Order code 81478275 - Running head BOWEL CANCER 1 Bowel...

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Running head: BOWEL CANCER 1 Bowel Cancer- Case Study Name Institutional Affiliation
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BOWEL CANCER 2 Bowel Cancer- Case Study Bowel cancer refers to cancer localised in the colon and rectum hence also known as colorectal cancer. It comprises 98% of all the cancers of the large intestine. Next to lung cancer it is the most common cancer affecting visceral organs in the United States. Approximately, 40000 new cases are diagnosed every year in the UK. At least one in every 20 individuals are projected to develop the condition in the course of their lifetime (Siegel, DeSantis, & Jemal, 2014). It affects older patient’s more than younger patients. The following paper examines bowel cancer in the following contexts: its pathophysiology, physical assessment techniques, nursing strategies and medication strategies for its management. The pathophysiology of the disease The first/early event is the mutation of the APC (adenomatous polyposis gene).The gene codes for a protein important in the activation of oncogenes cyclin-D1 and c-Myc. These genes cause the progression of familial adenomatous polyposis (benign tumor of the colon) to the malignant type (bowel cancer).This mechanism accounts for 1% of colorectal cancer. Apart from mutations, events such as abnormal DNA methylation can cause inactivation of tumor suppressor genes that compromise genetic balance ultimately leading to malignant transformation (Moreno, Mittal, Sullivan, Staley, Cardona & Votaw, 2015). The next pathophysiological event is the inactivation of the KRAS oncogenes, SMAD4 and DCC tumor suppression genes. There are also chromosomal deletions and mutations of p53 tumor suppressor genes both of which are late events in colon carcinogenesis. Another subset of colorectal cancers are caused by a defect in DNA mismatch repair genes that can undergo mutations(for example MSH2, MLH1) in a process termed microsatellite instability. The last pathophysiological event is an uncontrolled growth of normal tissue that ultimately results in bowel cancer. Clinical features include fatigue, rectal bleeding, abdominal pains, weight loss,
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BOWEL CANCER 3 constipation (obstruction) and liver enlargement. It might spread to the rest of the body via lymph blood or by direct means (Van Cutsem, Tabernero, Lakomy, Prenen, Prausová, Macarulla & Allegra, 2012). . Techniques and Methods of Colorectal Cancer Physical Assessment Physical assessment entails general and focused physical examination both done after the clinical history. List of Questions used in the physical assessment of: a.) General Examination and History. The clinician will use the following questions for general examination for the physical assessment of the patient. (i) What are your primary symptoms? Even though the condition might not manifest symptoms, there are common symptoms to look out for.
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