Discussion Everyone should complete number 1 and then either number 2 or 3. Please present your findings in your discussion post. 1. Describe the pathology for one of the following diseases. Relate clinical manifestations, signs, symptoms, and laboratory findings. a. Melanoma b. Breast cancer c. Hodgkin’s lymphoma d. Bone cancer And 1. Describe 2 studies currently in progress that address cancer prevention or treatment. Or 1. Research and critique one alternative cancer treatment option. Your post is due by Wednesday. You must respond to at least 2 of your classmates’ posts by Friday. Your discussion should be thoughtful and answer the questions that are put forth. You should use peer-reviewed journal articles or textbooks and include proper APA references and citations. Posts Post by Linda Lindsey Stults: Discussion #8 Lindsey Stults posted Oct 16, 2017 4:47 PM Subscribe This page automatically marks posts as read as you scroll. Adjust automatic marking as read setting Melanoma Melanoma is a neoplasm which arises from melanocytes. Melanocytes are predominantly in skin but can also be found in the bowel and eyes. Melanoma is potentially the most lethal of skin cancers. It is commonly found in sites that are exposed to excessive sunlight such as the head and neck in men, legs in women, and back in men and women both. Other sites in which melanoma arises are the eyes, mucosa, gastrointestinal tract, and genitourinary tract (Lippincott, 2016). The pathophysiology of melanoma is that it arises due to “malignant degeneration of melanocytes located either along the basal layer of the epidermis or in a benign melanocytic nevus” (Lippincott, 2016). “Up to 70% of malignant melanomas arise from a preexisting nevus” (Lippincott, 2016). Cells initially grow radially through the epidermis, but then spread vertically through the dermis, which is when metastasis begin. Malignant melanoma is spread through the lymphatic and vascular systems and metastasizes to regional lymph nodes, liver, lungs, skin, and the central nervous system. Melanoma is unpredictable in its course with reoccurrence and metastasis not appearing for more than five years after resection of primary lesions (Lippincott, 2016). Clinical manifestations include atypical lesions which are asymmetric with irregular borders and dark black or blue in color variation and a size of 6 mm in diameter with elevation above the skin’s surface. Lesions tend to be on the ankles, back, or inside surfaces of the knees. Nodules on the knee or ankle are uniformly discolored. Nodules are small and tumor like with may ulcerate and bleed. “Palpable polypoid nodules resemble the surface of a blackberry” (Lippincott, 2016). Lesion can be on palms and soles or under nails which are pigmented. Long-standing lesions can be ulcerated. Flat nodules may appear with smaller nodules scattered over the surface. Patients with a history of a sore which does not heal, a persistent lump or swelling, or may have changes to preexisting skin lesions like moles, birthmarks, scars, freckles, or warts (Lippincott, 2016). Laboratory findings include: a completed blood count with differential which shows anemia, erythrocyte sedimentation rate test with elevated results, platelet counts which are abnormal when metastasis has occurred, and lactate dehydrogenase test results are elevated with advanced metastasis (Lippincott, 2016). Chest radiography can assist in staging of the disease. Computed tomography scanning, magnetic resonance imaging and positron emission tomography are other ways of assisting with staging of the disease (Lippincott, 2016). A ketogenic diet is a diet which minimizes carbohydrates and replaces them with healthy fats and moderate amounts of high-quality protein. This can offer hope against cancer both for treatment and prevention. Normal cells in the body have metabolic flexibility and can adapt from using glucose to ketone bodies, but cancer cells lack this ability. When carbs are reduced to only non-starchy vegetables, cancer cells are starved. Cancer is more accurately classified as a mitochondrial metabolic disease. Most people inherit genes that prevent cancer and few inherit genes that predispose them to cancer, with inherited mutations typically disrupting the function of the mitochondria. Mitochondria are the main power generators in the cells of the body and are believed to be the center point of the origins in many cancers. Damage to mitochondria can be caused not only by inherited mutations, but also by many environmental factors and toxins as well. Remarkable health benefits come from fasting with strength being given to mitochondrial network systems throughout the body in the process. When mitochondria are healthy and function normally, cancer is unlikely to develop (Seyfried, 2013). Other benefits of long-term ketogenic diet is reduction in body weight and body mass index, triglycerides levels decreased, an increase in HDL cholesterol, decrease in LDL cholesterol, and decrease in blood glucose levels. Studies have shown that administration of even long periods of a ketogenic diet did not produce any significant side effects in patients and is safe to use for longer periods of time than originally thought (Dashti, Mathew, Hussein, Asfar, Behbahani, Khoursheed, & Al-Zaid, 2004). Reference Melanoma (malignant). (2016, November 4). Retrieved