Mr. J.C. Case Study Case Assignment
Order ID 53563633773 Type Essay Writer Level Masters Style APA Sources/References 4 Perfect Number of Pages To Order 5-10 Pages Description/Paper Instructions
The anatomy of the human pancreas is made up of soft lobules of glandular tissue mixed with adipose tissue. It lies in the retro-peritoneal area behind the stomach and curves into the duodenum. The normal function of a pancreas is digestion of proteins, carbohydrates, and fats by breakdown from pancreatic enzymes. The pancreas is also responsible for the secretion of insulin and glucagon. (SEER Training Modules, Pancreatic & Biliary Cancer, 2020).
Due to the proximity the pancreas is to the duodenum, distal portion of stomach and distal portion of common bile duct the liver and peritoneum are common sites for metastatic disease. The lungs and distant lymph nodes are not uncommon sites for metastatic disease. (Sohal, Mangu, & Laheru, 2017). Diagnostic studies are used in the process of establishing a confirmed diagnosis of pancreatic cancer. One diagnostic study frequently utilized on patients highly suspected for malignancy of the pancreas is a tumor marker, Carbohydrate antigen (CA 19-9). This tumor marker, CA19-9 is expressed in pancreatic cancer cells but can also be expressed in gallbladder cancer diagnosis and benign issues such as biliary obstruction and acute pancreatitis. Another tumor marker used in the testing for pancreatic cancer is Carcinoembryonic antigen, (CEA) but does not have the specificity for pancreatic cancer as it does with colon cancer diagnosis. Once a patient receives a positive malignancy diagnosis, tumor markers are used within the course of the patient’s treatment to monitor the patient’s treatment response. (Delugash & Story, 2020).
Due to the positive perilesional lymph node, confirmed by a fine needle aspiration, (FNA) this confirms Mr. J.C has metastatic pancreatic disease. Staging for Mr. J.C. per the Tumor Metastasis Node (TMN) Staging system Mr. J.C. is stage at least T3N1M1. T3 is indicative of primary tumor identified and there is confirmation of infiltration of the peri-pancreatic tissue. N1 is indicative of a positive confirmed regional lymph node. M1 represents distant metastatic disease. Utilizing TNM staging provides uniform representation of patients cancer diagnosis. Staging information in addition to the size of the tumor and its anatomical presence it is then determined if the patient has a resectable tumor or non-resectable tumor. TNM staging is considered in addition to patient comorbidities and current performance status, to determine if surgery is a considerable treatment option. It is difficult to definitively state Mr. J.C.’s staging is Stage IV. Confirmation that the lymph node was biopsied, or CT and or PET imaging results are needed, to include metastatic lymph node component to his staging. The pancreas is vascular organ, therefore alternative imaging can be questionable. (Sohal, Mangu, & Laheru, 2017). Assuming the scenario is indicating confirmed evidence of metastatic disease, in the case of Mr. J.C, the patient is considered non-resectable.
Cancer cells are identified with a high-powered microscope utilizing specific stains prepared on slides of tissue obtained during a core tissue biopsy or cytology cells from an FNA biopsy. Cellular growth and the rapidness of replication of cancer cells are specific to different types of cancer, compared to cancer with smaller growth and slower replicating cancer cells. Mr. J.C. has biopsy proven ductal cell adenocarcinoma. This type of cancer originates in the stroma lining of cells. Adenocarcinoma is an aggressive behaving cancer cell. Ductal adenocarcinoma of the pancreas is typically found to have a mixture of stromal, inflammatory, and extracellular proteins, which is attributed to its aggressive nature. (Delugash & Story, 2020)
References
Delugash, L., & Story, L. (2020). Applied Pathophysiology for the Advanced Practice Nurse. Burlington, MA: Jones and Bartlett Learning.
SEER Training Modules, Pancreatic & Biliary Cancer. (2020, July 2). Retrieved from U. S. National Institutes of Health, National Cancer Institute: https://training.seer.cancer.gov/
Sohal, D., Mangu, P. B., & Laheru, D. (2017). Metastatic Pancreatic Cancer: American Society of Clinical Oncology Clinical Practice Guideline Summary. Journal of Oncology Practice, 13(4), 261-264. Retrieved 7 2, 2020, from https://ascopubs.org/doi/full/10.1200/jop.2016.017368
TNM staging system. (2020, July 2). Retrieved from National Cancer Institute: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/tnm-staging-system
RUBRIC
QUALITY OF RESPONSE NO RESPONSE POOR / UNSATISFACTORY SATISFACTORY GOOD EXCELLENT Content (worth a maximum of 50% of the total points) Zero points: Student failed to submit the final paper. 20 points out of 50: The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. 30 points out of 50: The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately. Elements of the required response may also be lacking. 40 points out of 50: The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples. The answer is complete. 50 points: The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples. No aspects of the required answer are missing. Use of Sources (worth a maximum of 20% of the total points). Zero points: Student failed to include citations and/or references. Or the student failed to submit a final paper. 5 out 20 points: Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. 10 out 20 points: References to scholarly sources are occasionally given; many statements seem unsubstantiated. Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. 15 out 20 points: Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented. APA 6th Edition is used with only a few minor errors. There are minor errors in reference and/or citations. And/or there is some use of questionable sources. 20 points: Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented. APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. Grammar (worth maximum of 20% of total points) Zero points: Student failed to submit the final paper. 5 points out of 20: The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors 10 points out 20: The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors 15 points out of 20: The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. 20 points: The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. Structure of the Paper (worth 10% of total points) Zero points: Student failed to submit the final paper. 3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. 5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. The can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements. The student also significantly writes too large or too short of and paper 7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. 10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper. GET THIS PROJECT NOW BY CLICKING ON THIS LINK TO PLACE THE ORDER
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