Case study Of A Patient With Stage IV Breast Cancer

1. 250 words, 3 or more references discuss these topics:
A 47-year-old female presents with Stage IV breast cancer. Today, the PET scan reveals brain metastasis.

Define proliferation and differentiation and relate these changes to cancer.
Describe invasion, angiogenesis and metastasis.
There are three underlying causes of growth and maturity abnormalities: telomerase, pRB changes and 53 changes. Discuss these in relation to the patient. Case study Of A Patient With Stage IV Breast Cancer

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Discuss tumor suppressor genes, oncogenes and DNA repair genes.

2. 150 words 2 or more references, discuss the condition encompassing clinical experiences .
A 30-year-old presents with a history of IV drug use, HIV +, and is today diagnosed with pneumonia.

Does the patient have an acute or chronic state of inflammation? Explain the rationale.
What is the significance of cellular replication in a patient with HIV?
What is viral load and what is the relationship with CD4 T cells?
How did the pneumonia occur?

3. 150 words 2 or more references discuss the condition encompassing clinical experiences
A 25-year-old male presents with chronic sinusitis and allergic rhinitis.

Define innate vs. acquired immunity.
Define active vs. passive immunity.
Discuss the genetic predisposition of allergens.
Describe the antigen-antibody response.
What is the pathology of sinusitis?Case study Of A Patient With Stage IV Breast Cancer

Case Study

Cell differentiation and cell proliferation are two distinct processes that take place during the development of cells in multicellular animals including humans. Whilst differentiation is triggered by the regulation of gene expression, proliferation is primarily attributed to cell division and cell growth. With regards to cancer, cell proliferation entails the rapid division and growth of a cancer cell through the coping of its DNA due to occurrence of mutations (Singh et al., 2020). On the other hand, cell differentiation in breast cancer affects the phonotypical and functional type of the dividing cancer cells due to differentiation-related gene expression, leading to the development of tumors (Rakha et al., 2021).

Tumor formation in a patient with breast cancer is understood as a multi-stage process encompassing various process and events over an extended duration. Some of these processes include cell invasion, angiogenesis and metastasis. Yüksel et al. (2017) described invasion as the penetration and extension of transformed cells into neighboring tissues, leading to increased proliferation of cancer cells. The tumor angiogenesis process involves the development of new cancer-specific vessels due to the stimulation of endothelial cells situated in the vascular networks, offering supply of blood for the growing tumor. On the other hand, metastasis entails the penetration and migration of cancer cells into blood and lymphatic vessels due to gene mutations and metastatic cascade, leading to the further spread of cancer cells to organs and tissues (Khodabandeh et al., 2022)Case study Of A Patient With Stage IV Breast Cancer.

Some of the underlying causes of growth and maturity of abnormalities include: pRB changes, telomerase, and p53 changes. In relation to the 47-year old patient with stage IV breast cancer, abnormal changes in retinoblastoma protein (pRB) may lead to dysfunction of this tumor suppressor protein, triggering the uncontrolled proliferation of cancerous tumors (Liang et al., 2019). An increase in telomerase may contribute to the increased capacity of cancer cells to divide indefinitely, thus enabling transformed cells to avoid cell death. Finally, p53 mutation due to transformations in regulators of p53 activity might undermine the capacity of this tumor suppressor gene to inhibit and eliminate the rapid multiplication of cancerous cells in a breast cancer patient (Huun et al., 2017)Case study Of A Patient With Stage IV Breast Cancer.

The prevalent occurrence of bacterial pneumonia at stage IV of HIV disease can be attributed to the significant decline in CD4 cell count. Head et al. (2019) established that chronic inflammation is one of the key mediators of pulmonary infection in a HIV-infected patient, and hence lung abnormalities and cardiopulmonary dysfunction may increase the risk of chronic inflammation experienced by the patient, and may last for a period of between 2 to 6 weeks.  Fitzpatrick et al. (2018) described cellular replication as the division and reproduction of the viruses through the utilization of C4D immune cells, leading to the continuation of the HIV lifecycle and infection of other cells. Viral load refers to the quantity of HIV in the blood of the infected person, whereby patients with high vital load may experience a significant reduction in CD4 cell count and the subsequent decline in the strength of their body’s immune system. The occurrence of bacterial pneumonia in an HIV-positive patient can be primarily attributed to lack of antiretroviral therapy (ART), reduced CD4 cell count, chronic infectious hepatitis, tobacco smoking, among others (Head et al., 2017)Case study Of A Patient With Stage IV Breast Cancer.

