From the provided case information, Kevin did work for ten years at a uranium mine, excavating uranium for the nearby nuclear power plant. Currently, 25 years later, Kevin tends to have small cell lung cancer. With the ongoing exposure to ionizing radiation, it is essential to note that the DNA damage did occur. The purpose of this case analysis is to examine and explore the three critical stages of carcinogenesis, changes in metabolic activities, and weakening of the muscles because of the changes resulting from the issue of cancer. There are three critical stages of carcinogenesis, which occurs following an individual’s exposure to radiation. These phases or stages include initiation, promotion, and progression (Pitot, 1993).
Initiation refers to the initial stage associated with the alteration, as well as change or mutation of the genes emanating from the spontaneous exposure to the carcinogenic agent or contributing factor. In most cases, genetic alterations might generate dysregulation of the biochemical signaling pathways associated with cellular proliferation, differentiation, and survival. The process occurs under the influence of diverse factors such as the rate and type of the carcinogenic metabolism or the response of the DNA repair function. Conversely, the promotion stage relates to the second phase, which is slightly lengthy, as well as reversible associated with the accumulation of the actively proliferating preneoplastic cells.
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In the course of this phase, it is possible to alter the process through integration or optimization of the chemo-preventive agents or factors affecting the growth rates. Progression relates to the phase associated with the premalignant lesion and the manufacturing of invasive cancer. It is the final stage concerning neoplastic transformation characterized by the occurrence of the genetic and phenotypic changes, as well as the proliferation of the cells. The final phase relates to the fast increase in the tumor size following further mutations with the metastatic potential and the invasive aspect. These processes are critical in the course of addressing diverse elements of carcinogenesis.
As evident in the case, Kevin is normally fit and an active individual with his wife, even commenting on the amount of food he did use to the consumer following a day at the mine. Nonetheless, there is muscle wasting and weight loss in the current state because of the negative effects of cancer in affecting or creating metabolic changes. One of the critical effects of cancer on metabolism is the increased consumption of glutamine, as well as glucose. Additionally, cancer contributes to an increase in glycolysis (Dik et al., 2018). There are also substantial changes in the use or optimization of the metabolic enzyme isoforms. Alternatively, cancer creates a metabolic change, which relates to an increase in the secretion of lactate. These aspects are critical in contributing to the changes in his weight and muscle loss.
As documented in the case information, in some cancer patients, muscle weakness might emanate from the production of oncoreural antigens. Critically, the spread of the onconeural antigens relates to the effects of two mutually non-exclusive mechanisms concerning the potential switch of antigen pattern expression associated with the tumor tissue resulting from mutagenic process from cancer and the self-propagated paraneoplastic immune response. The response relates to the destruction of the neuronal, processing, presentation, and liberation of the intracellular neural antigens (Dik et al., 2018). The aspect is an illustration of the potential dissociation concerning the central anti-neural and anti-tumoral immunity. As depicted in the analysis, onconeural antigens relate to the antigens found on the surface of cancer cells with the close resembles the antigen found on the nerve cells. The antibodies emanating from the influence of the immune cells against onconeural antigens contribute to the paraneoplastic syndromes. These antigens are highly common to the nervous system, as well as cancer cells. In Kevin’s situation, these antigens might contribute to the progressive weakening of the limbs, with the specific focus on the proximal muscles; thus, the presence of the muscle weakness. Notably, in Kevin’s case or situation, this would take a similar form of weakening of the muscles associated with the production of onconeural associated with the changes in the metabolic practices or activities.
References
Dik, A., Strippel, C., Mönig, C., Golombeck, K. S., Schulte-Mecklenbeck, A., Wiendl, H., ... & Melzer, N. (2018). Onconeural antigen spreading in paraneoplastic neurological disease due to small cell lung cancer. Oxford Medical Case Reports , ( 7), 34.
Pitot, H. C. (1993). The molecular biology of carcinogenesis. Cancer , 72 (S3), 962-970.
