Pathophysiology of Cancer With Metastasis, Case Study Example

Case study scenario

Mrs. L has been diagnosed with colon cancer and metastasis. She is very anxious and has many questions.

According to scientists metastases is a multistep process progression. Malignant neoplasms emerge from organs that are away from the central nervous system. Subsequently they grow developing their unique vascular supply. However, for tumors to gain access into the blood stream three conditions must be favorable. First lung growths have to occur intercepting the pulmonary venous circulation (DeAngelis & Posner, 2013).

Secondly, infiltration of cancer cells into the lung capillary bed along the left side of the heart must have taken place. Thirdly, upon arriving at this location cancer cells have to gain access into the patent foramen ovale and directly enter the pulmonary circulation. They then travel to the brain the vertebral venous system into the batson’s plexus. This explains reasons for   metastases not developing in the lungs. Once in the intracranial system cancer cells pursue a resting phase whereby 15-20% of them mingle in the blood supply and flourish. Eighty-five percent of metastases are located in the brain (DeAngelis & Posner, 2013).

Discussion pertaining to characterization of lab results of colon cancer

The diagnosis for colon cancer is usually confirmed through histology studies preceding concerns observed from colonoscopy or sigmoidoscopy results. Further initial investigations are CT scan of the abdomen, chest and pelvis. Depending on the suspected location PET as well as MRI tests may be conducted also. The next major testing is known as colon cancer staging. TNM system evaluations determine the stage; specific location; whether metastasis have developed; how many they are and locations (Adelstein et.al, 2011).            

Histology reports give an analysis of tissue taken retrieved during biopsy surgery; a pathology evaluation describes the cell type and grade. Adenocarcinoma prevails in many colon cancer cell types accounting for 95% of all such cases. Less popular types are lymphoma and squamous cell carcinoma. Cancer growths which occur on the right side ascending colon/cecum usually grow outwards from one location into the walls of the bowel wall. Fecal occult blood is an indicator of a colon cancer predisposition (Adelstein et.al, 2011).

Common symptoms and treatments of cancer with metastasis?

Some signs and symptoms include difficulty in passing feces; anemia; bowel obstruction appearing as a napkin ring subsequently passing fecal matter orally. Importantly, signs and symptoms depend largely on the location and extent of the growth. Serious signs and symptoms include constipation, that gets worse in someone over 50 years old along with, blood in the stool, decreasing stool caliber, nausea, loss of weight and appetite (Adelstein et.al, 2011).

Treatment intervention depends on the stage of the disease and location of growth. As such, there are two approaches towards intervention one curative and the other palliative. Attempts at curative are through surgery; palliative approaches involve chemotherapy. When metastases are present the obvious approach is palliative. Radiation is also used during the palliative stages. In many cases patients would need blood transfusions and supportive nutritional supplements due to progressive anemia (Adelstein et.al, 2011).

Patient education and community services

Many patients who have been diagnoses with cancer become very depressed and learning of the stages along with the metastic implications may become suicidal. As such, the first line of support and education is aligning the patient with family members. The patient can be referred to religious groups and community organizations that support cancer patients. One notable reference is the American cancer society, which has numerous resources to assist patients and their families through the most difficult stages of the disease.

References

DeAngelis, L., & Posner, J. (2013).  Pathophysiology of the Metastatic Process. Retrieved on 19^th October, 2013 from  http://www.ncbi.nlm.nih.gov/books/NBK12889/

Adelstein, B. Macaskill, P. Chan, S. Katelaris, P., & Irwig, L. (2011). Most bowel cancer symptoms do not indicate colorectal cancer and polyps: a systematic review. BMC gastroenterology 11: 65.