Insulin Exposure And Breast Cancer Nursing Essay Assignment Paper

Insulin Exposure And Breast Cancer Nursing Essay Assignment Paper

Insulin Exposure And Breast Cancer Nursing Essay Assignment Paper

Despite multiple advances in recent years, cancer remains one of the most challenging diseases to treat. Overall mortality has improved only marginally since the first cytotoxic chemotherapy was introduced at Roswell Park in 1950. In part, this is due to the inherent behavior of cancer. Basic research has firmly established that cancers are highly heterogeneous, resulting in wide inter-individual variations in response to therapy []. This divergence underscores the necessity of personalized medicine wherein the data garnered from a person’s own cancer is utilized to develop a highly individualized therapeutic regimen.Insulin Exposure And Breast Cancer Nursing Essay


Mammalian cell death can occur by several mechanisms: necrosis, apoptosis and autophagy. Autophagy is a catabolic process that results in degradation of bulk cytoplasmic contents, abnormal protein aggregates, and excess or damaged organelles. Autophagy is generally activated by starvation but has also been associated with physiologic processes, pathologic processes (such as cancer), and is inhibited by the biochemical mTOR pathway. Inhibitors of mTOR such as the immune suppressant rapamycin and the antiviral ribavirin, strongly induce autophagy []. It has been shown that metformin can also induce autophagy and apoptosis in cancer cells []. Autophagy is the predominant pathway leading to cellular death in various tumors cells and leukemia cells because it is a simple process that is unaffected by mutations in p53 or the over expression of survival factors [4].

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Metformin, a known mTOR inhibitor [], is an oral antidiabetic drug used as a first-line therapy for the treatment of type 2 diabetes in obese patients with normal kidney function [6]. Recently, metformin has emerged as a potential anticancer agent. A large case-control study conducted at M.D. Anderson Cancer Center has suggested metformin may protect against pancreatic cancer [7]. Similarly, several epidemiological and case-controlled studies found diabetics using metformin have lower cancer risk in comparison to those using other anti-diabetic medications [8]. Further, it has been noted that combining statins and metformin is associated with reducing the risk for several cancers including hepatocellular, pancreatic, colorectal, gastric, and breast [].Insulin Exposure And Breast Cancer Nursing Essay

Metformin also displays significant growth inhibitory effects in several in vitro human and mouse tumor models []. In cell culture, metformin inhibits the proliferation of a range of cancer cells including breast, prostate, colon, endometrial, ovarian, and glioma []. These cellular studies were followed up with research showing a consistent antitumoral effect in various mouse models. Human clinical trials have confirmed the beneficial effect of metformin in breast and colon cancer [12].

Tumor cells often express high levels of insulin receptors, indicating a potential sensitivity to the growth promoting effects of insulin [13]. Thus, obesity and high insulin levels would be adverse prognostic factors for a number of cancers particularly those of the breast, prostate and colon, as noted above. Since metformin lowers blood insulin levels, it may diminish the negative effects of insulin on tumor development and growth. Therefore, to better appreciate the potential role of metformin as an anticancer vehicle and adjuvant to cytotoxic and targeted chemotherapy drugs, we tested its ability to augment response rates to these agents.

Materials and Methods

A variety of fresh solid-tumor specimens were obtained from patients of a private clinic, Medicor Cancer Centres Inc. (Toronto, Ontario, Canada) The tumor specimens were either obtained from biopsies of superficial metastases, superficial lymph nodes infiltrated with metastases, or at the time of major cancer surgery. The tumor specimens were accredited by the attending pathologist to be comprised of tumor tissue. Patients provided written informed consent to CS/CR assay.

The live cell tumor fragments obtained were mechanically disaggregated to obtain single-cell heterogenates (SCH). The SCH were then incubated at 36οC/5% CO2 for 48 hours in a humidified chamber to allow for equilibration. Following the incubation, the SCH were washed, counted, and a small aliquot stained with trypan blue to assess initial viability. Twenty thousand cells were added to each analysis vial. The vials of SCH were then exposed to the various chemotherapeutic agents at clinically achievable concentrations, singly and in combination with metformin (manufacturer: Ratiopharm Inc., metformin: 1,1-dimethylbiguanide,clinically achievable peak plasma concentration of 2.5 μg/ml) [] and incubated at 36οC/5% CO2 for 72 hours in a humidified chamber. SCH were also incubated without cytotoxic drug(s) as controls, without stain as auto controls and as reference for 100% tumor cell viability (data not shown).Insulin Exposure And Breast Cancer Nursing Essay

