BIO FPX 1000 Assessment 6 Patient Case Study Profiles – Cancer Causes

Student Name

Capella University

BIO FPX 1000 Human Biology

Prof. Name:

Date

Patient Profile – Cancer Causes and Patient Recommendations

Mary

Mary is a 64-year-old woman in generally good health.
She had her first child at the age of 20.
She began menopause at the age of 58.
She has been on hormone replacement therapy for the past 6 years since entering menopause.
She has gained some weight since menopause.
Her mother was diagnosed with breast cancer at the age of 37.
She had her first menstrual period at 13.

Recommendation for Mary:

Although this profile provides substantial information, some key details are missing to accurately assess risk, such as genetic testing results, her race/ethnicity, and whether she has ever had a biopsy. Based on the information available, Mary’s risk of developing breast cancer in the next 5 years is slightly elevated from the average of 2% to 3.1%, and her lifetime risk is increased from 8.1% to 12.1%. To reduce her risk, Mary could consider losing weight, as weight gain after menopause is a known risk factor (Wyant, 2020). Increasing physical activity can also help lower the risk of breast cancer. Additionally, certain medications could be considered to reduce breast cancer risk, though these are generally recommended only for patients with a higher risk profile. Since Mary has been on hormone therapy for 6 years, she should be aware that her risk may increase after 10 years of use, prompting reconsideration of continued hormone use. Given her mother’s early breast cancer diagnosis, it is crucial for Mary to maintain a healthy lifestyle, including weight management, regular physical activity, and a balanced diet. Regular mammograms are essential for early detection, which significantly improves treatment outcomes.

Paula

Paula is 71 years old and currently has a urinary bladder tumor, with metastases in the ovaries and possible involvement of one lymph node.
She had her first period at 13.
Paula’s sister was diagnosed with breast cancer three years ago, followed by ovarian cancer two-and-a-half years ago.
Paula’s mother passed away from lung cancer.
Two maternal uncles had pancreatic cancer.
Her maternal aunt had myeloma.
Her maternal grandmother had uterine cancer.
Paula’s sister underwent genetic testing and was found to have a BRCA1 mutation.

Recommendation for Paula:

Based on the National Cancer Institute’s breast cancer risk assessment tool, Paula’s risk of developing breast cancer within the next 5 years has increased from 2.2% to 3.2%, with her lifetime risk rising from 6% to 8.8%. However, this assessment does not account for her current bladder tumor with ovarian and possible lymph node involvement, her family’s history of various cancers, or her sister’s BRCA1 mutation, all of which significantly elevate her risk. Paula might be a suitable candidate for medications like Tamoxifen and Raloxifene to reduce her breast cancer risk. Maintaining a healthy weight, increasing physical activity, and adopting a healthy diet are crucial for her. While Paula’s family history shows a high incidence of cancer, the most significant risk factors come from her immediate family members (mother and sister). Genetic testing could help determine if Paula also carries a BRCA mutation. Regular mammograms are vital for early detection, which is key to successful outcomes. Testing and treating any precancerous conditions may also be beneficial, as there are preventive surgeries that can greatly reduce risk if her risk factors increase.

June

June is 58 years old.
She has been having regular mammograms every two to three years.
Her first period occurred at age 13.
She has had two pregnancies, resulting in two children, with her first child born at age 27.
She experienced menopause at age 51.
She did not undergo hormone replacement therapy (HRT) but used oral contraceptives for a total of four years in the past.
She has high blood pressure and high cholesterol. She also has low levels of thyroid hormones.
She has weak bones.
Her maternal aunt died of breast cancer in her 30s.
Her mother passed away from a brain tumor at age 39.
Her father is alive and well at age 84.

Recommendation for June:

According to the National Cancer Institute’s risk assessment tool, June’s 5-year breast cancer risk is slightly below average at 1.5%, compared to the average of 1.7%, and her lifetime risk is 8.5%, while the average is 7.5%. This assessment does not factor in her high blood pressure, high cholesterol, low thyroid levels, weak bones, her aunt’s breast cancer, or her mother’s brain tumor. Although these factors may not significantly impact her risk, they could contribute to an increased risk. By not taking hormone replacement therapy and having only used birth control for four years, June has not added significant risk from those factors. At age 58, June should have mammograms at least annually. To reduce her risk, June should work on lowering her blood pressure and cholesterol levels, which can sometimes be achieved through a healthy lifestyle and diet but may require medication. Interestingly, her low levels of thyroid hormones may actually reduce her risk of breast cancer, as research has shown a significant reduction in breast cancer cases among patients with hypothyroidism, regardless of treatment (Hercbergs, Mousa, Leinung, Lin, & Davis, 2018).

Nora

Nora is a 51-year-old pre-menopausal woman.
Her last bilateral mammogram showed no evidence of a mass.
She had her first period at 13.
She has had two pregnancies, each resulting in the birth of a child, with her first child born at age 32.
She used oral contraceptives for six years.
She has not undergone hormone replacement therapy (HRT).
She smoked until the age of 26.
She consumes between 1 and 4 alcoholic drinks per week.
Her mother was diagnosed with breast cancer at age 48 and now has lymphoma at age 72.
Her maternal grandmother had breast cancer at age 47 and later died of lung cancer.
Her paternal first cousin currently has breast cancer.
Her paternal aunt died “at a young age” from breast cancer.
Her father was of Ashkenazi Jewish heritage and died of colon cancer at age 66.

Recommendation for Nora:

Nora’s risk, according to the risk assessment tool, is increased from the average of 1.3% to 2% for the next 5 years, with a lifetime risk increase from 11% to 17%. This assessment does not consider additional factors like her oral contraceptive use, smoking history, social drinking, and family cancer history, which all contribute to her elevated risk. Her lack of hormone replacement therapy is beneficial in reducing risk. Notably, Ashkenazi Jewish women have a higher likelihood of carrying a BRCA gene mutation, so BRCA genetic testing could be highly beneficial for Nora, as early detection greatly improves treatment success (CDC, n.d.). To reduce her breast cancer risk, Nora should maintain a healthy lifestyle, including regular mammograms, quitting smoking, and minimizing alcohol consumption. When she reaches menopause, she should consider non-hormonal treatments to manage symptoms. Maintaining a healthy weight is also crucial, as excess weight increases the risk of breast cancer.

References

Hercbergs, A., Mousa, S., Leinung, M., Lin, H., & Davis, P. (2018, June). Thyroid Hormone in the Clinic and Breast Cancer. Retrieved November 23, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5945724/

Personalized Results. (n.d.). Retrieved November 23, 2020, from https://bcrisktool.cancer.gov/calculator.html