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Create a presentation (powerpoint) on my already written essay about Lung Cancer. Also please include a script where I could speak for about 5 minutes. All the instructions, essay, and examples will be attached. Also include all perspectives of inquiry
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Running head: LUNG CANCER
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Aram Bulutyan
West Coast University
GE Capstone
12 February 2019
LUNG CANCER
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Abstract
In 2012, worldwide lung cancer appeared in 1.8 million people which 1.6 million of them died.
This has made it the leading cancer-related mortality in males and the second most commonly
occurring in women following breast cancer (Siegel, 2013). Past being the largely occurring kind
of cancer, which also happens to be challenging to cure. Consequently, lung cancer is the
deadliest form of cancer. This paper aims to shed light on the progress of lung cancer in the
human body and also the measures of treatment which is surgery and chemotherapy.
Additionally, with the high mortality associated with lung cancer, the paper describes that are
associated with this form of cancer.
LUNG CANCER
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Introduction
Lung cancer is universal cancer- related cause of fatality among men as well as women.
Lung cancer can be invisible for an extended period which makes it the most dangerous as well as
fatal disease. Besides, there is no cure for lung cancer apparently for any form of cancer.
However, if noticed during its early stages the sickness can be taken care of treated and may be
ended. All the same, there are a lot of new suggestions in terms of treatments which under research
and tested which have the ability to save lives. Through comprehension of what lung cancer
entails, medical experts can effortlessly diagnose and evaluate cancer patients. Most ethical
obstacles in lung cancer diagnosis and treatment are legislated. The most common barrier is the
issue of informed consent. Cancer patients may require the physician to do something that is not
professional, but they have a right to decide and accept whatever treatment proposals are
presented to them. Some religious patients, for instance, may reject treatment and the physician
cannot force them to be treated regardless of how essential the therapy is. Cancer patients are
also discussed in multidisciplinary teams (MDTs). These are teams of cancer experts in any
cancer facility who discuss the cure for the patient. Any medical practitioner bringing their
patient into the discussion is not allowed to mention the name of their patient in the MDTs.
Before delivering the patient in the MDM discussion, informed consent should be obtained from
the patient. Lung cancer is a global disaster which every single nation, hospital, and expert
strive to curb in any way possible.
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Scientific Inquiry
Pathophysiology
Lung cancer or otherwise known as lung carcinoma is a malignant tumor in the lung
depicted by unconstrained cell growth in the lung tissues. This unrestrained cell growth can
stretch past the lung through a process of metastasis and affecting the tissue nearby to other body
parts. Like numerous forms of cancers, lung cancer is introduced into the lung cells by either
activation of oncogenes or by inactivation of the tumour suppressor genes (Collins, 2007). The
major inducers of these mutations of genes are Carcinogens which cause the development of the
tumour. K-ras proto-oncogene occurring mutations trigger nearly 10–30% adenocarcinomas in
the human lung. Additionally, the fusion gene EML4-ALK tyrosine kinase is also involved in
virtually four percent of non-small-cell lung cancer. Epigenetic alteration changes for instance:
histone tail modification, alteration of DNA methylation, or microRNA regulation might affect
Lung Cancer on inactivation of lung tumour suppressor genes. Significantly, cancer cells
establish resistance to oxidative stress. This resistance aids the cells to endure and exacerbate the
inflammatory lung state. This further inhibits the human immune system activities against the
tumour.
The origin of the cell lines fully comprehended. The process could include an
uncharacteristic activation of stem cells. The stem cells that in the proximal airway and
expressing a keratin 5 might be highly affected naturally result in squamous-cell lung cancer.
The epidermal growth factor receptor (EGFR) normalizes apoptosis, angiogenesis, cell
LUNG CANCER
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proliferation, and tumour invasion. Alterations and augmentation of EGFR are conventional in
non-small-cell lung cancer and they offer the base for therapy with EGFR-inhibitors. Additional
genes that are frequently altered or augmented include NKX2-1, c-MET, PIK3CA LKB1, and
BRAF (Tsou, 2002). Impairment of genes triggers cells to be mutated and develop into cancer
cells. Even though genetic cell modifications may be inherited, as for lung cancer, these changes
result in the development of cancer.
