Wednesday, May 6, 2020
Case Study Discussion and Analysis for Genetic-myassignmenthelp
Question: Discuss about theCase Study Discussion and Analysis for Genetic Factors. Answer: The patient is a 68 years old male who is suffering from prostate cancer with an enlarged nodular asymmetrical prostate. The aim of this discussion is to describe the link between Ahmeds risk factors and aetiology related to the disease. The discussion will further consider the pathophysiology manifestations of prostate cancer, while justifying the recommended diagnostic tools and treatment modalities. Links between Patients Risk Factors and Aetiology As reflected in several researches, age is a major risk factor for the occurrence of prostate cancer. Other risk factors include dietary habits, lifestyle, race, genetic factors, and family history (Morigi et al., 2015). Considering the case of Ahmed, he is an African-American and 68 years old. In addition, he stated that 30 years ago his father died from prostate cancer. These factors have created major risks for Ahmed considering his age, race, and genetic factors. He is suffering from stage four malignant prostate mainly due to the mutation faced by the BRCA1 gene. Irrespective of many risk factors involved, there is no exact acknowledgment for what ends up causing prostate cancer (Taylor et al., 2010). Several factors might have developed the condition for Ahmed such as his age, his family history, and his race. Pathophysiology Manifestations In majority of the cases, the symptoms of prostate cancer do not become evident during the initial stages of the disease. There are different symptoms of cancer for different men and any of the symptoms may occur due to other conditions (Sylvester et al., 2007). Specifically, there are urinary symptoms of the disease. Due to the close distance of prostate gland to urethra and bladder, there can be accompany of prostate cancer by a number of urinary symptoms. Being highly dependent on the location and the size, a tumour may possibly pressurize and constrict the urethra that inhibits the urine flow. Some signs of prostate cancer in context with urination are as follows (Bill-Axelson et al., 2014): Blood consisting of urine Decreased velocity or flow or urine stream Loss in the control of bladder More frequent feeling of urination during night Difficulty in urination Pain or burning feel while urinating Prostate cancer has the ability of spreading across closer bones or tissues. If there is spreading of cancer across the spine, it is strongly pressed upon the spinal nerves (Baade et al., 2009). Other symptoms of prostate cancer is inclusive of additional bone, pain or numbness in the feet, legs, or hips, swelling in pelvic area or legs, pain during ejaculation, difficulty to gain erection, and blood in semen (Heidenreich et al., 2014b). As in the case of Ahmed, he has been dealing with pelvic pain and consistent weight loss since the last two months. He has to urinate at least five times during the night and on occasional basis, urine consists of blood. He complains about facing weak urine streams since a number of years. Justification of Diagnostic Tests and Treatment Modalities After the performance of digital rectal examination, an enlarged nodular, asymmetrical prostate was found and hence, there was requirement for further tests. The following diagnostic tests can be recommended in the case of Ahmed. Ultrasound: In case of raising concerns in other tests, there can be utilization of trans-rectal ultrasound for further evaluation of the prostate. This utilizes sound waves for obtaining view of the prostate gland (Klotz et al., 2014). Collection of prostate tissue as a sample: This considers the conduct of prostate biopsy involving the analysis of tissue sample for determining the presence of cancer cells. MRI Fusion: This is helpful for the conduct of prostate biopsy and further diagnosis (Kwon et al., 2014). There is a collaboration between radiologists and urologists for leveraging the technology of MRI fusion biopsy to yield the best imaging for caring for prostate cancer. Further ahead, it is necessary to determine the aggressive or passive nature of prostate cancer. The scale commonly used for the evaluation of cancer aggressiveness is known as Gleason Score. This involves the combination of two numbers while ranging between 2 and 10. The treatment of prostate cancer involves surgery for the removal of prostate gland that is known as radical prostatectomy. This involves the removal of some lymph nodes and surrounding tissue (Taylor et al., 2010). However, Ahmed is at stage 4 prostate cancer. There is no cure for stage 4 cancer but it can be treated with the objective of controlling the cancer as much as possible and improving the quality of life. The following treatment options are available for preventing or relieving symptoms like pain: hormone therapy with chemotherapy, external beam radiation, radical prostatectomy, surgery for symptoms like urinary obstruction or bleeding, active surveillance, and clinical trial for new treatments (Heidenreich et al., 2014a). Ahmed cancer can only be avoided not cured. References Baade, P. D., Youlden, D. R., Krnjacki, L. J. (2009). International epidemiology of prostate cancer: geographical distribution and secular trends.Molecular nutrition food research,53(2), 171-184. Bill-Axelson, A., Holmberg, L., Garmo, H., Rider, J. R., Taari, K., Busch, C., ... Andrn, O. (2014). Radical prostatectomy or watchful waiting in early prostate cancer.New England Journal of Medicine,370(10), 932-942. Heidenreich, A., Bastian, P. J., Bellmunt, J., Bolla, M., Joniau, S., van der Kwast, T., ... Mottet, N. (2014a). EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intentupdate 2013.European urology,65(1), 124-137. Heidenreich, A., Bastian, P. J., Bellmunt, J., Bolla, M., Joniau, S., van der Kwast, T., ... Mottet, N. (2014b). EAU guidelines on prostate cancer. Part II: treatment of advanced, relapsing, and castration-resistant prostate cancer.European urology,65(2), 467-479. Klotz, L., Vesprini, D., Sethukavalan, P., Jethava, V., Zhang, L., Jain, S., ... Loblaw, A. (2014). Long-term follow-up of a large active surveillance cohort of patients with prostate cancer.Journal of Clinical Oncology,33(3), 272-277. Kwon, E. D., Drake, C. G., Scher, H. I., Fizazi, K., Bossi, A., Van den Eertwegh, A. J., ... Ng, S. (2014). Ipilimumab versus placebo after radiotherapy in patients with metastatic castration-resistant prostate cancer that had progressed after docetaxel chemotherapy (CA184-043): a multicentre, randomised, double-blind, phase 3 trial.The lancet oncology,15(7), 700-712. Morigi, J. J., Stricker, P. D., van Leeuwen, P. J., Tang, R., Ho, B., Nguyen, Q., ... Hickey, A. (2015). Prospective comparison of 18F-fluoromethylcholine versus 68Ga-PSMA PET/CT in prostate cancer patients who have rising PSA after curative treatment and are being considered for targeted therapy.Journal of Nuclear Medicine,56(8), 1185-1190. Smith, D. P., King, M. T., Egger, S., Berry, M. P., Stricker, P. D., Cozzi, P., ... Armstrong, B. K. (2009). Quality of life three years after diagnosis of localised prostate cancer: population based cohort study.Bmj,339, b4817. Sylvester, J. E., Grimm, P. D., Blasko, J. C., Millar, J., Orio, P. F., Skoglund, S., ... Merrick, G. (2007). 15-Year biochemical relapse free survival in clinical Stage T1-T3 prostate cancer following combined external beam radiotherapy and brachytherapy; Seattle experience.International Journal of Radiation Oncology Biology Physics,67(1), 57-64. Taylor, B. S., Schultz, N., Hieronymus, H., Gopalan, A., Xiao, Y., Carver, B. S., ... Antipin, Y. (2010). Integrative genomic profiling of human prostate cancer.Cancer cell,18(1), 11-22.
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