J.C is an 82-year-old white man who was evaluated by GI specialist due to abdominal discomfort, loss of appetite, weight lost, weakness and occasional nausea.

Past Medical History (PMH):
Patient is Diabetic, controlled with Metformin 500 mg by mouth twice a day, Lantus 15 units SC bedtime. Hypertensive, controlled with Olmesartan 20 mg by mouth once a day. Atrial Fibrillation, controlled with Rivaroxaban 15 mg by mouth once a day and bisoprolol 10 mg by mouth once a day.

Hb 12.7 g/dl; Hct 38.8% WBC 8.2; Glycemia 74mg/dl; Creatinine 0.8 mg/dl; BUN 9.8 mg/dl; AST 21 U/L ALT 17 U/L; Bil T 1.90 mg/dl; Ind 0.69 mg/dl; Dir 1.21 mg/dl.

Diagnostic test:
Endoscopic Ultrasound of the Pancreas. Solid mass in the head of pancreas 4 cms, infiltrating Wirsung duct. The solid mass impress to infiltrate the superior mesenteric vein. Perilesional node is detected, 1.5 cms, metastatic aspect. Fine needle aspiration (FNA) biopsy: Ductal adenocarcinoma.

Case study questions:

Please name the potential most common sites for metastasis on J.C and why?
What are tumor cell markers and why tumor cell markers are ordered for a patient with pancreatic cancer?
Based on the case study described, proceed to classify the tumor based on the TNM Stage classification. Why this classification important?
Discussed characteristic of malignant tumors regarding it cells, growth and ability to spread.
Describe the carcinogenesis phase when a tumor metastasizes.
Choose the tissue level that is affected on the patient discussed above: Epithelial, Connective, Muscle or Neural. Support your answer.
Submission Instructions:

Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources within the past 5 years.

The potential most common sites for metastasis in J.C with pancreatic cancer are the liver and the lungs. Pancreatic cancer often spreads to these areas because they are close to the pancreas and have a good blood supply, which allows cancer cells to easily reach them.

Tumor cell markers are substances produced by cancer cells that can be detected in the blood, urine, or tissue samples. They are ordered for a patient with pancreatic cancer to help diagnose the cancer, determine the stage of the cancer, and monitor the effectiveness of treatment.

Based on the case study described, the tumor in J.C’s pancreas would be classified as T3N1M1 based on the TNM staging system. This classification is important because it helps determine the extent of the cancer and the appropriate treatment options.

Malignant tumors are characterized by uncontrolled cell growth, the ability to invade nearby tissues, and the ability to spread to other parts of the body (metastasize).

The carcinogenesis phase when a tumor metastasizes is the process by which cancer cells spread to other parts of the body. This can occur through the bloodstream or through the lymphatic system.

The tissue level that is affected in J.C is the epithelial tissue. This is the tissue that lines the organs and glands in the body, including the pancreas. The presence of a ductal adenocarcinoma, a type of cancer that arises from the cells lining the ducts in the pancreas, indicates that the cancer is affecting the epithelial tissue.