Discussion Questions
Response to Question 1
A diagnosis of cancer in any patient brings to the fore a host of emotions. It usually activates the patient's worst health fears. A diagnosis of cancer in any patient may bring up emotions like fear, anxiety and a feeling of isolation (National Cancer Institute, 2012). The patient is eager to know many things about their condition. Adjustment to cancer is arguably one of the most difficult and most stressful periods of most people's lives (Melchor-Beaurpe 2008).
A poorly differentiated cancer cell is a pointer to the fact that the cancer cell is a rapidly dividing cell. Because of this, the doubling time of the cell is short. This means that the cancer cell has a shorter time to differentiate and so, the cancer grows aggressively and within a short time, might become a huge growth. In addition, the fact that they are poorly differentiated means that cell-to-cell adhesion is not strong. This leaves room for uncontrolled proliferation of the cell in the local tissue, and invasion of nearby tissues, organs and even blood vessels. In short, the propensity for metastasis to other regions of the body is increased in undifferentiated cancer cells (McCance, et al, 2009)., (John, 2010). Also in terms of treatment, since the poorly differentiated cells would be in various stages of the cell cycle, it would be difficult to eradicate all the cells with one dose of chemotherapy (Mellors, 2012). Non-encapsulation is another characteristic that poorly differentiated cancer cells possess. Because of this, it is ways for the cancer cells to be seeded to other regions of the body through direct spread to adjacent tissues, via blood vessels and through lymphatics (McCance, et al, 2009), (John, 2010). This is because unencapsulated cells lack compact cell-to-cell adhesion. Poorly differentiated cancer cells are also so aggressively growing so much that they usually infiltrate adjacent tissues. This is one of the ways by which they are disseminated to other regions of the body (McCance, et al, 2009), (John, 2010).
Benign tumors are well-differentiated cells. Benign growths can be successfully treated with surgery, while it is difficult to treat malignant growths that way (McCance, et al, 2009). They are most times encapsulated by areolar connective tissue and this shields them away from normal tissue. Because of this, surgical excision of the tumor is more likely to lead to complete remission of the tumor. Also, the propensity for metastasis is reduced because of this fact. Well-differentiated tumors also have a longer doubling time, they are slow growing. A benign tumor may grow by only a few centimeters over a period of five years. The cell-to-cell adhesion among well-differentiated cancer tissues are also high, this reduces the propensity for metastasis (McCance, et al, 2009). Also, the probability of local tissue invasion and distant metastasis is low in well-differentiated cancer tissues.
Response to Question 2
Stress is a vague concept that is difficult to define. However, it can be described as any action or experience that poses a threat to the homeostasis of the body, and as such, requires immediate action. Stress can both be positive and can be detrimental to the body. Stress can be positive because it improves our physical, mental and emotional agility. It allows us to solve problems whenever they arise.
Similarities include the fact that both cathecolamines and cortisol are released in times of stress. Both substances are released by the Hypothalamo-pituitary-adrenal system. The trigger for the release of both catecholamines and cortisol come from the hypothalamus (McCance, et al, 2009).
A difference in both hormones can be found in their mechanism of action. Adrenaline causes an increase in heart rate and increase in the blood pressure. Cortisol causes an increase in the level of glucose in the bloodstream by mediating the conversion of the storage form, glycogen into glucose
In terms of pathologic stress response, the actions of catecholamines need to be abolished as soon as they are activated or else they can contribute to the development of sustained high blood pressure and ultimately hypertension. Hypertensive heart disease can result from continued exposure of the heart to the effect of the catecholamines, especially epinephrine. Cortisol on the other hand, because it functions to make glucose available to the body tissues, can lead to the development of glucose intolerance due to decreased sensitivity of peripheral tissues to the action of insulin. This is a precursor to diabetes mellitus. In addition, obesity can also develop over time due to continued exposure to the action of cortisol.
References
McCance, K.L., Huether, S.E., Brashers, V.L. & Rote, N.S. (2009). Pathophysiology: The biologic basis for disease in adults and children. Philadelphia: Mosby Elsevier
National Cancer Institute (2012).” Adjustment to Cancer: Anxiety and Distress (PDQ)”. National Cancer institute. Retrieved 18th April, 2012 from http://www.cancer.gov/cancertopics/pdq/supportivecare/adjustment/HealthProfessional
Mellors, R. C. (2012). “Biological Properties of Neoplastic Cells”. Neoplasia. Retrieved 18th April, 2012 from http://www.medpath.info/MainContent/Neoplasia/Neoplasia_05.html
Mellors, R. C. (2012). “Biological Characteristics of benign and malignant Neoplasms”. Neoplasia. Retrieved 18th April, 2012 from http://www.medpath.info/MainContent/Neoplasia/Neoplasia_02.html
Melchor-Beaupre, R (2008). Psychological Aspects of Coping with cancer. Clinical Psychology Associates. Retrieved 18th April, 2012 from http://cpancf.com/articles_files/PsychologicalCopingCancer.asp
