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Cytotoxic Chemotherapy - Essay Example

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Introduction: This is a reflective essay about a patient whose identity is has been intentionally kept undisclosed for ethical reasons and for reasons of confidentiality. The patient is a 40-year-old single female who was taken care of in the clinical practice…
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Cytotoxic Chemotherapy
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Download file to see previous pages While reflecting, this would enable the practitioner to improve the understanding of the cytotoxic drugs and their roles in management of carcinoma breast, and while undergoing such therapy, the impact of that on the overall physiology and psychology of our patient.
Cell Cycle: The cell cycle is a series of events that regulate the life of the cell. Two main events characterize the cell cycle. The S-phase in which the cell duplicates its genome, and M phase, in which the cell splits into two daughter cells. It is necessary that these two crucial events are regulated and coordinated to occur in an ordered fashion at precisely the right time. The cell cycle has a central role in controlling cell growth and proliferation. This frequently becomes the target of genetic alteration. The accumulation of the genetic alteration may lead to deregulation of these ordered events and may be related to the onset of cancer. Neoplastic transformation is a multi-step process involving the clonal accumulation of genetic lesions that affect proto-oncogenes or tumor suppressor genes. The mechanism of cell division assures that the cell accurately duplicates its contents, especially its chromosomes. The cell cycle is divided into 4 (Molassiotis, A, Gibson, F. and Kelly, D. et al., 2006) phases. During M phase, the replicated chromosomes are separated and packaged into two new nuclei by mitosis, and the cytoplasm is divided into the two daughter cells by cytokinesis. The other three phases of the cell cycle are called interphase, G1 (gap 1), a period of growth during which the cell determines its readiness to commit to DNA synthesis; S during which the genetic material is replicated, and no replication is permitted; and G2 during which the fidelity of DNA replication is determined and errors are corrected.
The transition between the G1 and S and between the G2 and M are tightly regulated to minimize errors in the replication process. Check points in G1 and G2 that determine whether to enter are regulated by protein kinases, cyclin-dependent kinase or cdk and kinase-associated proteins called cyclins. The cdk family of compounds associate with a distinct cyclin with characteristic substrate specifications, and these are expressed in different phases of the cell cycle. The check point regulating transition from G1 to S is frequently disrupted in cancer. For a cancer to arise, mutations must occur that affect a variety of pathways. Often the G1 cell cycle check point is affected. The expression of telomerase is a common feature in cancer. Overexpression of growth factors and their receptors is commonly detected. Activation of the ras protooncogene or other changes leading to a constitutively active MAP kinase cascade is common. Changes in cytoskeleton and responsiveness to contact-mediated growth inhibition are frequent in cancer cells. Usually when a mutation occurs in one component of a signaling pathway, other mutations are seen in the other pathways rather than in another component of the same pathway (Smith, T.J. et al., 2006). The high level of mutability of cancer cells facilitates adaptation to the environment including the development of resistance to anticancer drugs. As tumor ...Download file to see next pagesRead More
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