Comment 1

A colleague recently was diagnosed with breast cancer. The American Cancer Society (ACS) has an easy website to navigate for information. There is a search bar for questions that may be posed. One can begin with cancer from A to Z. Breast cancer has many headers such as about, risk and prevention, early diagnosis and prevention, understanding the diagnosis, treating, reconstruction surgery, living as a survivor, and non-cancerous breast conditions. A patient can even find easy reading for those with breast cancer. They have downloadable information under pdfs with similar headings. Related topics, news and stories, and more resources are available. Their site has a handy tool bar and toll-free phone number for those who prefer to use that resource. At the end of their page is another way to approach subjects. For example, to find information about rides to treatment one can just navigate to the bottom of the page, rather than using the search bar. Reach to Recovery is a phenomenal resource, allowing you to speak with a person that has survived breast cancer (Cancer Caregiver Support, n.d.).

Factors that are associated with cancer risk are tobacco use and secondhand smoke, inactivity, obesity, nutrition and diet, alcohol, ultraviolet light, and cancer-associated infections such as HPV. Six infections are listed. I live in Connecticut and it is estimated that there will be 21,240 new cases diagnosed and 6,590 deaths this year. In my state, there is a partnership with Center for Disease Control (CDC). State specific cancer issues are identified and a plan has been developed with goals and strategies for improvement. For example, at St. Francis Hospital, Men’s Health Institute has the goal of providing free services to the underinsured or uninsured and to address the disparities affecting African-Americans. I feel that research and medication and treatment trials will make an enormous impact in the future. The ACS is always trying to raise not only awareness but funding for further research. I think that statistics will change to percentages rather than number of people in diagnosis and mortality because we are living longer. I believe there will be some cures that will decrease certain kinds of cancers in the future as well as people being more aware.

ACS conducts Palliative Care Research. It has come to mean pain relief with treatments and management of side effects; it is not only specific to terminal cancers. According to the website, the ACS is funding more than $26 million for survivorship and quality of life research. Included is the improvement of lives of children with cancer and studies of survivors. The research has the goal of relieving cancer pain and managing side effects. I would imagine a person newly diagnosed would be most worried about prognosis and pain. This research is tantamount to cancer patients (American Cancer Society, 2018).

Comment 2

It was fascinating to learn of “liquid biopsy” as an emerging technology. I learned from the National Cancer Institute that liquid biopsy is “A test done on a sample of blood to look for cancer cells from a tumor that are circulating in the blood or for pieces of DNA from tumor cells that are in the blood. A liquid biopsy may be used to help find cancer at an early stage. It may also be used to help plan treatment or to find out how well treatment is working or if cancer has come back” (NCI, 2018). It is technically known as rapid plasma genotyping, and has a plausable rate of accuracy, according to researches from the study at Dana Farber Cancer Institute, where the study took place. According to the website from Dana Farber Cancer Institute, they are working on not only this technology, but target cancer therapy technology, where they pinpoint the origin of cancer, and create a tumor profile. 

comment1

Diabetes mellitus is characterized by glucose intolerance, chronic hyperglycemia, and disturbances of carbohydrate, protein, and fat metabolism (Huether & Mccance, 2016). Generally, a diagnosis of diabetes mellitus is based on elevated plasma glucose concentrations and measurement of glycosylated hemoglobin (A1C). Genetic susceptibility in combination with other environmental risk factors such as obesity place someone at higher risk for DM II. Obesity contributes to metabolic syndrome, altered adipokines, increased fatty acids, inflammation, and hyperinsulinemia, increasing insulin resistance further (Huether & Mccance, 2016).

Acute complications such as diabetic ketoacidosis and hyperosmolar hyperglycemic nonketotic syndrome are life threatening (in the short term), but not as common as the long-term life-threatening chronic complications of diabetes mellitus. Most long-term complications related to hyperglycemia are sequelae of hyperglycemia on the micro and macro vasculature.

Identify a long-term complication of the vasculature (micro or macro) related to diabetes, the clinical manifestations, and other health concerns they may contribute to.

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According to (Lewis, Bucher, Heitkemper, & Harding, 2017), angiopathy is the leading cause of end organ disease secondary to chronic hyperglycemia. There are several theories as to why these complications exist that include toxic byproducts of high glucose metabolism such as sorbitol, the collection of glucose molecules in the basement membranes of capillaries, and a derangement of red blood cell function (Lewis, Bucher, Heitkemper, & Harding, 2017).  The microvascular complications are related to the thickening of the capillary membranes that result in micro occlusions. The micro occlusions lead to small herniations with swelling that lead to ischemia and tissue damage most commonly to tissues like the retina and the glomeruli of the kidneys (Lewis, Bucher, Heitkemper, & Harding, 2017).