Treatment
Execution of a chest radiograph is a foremost exploratory action if an individual
describes symptoms which could be indicative of lung cancer. The radiograph may divulge a
noticeable mass, flared mediastinum, atelectasis or a collapsed, lung amalgamation or pleural
effusion. CT imaging is characteristically employed to offer more knowledge of the form and
degree of the mutation. On the chest radiograph, Lung cancer habitually emerges as an isolated
pulmonary nodule (Shepherd, 2005).
Once the investigations validate, the stage is assessed to ascertain whether the cell
mutation is contained and amenable for surgery. However, if the disease is spread other regions,
surgery may not be a viable option for treatment. Whenever mediastinal lymph node connection
is deduced, those nodes should undergo sampling to aid in the staging of cancer. Practices
employed for staging include transbronchial needle, transthoracic needle, mediastinoscopy
endoscopic ultrasound, and thoracoscopy. Pulmonary function and blood tests are applied to
assess the feasibility of surgery. (Mountain, 2011)Measures to get rid of lung cancer include
wedge resection which removes a slight portion of the lung affected by the tumour accompanied
by a margin a healthy tissue. Segmental resection aimed at removing a bigger section of the lung,
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though not the whole lobe, Lobectomy, on the other hand, removing an entire lobe of one lung.
Pneumonectomy eliminates the whole lung. At the initial stages Non-small-cell lung carcinoma,
lobectomy is the medical treatment choice. Chemotherapy treatment is subject to the tumour
type. Small-cell lung carcinoma even comparatively primary stages of the disease are chiefly
remedied through radiation and chemotherapy. In (small-cell lung carcinoma) SCLC, etoposide
and cisplatin are normally used. Blends with, gemcitabine, carboplatin, vinorelbine, paclitaxel,
irinotecan, and topotecan, can also be used in chemotherapy treatments. In progressive stages of
NSCLC, chemotherapy advances the survival of patients. When applied especially in the first
line of medication it is helpful on the condition that the patient is fit enough to withstand the
treatment. Other usually applied drugs in treatment include paclitaxel, docetaxel, gemcitabine,
Platinum-based drugs and blends that consist of platinum therapy results in greater risks of
undesirable severe effects especially to patients above 70 years old.
Mathematical/Analytical Inquiry
Smoking is accountable for approximately 85% of lung cancer illnesses and 30% of all
the deaths related to cancer. Lung cancer was infrequent before the dawn of cigarette smoking.
The disease had not even been documented as a definite sickness until 1761.from then diverse
facets of lung cancer came up and were defined more in 1810. But as time went by the numbers
have gone up. The general probability of a man developing lung cancer during his life is a ratio
of 1 to 15, and for women, it is nearly 1 to 17. These include non-smoker and, smokers through
the peril to smokers being much higher. Roughly 541,000 Americans today are diagnosed with
lung cancer or have been diagnosed at some instant in their lives. In 2018, an estimate of 234,030
patients of lung cancer was anticipated to be diagnosed; this figure represents around 13 percent
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of the county’s cancer cases.
Lung cancer takes its toll on the economy of the country as well. During 2010, an
estimate of $125 billion spent on cancer care with lung cancer accounting for 13% ($16.5 billion)
of all direct health expenditure on cancer in 2010 (Siegel, 2013). Lung Cancer has caused a large
number of deaths, deaths peaking at 159,292 in the year 2005 and have since reduced by 6.5% to
148,945 in 2016. But still through statistical analysis, extrapolated from previous years’ data,
154,050 Americans were projected to pass from lung cancer in 2018, which accounts for about
25 percent of all deaths associated with cancer (Siegel, 2013). The five-year persistence
frequency to this disease is 18.6 percent, relatively lower to several other types of cancers such
as breast (89.6 percent) colorectal cancer (64.5 percent), and prostate cancer (98.2 percent).
However, a decrease in mortality rates from lung cancer can be attributed to the upsurge in the
medical field and new treatment techniques. Additionally, the awareness against smoking, the
leading cause of lung cancer has aided with this reduction.
