A 65-year-old obese African American male patient presents to his HCP with crampy left lower quadrant pain, constipation, and fevers to 101˚ F. He has had multiple episodes like this one over the past 15 years and they always responded to bowel rest and oral antibiotics. He has refused to have the recommended colonoscopy even with his history of chronic inflammatory bowel disease (diverticulitis), sedentary lifestyle, and diet lacking in fiber. His paternal grandfather died of colon cancer back in the 1950s as well. He finally underwent a colonoscopy after his acute diverticulitis resolved. A colonoscopy revealed multiple polyps that were retrieved, and the pathology was positive for adenocarcinoma of the colon
Explain why you think the patient presented the symptoms described.
Identify the genes that may be associated with the development of the disease.
Explain the process of immunosuppression and the effect it has on body systems.
This case study analysis explores the presentation, underlying genetic factors, and the impact of immunosuppression in a 65-year-old obese African American male patient diagnosed with colon adenocarcinoma.
Patient Presentation: The patient’s symptoms of crampy left lower quadrant pain, constipation, and fevers along with a history of chronic inflammatory bowel disease (diverticulitis) are indicative of a flare-up of diverticulitis. However, the persistence and recurrence of these symptoms despite bowel rest and antibiotics raise concerns. The patient’s reluctance to undergo a colonoscopy despite family history of colon cancer suggests a delayed diagnosis.
Etiology and Genetic Factors: The development of colon adenocarcinoma is multifactorial, influenced by genetic, environmental, and lifestyle factors. In this case, genetic predisposition plays a significant role, especially given the patient’s family history of colon cancer. Specific genes associated with the development of colon cancer include APC, KRAS, and TP53 mutations, among others. These mutations can lead to uncontrolled cell growth and the formation of malignant tumors in the colon.
Immunosuppression and its Effects: The chronic inflammation resulting from diverticulitis and the patient’s sedentary lifestyle and poor diet lacking in fiber contribute to ongoing immunosuppression. Immunosuppression weakens the body’s immune response, making it less effective in identifying and eliminating abnormal cells, such as those that can develop into cancer. Additionally, chronic inflammation itself can create an environment conducive to the growth and progression of cancer cells.
In summary, this case highlights the complexity of factors contributing to the development of colon adenocarcinoma. Genetic predisposition, chronic inflammation from diverticulitis, sedentary lifestyle, and the patient’s reluctance to undergo screening procedures collectively contributed to the delayed diagnosis. Understanding the interplay between genetics, inflammation, and immunosuppression is crucial in managing and preventing the progression of diseases like colon adenocarcinoma.