Potential and Common Sites for Metastasis
The potential site for metastasis in the patient is the liver. The fine needle aspiration (FNA) biopsy indicates that J.C has ductal adenocarcinoma, a highly aggressive disease with a high potential to metastasize. Pancreatic ductal adenocarcinoma is an endocrine disorder because, in the patient above, the site of origin is the pancreas (Sarantis et al., 2020). The liver is the primary site for metastasis because of its rich blood supply and the presence of bodily fluids promoting the growth of cells. J.C has ductal adenocarcinoma, and cancer spreads to the liver as the blood from the pancreas drains directly via the liver.
Tumor Cell Markers
Tumor markers are biomarkers found in blood, body tissues, and urine and are elevated by the presence of cancerous cells. The tumor markers indicate the disease process and help detect the type of cancer. These biomarkers are ordered for patients with pancreatic cancer as they are prognostic factors providing valuable information helping in therapeutic decision-making for surgeons. Markedly, early recurrence is common in patients experiencing high preoperative levels of these markers (Orth et al., 2019). The biomarkers also inform the physician why the tumor is thriving, making it easier to determine the most effective treatment for the patient.
Tumor Classification Based on TNM Stage Classification
J.C has stage I pancreatic cancer, which means it has not grown to invade the nearby tissues. Cancer has not spread to the lymph nodes and other body parts. Consequently, this is early-stage cancer. Rosen and Sapra (2022) explain that the tumor node metastasis (TNM) system is essential in classifying cancer as it helps establish the anatomic extent of cancer and the combination of the three aspects serving as the defining factors of the overall tumor stage. The system allows for simple cancer staging, with stage I being the least severe and IV being the most aggressive.
Characteristics of Malignant Tumor
A malignant tumor is invasive and metastasizes. Cancerous tumors invade nearby cells because they have poor boundaries. According to Dlugasch and Story (2021), these tumors also metastasize locally through the lymphatic system or the bloodstream. Markedly, malignant tumors have a high likelihood of recurrence after their removal. They may recur locally, regionally in the lymph nodes, or distantly in organs far from the original. Malignant cells are rapidly growing cells with a high nucleus-to-cytoplasm ratio, many mitoses, prominent nucleoli, and invading cells in normal tissues.
Carcinogenesis Phase
The carcinogenesis phase, when a tumor metastasizes, involves spreading cancerous cells from its original site to other parts of the body. Sarantis et al. (2020) posit that carcinogenesis results from the action of one or many chemicals and physical or genetic insults to the cells. This process occurs in three stages initiation, promotion, and progression. The metastasis can be either through the lymphatic system or the bloodstream. Chemo-preventive agents prevent the invasion of the primary tumors, and angiogenesis thus is effective in preventing cancer from metastasizing. Most cases of pancreatic cancer begin in the cells lining the pancreatic ducts.
Tissue Level Affected
The tissue level affected in J.C is the epithelial and connective tissues. Ninety-five percent of the pancreas contains exocrine tissues producing pancreatic juices (Orth et al., 2019). The diagnostic tests indicate that the patient’s epithelial and connective tissues have been invaded by cancer. The epithelial cells are affected as the head of the pancreas has a solid mass. This mass affects the connective tissue as it infiltrates into the Wirsung duct and the mesenteric vein. This vein drains blood from the small intestines. Therefore, the masses are invading more than one type of tissue in the above patient.
References
Dlugasch, L., & Story, L. (2021). Applied pathophysiology for the advanced practice nurse. Jones & Bartlett Learning.
Orth, M., Metzger, P., Gerum, S., Mayerle, J., Schneider, G., Belka, C., Schnurr, M., & Lauber, K. (2019). Pancreatic ductal adenocarcinoma: Biological hallmarks, current status, and future perspectives of combined modality treatment approaches. Radiation Oncology, 14(141), 1-20. https://doi.org/10.1186/s13014-019-1345-6
Rosen, R. D., & Sapra, A. (2022). TNM classification. StatPearls Publishing.
Sarantis, P., Koustas, E., Papadimitropoulou, A., Papavassiliou, A. G., & Karamouzis, M. V. (2020). Pancreatic ductal adenocarcinoma: Treatment hurdles, tumor microenvironment, and immunotherapy. World Journal of Gastrointestinal Oncology, 12(2), 173-181. https://doi.org/10.4251/wjgo.v12.i2.173Links to an external site.