October 13, 2017, from http://advisor- edu.lww.com/lna/document.do?bid=4=504507 VanMeter, K., Hubert, R. J., & Gould, B. E. (2014). Goulds pathophysiology for the health professions (5th ed.). St. Louis, MO: Elsevier/Saunders. Seyfried, T. (2013, June 16). Natural Health Articles, News, and Information by Dr. Mercola. Retrieved October 14, 2017, from https://articles.mercola.com/sites/current.aspx Dashti, H. M., Mathew, T. C., Hussein, T., Asfar, S. K., Behbahani, A., Khoursheed, M. A., . . . Al-Zaid, N. S. (2004). Long-term effects of a ketogenic diet in obese patients. Retrieved October 14, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716748/ post by Sheldyn Sheldyn Stark; Week 8 Initial Post Sheldyn Stark posted Oct 16, 2017 10:03 PM Subscribe This page automatically marks posts as read as you scroll. Adjust automatic marking as read setting Melanoma & Alternative Cancer Treatment Melanoma is the most dangerous form of skin cancer and it develops when unrepaired DNA damage to skin cells triggers mutations that cause skin cells to multiply rapidly forming malignant tumors (The Skin Cancer Foundation, 2017). The cause of this is most common from ultraviolet radiation from sunshine or tanning beds. These tumors originate in the melanocytes which are what produce pigment, and they are located in the basal layer of the epidermis (The Skin Cancer Foundation, 2017). Usually melanoma appears to look like moles and sometimes it does develop from moles, they can be black, brown, skin-colored, red, purple, blue, or white (The Skin Cancer Foundation, 2017). Most commonly they appear black or brown in color. Melanoma kills about 10,130 people in the United States each year (The Skin Cancer Foundation, 2017). If recognized and treated early on melanoma is usually curable, but without early recognition it will spread to other areas of the body and may become fatal (The Skin Cancer Foundation, 2017). For warning signs of melanoma the ABCDE acronym is used and it stands for asymmetry, border, color, diameter, and evolving. You should check for symmetry by drawing a line down the middle and looking at both sides to compare, a benign mole has smooth even borders and all one color, malignant moles are usually larger than the tip of a pencil eraser, and benign moles usually look the same over time and aren’t evolving (The Skin Cancer Foundation, 2017). For melanoma a biopsy of the skin tissue is the only way to know if it is cancerous (American Society of Clinical Oncology, 2017). A pathologist will examine the tissue sample and determine if there is cancerous cell growth present and then will file a pathology report (American Society of Clinical Oncology, 2017). If there is cell division present the report will include the type of melanoma and the thickness of the melanoma (American Society of Clinical Oncology, 2017). The four most common types of melanoma are superficial spreading melanoma, lentigo maligna melanoma, nodular melanoma, and acral lentiginous melanoma (American Society of Clinical Oncology, 2017). One alternative cancer treatment that many people use is aromatherapy, this is the use of fragrant oils to provide a calming sensation (National Cancer Institute, 2017). Aromatherapy may be helpful in relieving nausea, pain, and stress as well as improve emotion, spiritual, and physical well-being. Aromatherapy may work by sending chemical messages to the part of the brain that affects a person’s moods and emotions (National Cancer Institute, 2017). Laboratory and animal studies have shown that some essential oils have antibacterial, antiviral, antifungal, calming, and energizing effects (National Cancer Institute, 2017). I definitely believe that certain oils such as lavender have a calming effect on people since I use it myself. I know there is still a lot of research to be done on these oils, but I believe they could be beneficial, and even if it is just in your mind, the mind is powerful. I think if you were in this situation it would be beneficial to give essential oils a try. References American Society of Clinical Oncology. (2017, June). Melanoma: Diagnosis. Retrieved October 16, 2017, from Cancer.net: http://www.cancer.net/cancer-types/melanoma/diagnosis National Cancer Institute. (2017, June 9). Aromatherapy and Essential Oils. Retrieved October 16, 2017, from Cancer.gov: https://www.cancer.gov/about-cancer/treatment/cam/patient/aromatherapy-pdq The Skin Cancer Foundation. (2017). Melanoma. Retrieved October 16, 2017, from What is Melanoma?: http://www.skincancer.org/skin-cancer-information/melanoma Post by SHELBY Lampley Initial Post Shelby Lampley posted Oct 16, 2017 2:52 PM Subscribe This page automatically marks posts as read as you scroll. Adjust automatic marking as read setting “In Hodgkin disease, malignant B lymphocytes grow in the lymph tissue, usually starting in one general area of lymph nodes. The presence of Reed- Sternberg cells (giant transformed B lymphocytes with one or two nuclei) differentiates Hodgkin disease from other lymphomas” (Ricci, S.S., Kyle, T., Carmen, S., 2013). The disease occurs mostly in two different groups, the first of which is the 15-40 age range, and the second as the older adult range of 55+. (Porth, 2011). Porth (2011) also estimates that only 10-15% of cases are diagnosed in children and teenagers. In Hodgkin’s lymphoma, the lymph nodes