Clinical Essay Analysis
A 65-year-old obese African American male patient presents to his HCP with crampy left lower quadrant pain, constipation, and fevers to 101˚ F. He has had multiple episodes like this one over the past 15 years and they always responded to bowel rest and oral antibiotics. He has refused to have the recommended colonoscopy even with his history of chronic inflammatory bowel disease (diverticulitis), sedentary lifestyle, and diet lacking in fiber. His paternal grandfather died of colon cancer back in the 1950s as well. He finally underwent colonoscopy after his acute diverticulitis resolved. Colonoscopy revealed multiple polyps that were retrieved, and the pathology was positive for adenocarcinoma of the colon.
Develop a 2-page case study analysis in which you:
• Explain why you think the patient presented the symptoms described.
• Identify the genes that may be associated with the development of the disease.
• *Remember when you think of genes do not just think of congenital anomalies. Think environment, disease that would or could specifically modify the gene and cause mutation.
• Explain the process of immunosuppression and the effect it has on body systems.
• *When you have an injury to a gene why or how does this cause immunosuppression? If one is immune compromised what as a provider should you do? Consider?
Adenocarcinoma of the Colon
Adenocarcinoma of the rectum is described as a kind of cancer that forms in the cells that generate glands causing mucus to lubricate the interior of the rectum and colon (Attar et al., 2018). Research indicates that this is the most prevalent form of rectum and colon cancer. According to the case study, the patient presented the mentioned symptoms due to various reasons. For instance, the pain in the lower left side of the abdomen or the lower quadrant pain, is associated with the digestive tracts and linked to condition in the urinary tract, body wall, skin, reproductive organs and blood vessels. Severe pain is often described as sign of inflammation of the bowel, mostly if constipation is present (Cornacchia et al., 2020). The patient may be experiencing aching from testicular torsion. Moreover, the crampy aches may be a result of indigestion, gas, infection, or inflammation.
Adenocarcinoma of the colon is identified as the most prevalent inherited cancer disorder. The genes that contribute to Adenocarcinoma of the colon include: MSH2 and MSH6, both in chromosomes 2 and MLH1, in chromosomes 3. Normarly,, the protein substances of these genes assist in repairing errors made in DNA reproduction. Researchers indicate that if the MSH6, MLH1, and MSH2 proteins are transformed and fail to work correctly, the reproduction errors are not required, resulting in vandalised DNA, which in this case is Adenocarcinoma of the colon (Tochio et al., 2018). Current studies indicate that it is not evident why mutations in genes that are fundamental in all organs preferentially cause Adenocarcinoma of the colon (Cornacchia et al., 2020). However, researches on the similar genes assist to further in comprehension of the mechanism of DNA modification and the impact that environmental aspects may have a significant role in the emergence of colon cancer.
Adenocarcinoma of the Colon weakens the immune system by spreading into the bone marrow. The bone marrow often generates blood cells that assist in fighting illneses. When an individual has injury to a gene, this disrupts normal immune system homeostasis. Moreover, injuries to a gene often result in the formation of systemic inflammatory response syndrome (SIRS) and compensatory anti-inflammatory response syndrome (CARS) (Cornacchia et al., 2020). If a person is immunocompromised, the first step as a care provider is to conduct a number of tests. Moreover, I would ask for a detailed medical history to evaluate if the patient has had the repeated infection that can be the base of an immune disorder. The blood tests will incorporate white blood cell count, a T-cell count, and an evaluation of the patient’s antibody levels (Tochio et al., 2018). I may also consider vaccinating the patient if the vaccine causes the patient’s body to produce protective antibodies.
Attar, L., Trabulsi, N., Maghrabi, A. A., & Nassif, M. (2018). Adenocarcinoma of the colon disguised as abdominal wall abscess: case report and review of the literature. Case reports in surgery, 2018.
Cornacchia, C., Rutigliani, M., Belli, F., Romano, N., Serventi, A., Fiocca, R., & Filauro, M. (2020). Collision Tumor Composed of an Inflammatory Myofibroblastic Tumor and Adenocarcinoma of the Colon: a Rare Entity. Journal of Gastrointestinal and Liver Diseases: JGLD, 29(3), 461-463.
Tochio, T., Mukai, K., Baba, Y., Asakawa, H., Nose, K., Tsuruga, S., … & Sase, T. (2018). Early stage clear cell adenocarcinoma of the colon examined in detail with image- enhanced endoscopy: a case report. Clinical Journal of Gastroenterology, 11(6), 465- 469.