Question

1. A 49-year-old woman is seen for her yearly gynecologic examination. Basic screening indicates a severe anemia, and she is referred to a hematologist. Further investigation of the anemia requires a visit to a gastroenterologist. An endoscopy and colonoscopy are performed, and the woman is diagnosed with a partially obstructing tumor in her colon. After surgery to remove the tumor, the woman and her husband are informed that she has stage III colon cancer with involvement of two lymph nodes. (Explain)

A. Cancer cells are characterized by

B. The most commonly reported symptom of cancer is:

C. After discussing her diagnosis with an oncologist, the woman chooses to undergo chemotherapy. Since she has already undergone a resection or removal of the tumor, her treatment therapy is considered to be:

Answer 1

( A )

cancer is a group of diseases characterized by the development of abnormal cells that divide uncontrollably and have the ability to infiltrate and destroy normal body tissues.

Cancer cells are characterised by ;

• They form clones and begins to proliferate abnormally,ignoring growth-regulating signals in the environment surrounding the cell.
• Cells acquire invasive characteristics, and changes occurs in surrounding tissues.
• Cell infiltrate these tissues and gain access to the lymph and blood vessels, which carry the cells to other areas of the body.
• They are defined as malignant neoplasms. They demonstrate uncontrollable cell growth that follows no physiologic demand (neoplasia) .
• Cells are undifferentiated and often bear little resemblance to the normal cells of the tissue from which they arose
• Rate of growth is variable and depends on level of differentiation.
• The cell membranes are altered in cancer cells, which affect fluid movement in and out of cells.
• The cell membrane also contains protein called tumor specific antigens, which develop over time as the cells become less differentiated.
• Malignant cellular membrane also contains less fibronectin, a cellular cement. It makes them less cohesive and donot adhere to adjacent cells readily.
• Nuclei of cancer cells are large and irregular in shape (pleomorphism).
• Mitosis occurs more frequently in malignant cells than in normal cells.
• If glucose and oxygen are unavailable for their need, malignant cells use anaerobic metabolic channels to produce energy , which makes the cells less dependent on the availability of a constant oxygen supply.

( B)

Most commonly reported symptoms of cancer includes;

- Breast changes ( Lump, retracted nipple, discharge from nipples, dimpled skin etc)

- Bladder and bowel changes ( changes in bowel and bladder habits)

- Unusual discharge or bleeding from any body orifice.

- Indigestion or difficulty in swallowing.

- Nagging cough or hoarseness.

- Obvious change in wart or mole and other skin changes.

- Fever or night sweats for no reason.

- Neurologic problems.

- weight gain or weight loss with no reason.

(C)

Stages of colon cancer

Stage 1 : Cancer has grown beyond the mucosa into the submucosa but no lymph nodes are involved.

Stage 2 : Cancer has grown beyond the mucosa into the muscle ,but there is no lymph node involvement or metastasis.

Stage 3 : Cancer is any tumor with lymph node involvement but no metastasis.

Stage 4 : Is any tumor with lymph node involvement and metastasis.

In the above question,

Initially the woman was diagnosed with partially obstructing tumor, so she was recommended to undergo surgery to remove the tumor.

Later, after surgery she was diagnosed with stage 3 Colon cancer.

As the cancer has not yet spread to the other parts of body, surgery to remove the section of colon with the cancer (partial) along with near by lymphnodes, followed by adjuvant chemotherapy is the standard treatment of this stage.

Adjuvant therapy is given to patients after primary treatment ,when there is a high risk of the cancer to return. After a primary treatment of surgery or radiation, adjuvant chemotherapy reduces the risk of recurrence.

In this case, the woman had undergone Primary surgery to remove the tumor. So, her treatment therapy is considered to be adjuvant chemotherapy.