Whilst innate immunity is genetically-acquired at birth and key in generation of firth-line and second-line immune responses, acquired immunity can be acquired through the use of antibodies from another source to produce third-line immune responses against microorganisms or foreign substances. Although active immunity is attributed to the natural response of the body’s immune system against pathogens, passive immunity is associated with the use of antibodies from someone else, such as from a mother to a baby through breast milk (Oliver Metzig & Hoffmann, 2022). The genetic predisposition of allergens can be explained by the increased prevalence of allergic disease in patient born into atopic families than their counterparts from families with no history of allergic conditions. Tew and Phipps (2019) described the antigen-antibody response to involve the interactions between the red blood cells and antibodies to generate an immune complex against pathogens. The pathology of sinusitis is attributed to the viral infection occurring in the upper respiratory tract, leading to inflammation and blockage of the nasal sinuses (Raj et al., 2022).

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References

Fitzpatrick, M. E., Kunisaki, K. M., & Morris, A. (2018). Pulmonary disease in HIV-infected adults in the era of antiretroviral therapy. AIDS, 32(3), 277-292. https://doi.org/10.1097/qad.0000000000001712

Head, B. M., Mao, R., Keynan, Y., & Rueda, Z. V. (2019). Inflammatory mediators and lung abnormalities in HIV: A systematic review. PLOS ONE, 14(12), e0226347. https://doi.org/10.1371/journal.pone.0226347

Head, B. M., Trajtman, A., Rueda, Z. V., Vélez, L., & Keynan, Y. (2017). Atypical bacterial pneumonia in the HIV-infected population. Pneumonia, 9(1). https://doi.org/10.1186/s41479-017-0036-z Case study Of A Patient With Stage IV Breast Cancer

Huun, J., Lønning, P. E., & Knappskog, S. (2017). Effects of concomitant inactivation of p53 and pRb on response to doxorubicin treatment in breast cancer cell lines. Cell Death Discovery, 3(1). https://doi.org/10.1038/cddiscovery.2017.26

Khodabandeh, Z., Valilo, M., Velaei, K., & Pirpour Tazehkand, A. (2022). The potential role of nicotine in breast cancer initiation, development, angiogenesis, invasion, metastasis, and resistance to therapy. Breast Cancer. https://doi.org/10.1007/s12282-022-01369-7

Liang, Y., Wang, S., & Liu, J. (2019). Overexpression of tumor protein p53-regulated apoptosis-inducing protein 1 regulates proliferation and Apoptosis of breast cancer cells through the PI3K/Akt pathway. Journal of Breast Cancer, 22(2), 172. https://doi.org/10.4048/jbc.2019.22.e21

Oliver Metzig, M., & Hoffmann, A. (2022). Controlling cancer cell death types to optimize anti-tumor immunity. Biomedicines, 10(5), 974. https://doi.org/10.3390/biomedicines10050974

Raj, G., Raj, M., & Loh, J. S. (2022). Pathophysiology and clinical presentation of odontogenic maxillary sinusitis. Dentistry Review, 2(2), 100044. https://doi.org/10.1016/j.dentre.2022.100044

Rakha, E., Toss, M., & Quinn, C. (2021). Specific cell differentiation in breast cancer: A basis for histological classification. Journal of Clinical Pathology, 75(2), 76-84. https://doi.org/10.1136/jclinpath-2021-207487

Singh, A., Devkar, R., & Basu, A. (2020). Alternative MyD88 -cyclin D1 signaling in breast cancer cells regulates TLR3 mediated cell proliferation. https://doi.org/10.1101/2020.04.12.037986

Tew, J. G., & Phipps, R. P. (2019). Cyclic antibody production: Role of antigen retaining follicular dendritic cells and antibody feedback regulation. Regulation of Immune Response Dynamics, 27-42. https://doi.org/10.1201/9780429286070-3

Yüksel, Ş., Boylu Akyerli, C., & Cengiz Yakıcıer, M. (2017). Angiogenesis, invasion, and metastasis characteristics of hepatocellular carcinoma. Journal of Gastrointestinal Cancer, 48(3), 256-259. https://doi.org/10.1007/s12029-017-9962-5 Case study Of A Patient With Stage IV Breast Cancer