Ethical Perspectives of Inquiry:
Ethical Perspectives of inquiry Cancer, including lung cancer, is classified under
oncological conditions. These conditions mainly involve the treatment of tumors. Diagnosis,
treatment, and other involved medical procedures are legislated. Some ethical concerns,
however, are not legislated, but professionally required to be ethically handled. This paper looks
into the ethical inquiry perspectives with specific consideration of lung cancer patients,
physicians, and treatment protocols.
Laws Pertaining to Lung Cancer
In most cases, lawsuits that arise with oncological treatments, lung cancer included, are
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about late diagnosis or misdiagnosis. In such lawsuits, the court seeks to determine whether the
patient suffered reasonable injury and whether the medical practitioner or the facility played an
essential role in the damage. Additionally, most lung cancer patients have been associated with
lawsuits that revolve around stature of limitation and invariable treatment. Given the desperate
attempt of patients to seek aid from other unorthodox treatments, the medical practitioner
responsible for a given patient should give the patient permission to take unorthodox treatment,
especially if the patient insists, given the informed consent regulations (Vevaina, Bone, &
Kassoff, 2012). However, the practitioner, in this case, should weigh the benefits of any type of
therapy the patient proposes or insists on against the benefits of this type of treatment. There
have been few legal concerns regarding failure to comply on the part of the patient, especially
considering that treatment is only achievable with informed consent.
Most medical jurisdictions, including European, American, and Canadian jurisdictions
regulate the standard of care (Vevaina, Bone, &Kassoff, 2012). There are specialized lung cancer
medical and surgical oncologists. This oncologist should have the capacity to prove their medical
or oncological qualifications. In case of a lawsuit, a lung cancer medical practitioner or
oncologist is required to prove that they meet the standards of practicing in this field. The law
evaluates the practices in the suit with a focus on whether the practitioner was able to provide
professional standards of care to the patient, as would have done any other specialist of lung
cancer in similar conditions, and given the resources at the disposal of the medical practitioner in
question (Vevaina, Bone, &Kassoff, 2012). MDMs are held liable for negligence in cases of
therapeutic failure. However, it is not always their fault. Sometimes, the patient may require
some changes in the treatment plan proposed by the MDM. The patient might decide not to take
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the treatment plan proposed, or might decide to take unorthodox treatment. The law allows them
to take such decisions and request that they are implemented (Vevaina, Bone, &Kassoff, 2012).
However, for the purpose of securing the professional liability of the MDMs, the physicians
responsible are required to record any changes that the patients request for in the MDMs
proposed treatment proposal in the patient’s treatment plan. Referral and consultation procedures
are also legislated.
In most cases, the practitioner responsible for a given lung cancer patient is required to
refer or consult with other specialists in any area they do not specialize in that is required in their
patient’s treatment. If, for instance, a patient requires radiotherapy or chemotherapy, the
physician is supposed to consult a chemotherapist to advise on whether it can be of any
assistance given the patient’s condition. The same case occurs with radiotherapists (Vevaina,
Bone, &Kassoff, 2012). There are chances for professional negligence and undue pressure or
influence. For the sake of record keeping the practitioner is required to record the information of
a second expert opinion in the chart in order to evade liability. There can be cases where the
patient tries to sue the physician for negligence before sufficient harm is recorded. This is
legislated under causation. In order for any patient to successfully sue a physician for negligence,
there should be sufficient evidence of reasonable harm caused to the patient due to the negligent
acts of the physician. This aims at protecting physicians from allegations of negligence where
harm has not occurred. Negligence in care is defined as a violation of owed duty by a physician
to a patient who causes some harm, in which case the harm would not have happened to the
patient in cases the negligent act did not occur (Vevaina, Bone, &Kassoff, 2012). Wrongful death
to the lung cancer patient is also legislated. In cases medical or oncological negligence causes
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death that would otherwise not have occurred without the professional negligence, the family can
be compensated by the physician. Damages may also be compensated if the patient experiences
damages due to medical negligence caused by a physician that leads to certain damages that
could have otherwise not have occurred without their negligent actions. Damages are classified
into emotional distress, physical pain, and suffering (Vevaina, Bone, &Kassoff, 2012).