The chemotherapeutic agents and combinations of agents used included those considered to be the current standard of care for each cancer type, according to the Ontario Ministry of Health and Cancer Care Ontario. In addition, specific off-protocol agents were used. Post incubation, SCH were washed and tagged with Molecular Probes LIVE/DEAD® Fixable Green Dead Cell Fluorescent Stain (Invitrogen, Molecular Probes – L23101 Kit) to evaluate SCH viability by Flow Cytometric methodologies. The reactive stain can permeate the compromised membranes of dead cells and react with free amines on the interior and exterior of the cell, whereas only membrane-exterior free amines of viable cells are available to react with the dye, resulting in intense or dim staining, respectively. In vitro SCH chemotherapy response was determined using a Becton Dickinson FAC Scan Flow Cytometer (BD, 1 Becton Drive Franklin Lakes, NJ USA 07417) and SCH were analyzed for percentage of live versus dead cell populations.

Breast cancer is formed in the breast cells or the milk-producing glands also known as the lobules. The fibrous and fatty tissue of the breasts is an easy target for cancer to develop. It is the most common type of cancers found in women. Although it can even appear in men it is more commonly seen in the women patients.

Several breast cancer awareness programs are developed these days for early diagnosis and treatment of it. Over the span of time, with several inputs in research and medical field survival rates of breast cancer has increased.Insulin Exposure And Breast Cancer Nursing Essay

However, before starting with the breast cancer treatment it is always important to bridge the gap of all knowledge facts by providing brief understanding to the patient about cause and how the treatment will proceed further. All these things are new ways opted by all hospitals in India to serve the patients with better healing methods.

Hospitals are even offering several personalized approach treatment options for international patients for their comfort. Like by arranging online appointments and post-procedure follow-up sessions. Breast Cancer treatment includes surgery, chemotherapy, radiation therapy or a combination of two or more treatment modalities.

Who is getting affected by breast cancer?

This cancer is most prevalent among st women rather than men, after skin cancer. Breast cancer develops in the milk-ducts or its surrounding tissues and sometimes even meta size other tissues of the body as well.

Its early diagnosis and treatment are very important to avoid fatal consequences. In some cases, risks factors like hereditary presence of the disease contribute to the development of cancer but few women develop cancer even without the presence of any risks factors.

Early screening and better treatment options have reduced mortality rates due to this cancer.

Men with breast tissue also develop chances of getting breast cancer. However, the ratio of this cancer is 100 times more in women than in men.Insulin Exposure And Breast Cancer Nursing Essay

In case of appearance of any lump in the breast or any noticeable change must be evaluated by the doctor. Getting a mammogram done is easily possible these days from the diagnosis centers or even a doctor can help diagnose the issue. Once mammogram is done the oncologist can decide while keeping all risk factors in mind about the best breast cancer treatment that is appropriate depending on the stage. Mastectomy involves removal of the breast and doctors sometimes opt for a partial mastectomy to preserve the breast and remove the cancerous tissue.

What are the common types of breast cancer?

  • Invasive ductal carcinoma (IDC): This one is the most readily found form which accounts for nearly 80% of the cases. It is also known as infiltrating ductal carcinoma because of its nature of invasion crossing ducts and reaching other tissues of the body. It also has several sub-types depending upon its characteristics.
  • Ductal carcinoma in situ (DCIS): This is a stage 0 type of cancer or pre-cancer which is treatable with ease and is non-invasive by origin.
  • Invasive lobular carcinoma (ILC): This cancer begins in milk glands and spreads to tissues surrounding the breast and further metastasize other body parts. Such cases account nearly 10% of the invasive breast cancer cases.
  • Inflammatory breast cancer (IBC): This aggressive cancer involves swelling and redness of breast making it warm, tender, and heavy. Afro American women are predominantly at greater risk for developing this particular form of cancer in comparison to other women. This inflammatory cancer of the breast usually appears five years earlier than other breast cancers. A doctor can easily assess symptoms and diagnose via mammogram.Insulin Exposure And Breast Cancer Nursing Essay
  • Lobular carcinoma in situ (LCIS): LCIS, has another name of lobular neoplasia which begins in the milk-producing ducts or lobules. It is mainly a sort of abnormal cell collection which transforms into cancer over the span of time.
  • Paget breast or nipple disease: This kind of cancer affects the nipple skin or the areola. Patients with Paget disease might experience itchy, scaly, and red nipples accompanied by a bloody or yellow discharge. This condition usually comes up with one or more tumors or invasive cancer in the same breast.
  • Angiosarcoma of the breast: This cancer usually appears due to previously treated cancer complication. It grows quickly and spreads very fast in comparison to other cancers.
  • Metaplastic breast cancer: It is a rare type of cancer involving mixed cells which are different from breast cells and makes the diagnosis difficult as well.
  • Male breast cancer: This type of cancer can also develop in males but there are very few cases and males with breast tissue are prone to develop such cancers, not others

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