Irene is a 55-year-old female who went to a primary care clinic because she has had a “cold” for
the last 2 months. She tries to eat healthy and exercises daily. She plays tennis a few times per
week and goes for a short walk every day. Irene is now a non-smoker, but she used to smoke in
her 20s and 30s. Irene tells the clinic physician that she has a cough that she cannot seem to get
rid of. She said she feels more fatigued and is short of breath after playing tennis, which is not
like her. She has also been having some chest pain when she takes a deep breath.
The doctor ordered a chest X-ray, which showed a large mass in the right lung. She was booked
for a bronchoscopy and biopsy, and the pathology report indicates she has non-small cell
adenocarcinoma in the upper lobe of her right lung. She will be booked for surgery, followed by
chemotherapy. There were no targetable mutations found in the cancer cells, so Irene will receive
Cisplatin and Pemetrexed after surgery to ensure there are no cancer cells left.
1. Briefly describe the pathophysiology related to one of her symptoms. Choose one of the
following for your discussion post.
a. Persistent cough
b. Shortness of breath
c. Fatigue
d. Chest pain
Irene who is a 55-year-old female diagnosed with a tumour in the upper lobe of her right lung, is
experiencing many physical symptoms. Persistent cough is one of the symptom because it is
related to airway irritation and inflammation. According to Power-Kean et al. (2023), in non-
small cell lung cancer, the tumor can grow big enough to press upon or narrow the air passages in
the lungs and when this occurs, mucus may get trapped, and the irritated airways may stimulate
the cough reflex, causing people to cough more easily (pp. 1310).Tumour cells also stimulates the
local inflammatory response, where cytokines and immune cells stimulates thickening of air
passage walls, mucus secretion, and air passage sensitivity to mechanical stimuli. These changes
stimulate the cough reflex mediated by vagus nerve, resulting in a chronic cough that does not
resolve as a viral col. (Power-Kean et al., 2023).
2. Briefly describe how one of the chemo drugs works to treat her cancer
Cisplatin is a chemotherapy medication that is commonly administered following surgery to
eliminate any potential remaining cancer cells in the body. This is an effective measure to reduce
the risk of cancer recurrence. Cisplatin functions by binding to the DNA within cancer cells and
altering its configuration. This is because it inhibits the cancer cells from replicating their DNA
to form new cells. Consequently, cancer cells are unable to develop and proliferate effectively,
thereby slowing the progression of cancer (Sealock et al., 2021, p. 867).
References
Power-Kean, K., Zettel, S., El-Hussein, M. T., Huether, S. E., McCance, K. L., & Brashers, V.
(2023). Understanding pathophysiology (2nd Canadian ed., pp.1308-1312). Elsevier.