Ethical Obstacles Pertaining to Lung Cancer
Most ethical obstacles in lung cancer diagnosis and treatment are legislated. The most
common obstacle is the issue of informed consent. Cancer patients may require the physician to
do something that is not professional, but they have a right to decide and accept whatever
treatment proposals are presented to them. Some religious patients, for instance, may reject
treatment and the physician cannot force them to be treated regardless of how essential the
treatment is. Additionally, as medical practitioners, cancer practitioners have an obligation to
promote life, but in some countries where euthanasia is allowed, they might watch their patients
request for it, especially at the last stages where patients feel that the suffering is not worthwhile
(Denton, &Conron, 2016). Euthanasia is against the religious beliefs of some practitioners, but
their patients may be allowed to use the procedure.
Additionally, informed consent is required from the lung cancer patient (Denton, &
Conron, 2016). Most lung cancer patients, especially in the first three stages may have the
capacity to make informed consent. In cases where the patient is in a critical condition, for
instance, is unconscious, a responsible relative or close friend can make informed consent on
their behalf. Cancer patients are also discussed in multidisciplinary teams (MDTs). These are
LUNG CANCER
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teams of cancer experts in any cancer facility who discuss the treatment for the patient. Any
medical practitioner bringing their patient into the discussion is not allowed to mention the name
of their patient in the MDTs. Before bringing the patient in the MDM discussion, informed
consent should be obtained from the patient. The informed consent should be written or oral and
must be entered in the patient’s treatment records (Denton, &Conron, 2016).
Contributors in the recommendation for treatment also hold professional liability to their
recommendations, especially in cases where negligence is noted. However, the liability is shared
among the participating decision makers. In the MDTs some practitioners do not agree with the
majority decisions. A decision can be made in consideration of the similarity of the majority’s
opinion. In order to be exempted from the liability in cases of negligence, the dissenting MDT
members are required to record their dissents. Similar to the informed consent required before
introducing a patient’s information to the MDT, any dissenting opinions about
recommendations are supposed to be entered into the patient’s treatment plan (Denton, &
Conron, 2016).
Ethical Theories related to lung cancer diagnosis and treatment process
Deontologists believe that people are supposed to adhere to their decisional obligations
and duty. In this case, it applies to informed consent (Zwitter, 2019). The theory may require
practitioners always to take the duty to enhance the quality of life to the patient. This means that
the practitioners cannot allow the patient to take any ontological decision that is not proven to
enhance the quality of life. If patients in the final stage of lung cancer request for euthanasia, this
theory may require the medical practitioner to reuse it, especially because of the duty of a
medical practitioner is to enhance the quality of life, and never to end it. In this case, the theory
LUNG CANCER
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may recommend usage of strong painkillers and waiting for the rightful time for death.
Utilitarianism requires the prediction of the outcome of a decision. A decision that has an
outcome with more benefits is ethically correct. In the case of patients seeking informed consent,
the theory might require that the physician decides on the right procedures, even without the
patient’s consent (Zwitter, 2019). This is because the physician is more capable of predicting the
outcome of procedures than the patient who is desperate in the situation. Additionally, the theory
might accept euthanasia because at the end of the day the patient will die, and euthanasia reduces
the days of suffering for the patient.
Money, Power, and Control and their influence on the issue
In the recent past, cancer research has been enhanced by people in power who suffer from
cancer. Power has a chance of enhancing or reducing the chances of developing better treatment
protocols for patients (Mant, & Fowler, 2014). Additionally, lung cancer treatment may be
extremely expensive to some patients. This means that money has the power to decide on what
treatment plans a patient can take. In most cases, patients without sufficient money for
chemotherapy, radiotherapy, and other cancer therapies may not consent to such treatments. They
may seek to use alternative medicine options such as herbal medicine which is somehow
cheaper. Patients have control of their treatment. This affects greatly the outcome because of the
physicians might have different opinions on treatment, but patients decline to the proposed plans.
Conclusion
Lung cancer is the most common disease across the globe. Lung cancer kills more
victims compared to any other illness. There are different forms of lung cancer which include
LUNG CANCER
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colon, breast or ovarian cancer. There are two forms of lung cancer, namely small lung cancer as
well as non-small lung cancers. Hence, the named tow forms of lung cancer development and
spread in different ways. As a result, small lung cancer seems to spread so fast and forms over 15
percent of lung cancers. In essence, non-small lung cancer is the most popular or commonly
experienced type of lung cancer. There are …
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