destroy normal cells and enlarge therefore compressing nearby structures (Ricci, S.S., Kyle, T., Carmen, S., 2013). The staging of Hodgkin disease is Stage 1, one group of lymph nodes is affected. Stage 2, two or more groups on the same side of the diaphragm are affected. Stage 3, Groups of lymph nodes above or below the diaphragm are affected. Stage 4, metastasis to organs such as liver, bone, or lungs (Ricci, S.S., Kyle, T., Carmen, S., 2013). There are two types of Hodgkin’s lymphoma, type A and type B. Type A is classified as asymptomatic and B is classified as symptomatic at time of diagnosis. Common symptoms can include, fever, weight loss 10% or more, night sweats, fatigue, malaise, anorexia, or puritus (Ricci, S.S., Kyle, T., Carmen, S., 2013). “The cause of Hodgkin disease is still being researched, but there appears to be a link to Epstein-Barr virus infection” (Ricci, S.S., Kyle, T., Carmen, S., 2013). According to Porth (2011) the clinical manifestations include presenting with a painless enlargement of either one or a group of nodes. The initial lymph node involved is generally above the diaphragm, for example in the neck, axilla, or supraclavicular area. “A definitive diagnosis of Hodgkin lymphoma requires that the Reed-Sternberg cell be present in a biopsy specimen of lymph node tissue” (Porth, 2011). Other laboratory findings include CT scans of chest and stomach to assess other lymph node involvement. Also, a CBC may or may not indicate anemia (Ricci, S.S., Kyle, T., Carmen, S., 2013). “Irradiation and chemotherapy are used in treating the disease. Most people with localized disease are treated with radiation therapy… the survival of people with Hodgkin lymphoma also has improved. With modern treatment methods, a 5-year cure rate of 85% can be achieved” (Porth, 2011). One alternative cancer treatment plan is called The Gerson Therapy and Juicing plan. Dr. Max Gerson is said to have developed on of the most effective natural cancer treatments over 90 years ago. The Gerson Therapy is said to naturally reactive your body’s ability to heal itself and with no damaging side effects. This plan boosts the body’s immune system to heal a variety of diseases including cancer, heart disease, allergies, arthritis, and many degenerative diseases. The therapy consists of organic, plant based foods, raw juices, coffee enemas, beef liver, and natural supplements. The Gerson diet is composed of only eating organic fruit, vegetables, and grains. The diet advises patients to drink 13 glasses of freshly prepared juice, eat three plant-based meals, and only snack on fresh fruits a day. The diet claims to be exceptionally rich in vitamins, minerals, and enzymes. The diet also recommends eating raw beef liver because “it is the most nutrient-dense food on the planet and extremely high in vitamin B12” (Dr. Axe, 2017). The therapy sides that for the juicing aspect of therapy the juicer you use is highly important, noting that most commercialized juicers spin too fast and basically pasteurizes the juice and losing all value. The part that stood out the most to me was the coffee enemas. The therapy suggests up to five enemas a day for a cancer patient as it activates the parasympathetic nervous system. The last component of this therapy is supplementation. The diet suggests using the following supplements, pancreatic enzymes, potassium compound, vitamin B12, thyroid hormone, and Lugol’s solution which is potassium iodine mixed with iodine in water. “The theory [of the Gerson Therapy] is that disease can be cured by removing toxins from the body, boosting the immune system, and replacing excess salt in the body’s cells with potassium” (National Cancer Institute, 2015). While I do believe that alternative and compound therapies are important and can be beneficial to cancer treatment I do think it is important to also use clinical and self judgement of each alternative you read and/or choose. I think this therapy has good points, such as, eating more organic fruits and vegetables I think other parts can be detrimental, like coffee enemas, and limiting your diet to only a few things. As always, you should consult your doctor or licensed dietitian when choosing a diet plan that works best for you and still consuming all needed nutritional elements, especially at a time when your body needs it most like during cancer. I think it’s also important to note that peace of mind and how a healthy mind can help a patient cope with the disease. If a patient believes that this or a particular therapy will help cure their cancer I think as a healthcare provider you take their request seriously and really work it in to the plan of care, with clear cut boundaries and guidelines. References Dr. Josh Axe and Eric Zielinski. (2017, September 18). 10 Natural Cancer Treatments | Hidden Cures. Retrieved October 16, 2017, from https://draxe.com/10-natural-cancer-treatments-hidden-cures/ Gerson Therapy. (2015, January 7). Retrieved October 16, 2017, from https://www.cancer.gov/about-cancer/treatment/cam/patient/gerson-pdq Porth, C.M. (2011). Essentials of pathophysiology: concepts of altered health states (3rd ed.). Wolters Kluwer Health. Ricci, S. S., Kyle, T., & Carman, S. (2013). Maternity and pediatric nursing. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins.

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