1. 1.The most common sites for metastasis in pancreatic cancer are the liver, lungs, and the peritoneum. This happens because the invasion is made through the blood vessels in the circulation. 2).Tumor markers are substances found in higher-than-typical levels in the blood, pee, or tissues of certain individuals with malignant growth. These substances, which are likewise called biomarkers, can be made by the tumor. They can likewise be made by sound cells in light of the tumor. Tumor marker tests verify whether you have these substances in your body and in what sums. Tumor markers are regularly proteins. Likewise, certain hereditary changes are presently being utilized as tumor markers. This tumor cell marker tests are order to mainly differentiate the main site of origin of the cancer. (Andrianifahanana, Moniaux, Schmied, Ringel, Friess, Hollingsworth, & Batra, 2001) TNM stage classification is important to determine the anatomical extent of the disease, and the combination of these three factors can help define the stage of the tumor. It is also used worldwide, so that all doctors can talk about the same situation regarding their country. (Brierley, Gospodarowicz, & Wittekind, 2017) The classification would be: T4-refering to the main tumor N1-Only one affected node M0-There is no evidence of metastasis to other organs (although there is a perilesional node detected with metastatic aspect, this is not confirmed) Characteristics of malignant tumors: Cells: They are usually less differentiated than normal cells, or the cells of benign tumors. They have a large nucleus with irregular shape and size, the cytoplasm is scarce and intensely colored or, on the contrary, is pale. Growth: Rapid growth, many mitoses, and little specialized structure. Ability to spread: They can do metastasis locally, or through the bloodstream, and by this way, grow away from their origin site. (Heidari, & Gobato, 2019) Stages of carcinogenesis: Initiation: It consists of the modification of the genome of a cell in one or more genes that imply loss of fundamental functions due to the action of a carcinogen or genotoxic initiating agent, that is, with the capacity to generate changes in DNA. Promotion: During the promotion phase there is a selective expansion of the initiated cells, which are morphologically the same as the healthy cells of the tissue where the process is taking place. This process is induced by one to several carcinogens that have the capacity to act as promoter agents producing an alteration in the transduction of cellular signals, there is no modification in the DNA, so during this stage there are no structural alterations, and the damage is reversible. This point is fundamental, since the rate of multiplication of the damaged cell in a tissue will depend on the continued administration of the carcinogen, and therefore it is the object of preventive medicine. By reducing the time and amount of exposure to carcinogens we will reduce the chances of developing a malignant tumor. Progression: At some point during exposure to carcinogens, the conversion process can occur in which an initiated or promoted cell irreversibly becomes a potentially malignant cell, with new genomic modifications that will change its morphology and functionality. The multiplication of cells in the progression stage represents the end of the preclinical phase and the beginning of tumor development. tissue: Since adenocarcinoma begins in the glandular cells, and these are found in the tissue that surrounds the organs (pancreas). Peer 2 Discussion (.) Pancreatic Cancer Case Study The common sites for metastasis on Mr J. C include the peritoneum and liver. Literature depicts other lesser sites where the cancerous cells invade include the bones, brain, kidney, and lungs. Ductal carcinoma is a type of cancerous cell found in the pancreas. Additionally, adenocarcinoma is the most cancer cell emanating from the pancreas (Atkinson et al., 2020). In addition, the cancerous cells adenocarcinoma spreads to the peritoneum through the systemic circulation, where the cells get exfoliated from the tumor of the pancreas to the intrabdominal cavity. Tumor Cell Markers and why they are ordered for Patients with Pancreatic Cancer The tumor cells makers are ordered for patients with pancreatic cancer because of the accurate diagnosis. In addition, the laboratory technicians are aided in making broad-based decisions in distinguishing the stage of cancer and the extent of spread. The biomarkers are essential in differentiating whether the cells are benign or malignant (Matilla et al., 2020). The recurrence of pancreatic cancer increases the levels of the cells in the body, making it easy for the technicians to make a decisive diagnosis. Classification of Tumor Based on TNM Stage The American Joint Committee on Cancer (AJCC) has an assurance of the substantial and most significant standard in measuring cancer to be TNM (Matilla et al., 2020). According to the case study, the cells are multiplying on the pancreas body tissue. The pancreatic tumor is significant since it is a solid mass measuring 4cm in the head of the pancreas. T1, T2, T3, T4 are significant in explaining the size and how cancer has spread to the nearby body tissues. The N refers to the lymph nodes that have been infected by the cancer cells in the primary tumor. (Matilla et al., 2020) M refers to the metastasis to other body parts of the body. Importance of TNM Classification of Cancer The need for health care professionals to know and understand how far the cancer cells have spread to the entire body. TNM aids the health care providers to understand how efficient the treatment has been and any actions to take in case of more spread or curb the cancerous cells. In addition, TNM staging aids in deriving the best medication interventions available and choose on the best. In addition, staging is a way of screening to detect and treat cancer in its earliest stage (Matilla et al., 2020). Characteristics of Malignant Tumors The malignant tumor cells are differentiated from the mitoses, which increases, thus altering the shape of the cells. In addition, the existence of the mitotic spindle cell results in the asters, which are triple. The nucleus’s change thus alters the surface, volume, shape, and density of the normal cell. The cells are seen to have increased nucleus and shape, which is irregular (Atkinson et al., 2020). The malignant cells can spread to nearby body tissues and structures. Carcinogenesis Phase When Tumor Metastasizes The carcinogenesis phase entails the first step, namely tumor initiation. In this step, chemical changes are in the form of cell mutations. As a result, alteration of the normal development cell cycle is imminent, and daughter cells are altered to form carcinogenic cells (Rawla et al., 2019). The second stage of carcinogenesis is cell promotion, where rapid cell division is ascertained. The last step is cell progression. The cells have to compete for food and oxygen for survival (Rawla et al., 2019 As a result of competition, the cells have to mutate severally, leading to heterogeneity. Connective Tissue The reason for choosing connective tissue as per the case study is because the pancreas is composed of a thin layer of a bunch of connective tissues comprising the septae (Atkinson et al., 2020). As a result, the connective tissues are reached to remove some biopsy which is significant in detecting if the pancreas is composed of cancer cells.Show more
