes that are tumor suppressor genes. What tumor oncogenes are associated with breast cancer? Her-2/neu oncogene. Human epidermal growth factor receptor 2 (HER2) is involved with 185 KD glycoprotein receptor and tyrosine kinase. This receptor plays a part with epidermal growth factor receptor (EFGR). These receptors activate and signal transduction that controls epithelial cell growth as well as differentiation. This oncogene also has a role in angiogenesis (Yamauchi & Hayes, 2016) . Compare and contrast tumor suppressor genes from oncogenes? Tumor suppressor genes are the genes that slow the division within the cell down considerably and also repair any of the DNA mistakes. These genes direct the cells to die by apoptosis. When these genes do not work properly, they can then grow with no control, and this can lead to cancer (American Cancer Society, 2014). Proto-oncogenes are the genes that help cells to grow. When these genes mutate, or there are too many copies of the gene, it then becomes a “bad” gene and remains turned on permanently. The gene continues to be activated when it should not. This condition makes the cells grow rapidly and, with no control, can lead to cancer (American Cancer Society, 2014). The difference between oncogenes and tumor suppressor genes is that oncogenes come from activating of proto-oncogenes. However, tumor suppressor genes can cause cancer when they are not activated or turned off (American Cancer Society, 2014). References American Cancer Society. (2014, June 25). Oncogenes and tumor suppressor genes. Retrieved from http://www.cancer.org/cancer/cancercauses/geneticsandcancer/genesandcancer/genesand-cancer-oncogenes-tumor-suppressor-genes Centers for Disease Control and Prevention. (2014). What every woman needs to know about breast and ovarian cancers - Know: BRCA. Retrieved from https://www.knowbrca.org/Learn/what-every-woman-needs-to-know-aboutbreast-and-ovarian-cancers National Cancer Institute. (2014). A Snapshot of Breast Cancer. Retrieved from http://www.cancer.gov/research/progress/snapshots/breast Yamauchi, H., & Hayes, D. F. (2016). UptoDate. HER2 and predicting response to therapy in breast cancer. Retrieved from http://www.uptodate.com/contents/her2- and-predicting-response-to-therapy-in-breast-cancer Lanre Abawonse reply to Lorna Durfee 5/8/2016 1:39:13 AM RE: Discussion Part 3 Good Summary! I agree with you on factors that contribute to cancer development. Many of these risk factors have been stated time and again as well as the importance of taking every step serious. One of the important takeaways from your summary of the risk factors of cancer is the incidence of cancer development for females having their first pregnancy after age 30. In their study, Kakoulidis and Politi (2015) note Pregnancy-associated breast cancer (PABC) and define it as any breast malignancy diagnosed during pregnancy or within the first 2 years postpartum, and during lactation. The study further stated that the average age of women with PABC is between 32 and 38 years. Apparently this type of diagnosis will be more common as a result of western life style changes due to the fact many young women are now delaying pregnancy. Reference Kakoulidis, Ι., & Politi, E. (2015). Pregnancy-associated breast cancer Risk factors assessment as an important diagnostic modality. Archives Of Hellenic Medicine / Arheia Ellenikes Iatrikes, 32(5), 556-565.