Blog 26: Senior Project Reflection

(1) Positive Statement

What are you most proud of in your 2-Hour Presentation and/or your senior project? Why?

I am most proud of being able to complete a senior project topic about medicine, specifically about cancer. I have been interested in studying medicine for a very long time now, so by doing this project it let me explore the different medical options that are out there. It also helped reinforce my determination of being in the medical field as a physician. I am also most proud of being able to present in front of my peers about skin cancer, and how important it is to take care of your skin. I believe that through my presentation, my peers will hopefully engage in protective measures, such as wearing sunscreen, or UV protective sunglasses, to lower their risk of developing skin cancer, especially at such a young age. 

(2) Questions to Consider

a.     What assessment would you give yourself on your 2-Hour Presentation (self-assessment)?

AE. I believe that I deserve this grade for my 2-hour presentation because I presented a plethora of information to my peers that is really reliable and accurate, but I also felt that each activity was engaging and related to each of my answers. I also felt that after my presentation, my peers left with a deep understanding of what skin cancer was, and prevention methods they should take to avoid this disease. 

b.     What assessment would you give yourself on your overall senior project (self-assessment)?

AE. I would give myself an AE for my overall senior project because of the fact that I have strived to do the best that I can with each of the components in the senior project. I feel that the research I have attained is extensive and AE worthy. I have worked hard to educate myself about skin cancer and really stepped out of my comfort zone to get the information I needed to have a successful senior project. I have dedicated many hours to mentorship and the senior project which showcases the work that I have done throughout these 9 months.

(3) What worked for you in your senior project?

What worked for me during the course of the senior project was mentorship, research, and independent components. I have dedicated countless hours to Kasier Permanente Baldwin Park, not only to get my hours done, but because I truly love going to the hospital to interact with the patients, physicians, medical assistants, and other staff. They have really made my experience an enjoyable one, where I was able to learn so much! Research is another component where I felt that I did an excellent job. Having a topic that concerns something about medicine, there are multiple sources where you can get information. However, some of these sources aren't as reliable as others. I continually strived to get research articles that were from reliable sources such as medical journals, the National Cancer Institute, the Centers for Disease Control and Prevention, and the National Comprehensive Cancer Network. The research that I was able to attain from these sources gave me reliable, accurate information which I felt confident to present to my peers. Finally, both of my independent components really helped me solidify my senior project because of the experience I was able to attain in my first independent component, and the knowledge I was able to receive in my second independent component. 

(4) (What didn't work) If you had a time machine, what would have you done differently to improve your senior project if you could go back in time?

If I was able to go back in time, I would have wanted to manage my time more effectively. As the end of the senior project draws to a close, so does my college class, which would sometimes  conflict with the senior project deadlines. I felt that this inhibited me from working on my senior project as I would have liked, and have time to go to mentorship as often as I would have liked. Reflecting back, I would have liked not to take a college class this quarter, but if I didn't have that opportunity I would be missing out on the pertinent knowledge I have gained from my class. 

(5) Finding Value

How has the senior project been helpful to you in your future endeavors?  Be specific and use examples. 

The senior project has been really helpful for my future endeavors. As previously stated, I want to go into the medical field, specifically as a doctor. There are so many specialities that a physician can go into, but being introduced to cancer during the course of the senior project has really highlighted this speciality for me. I especially enjoy learning about the mechanisms that certain genes undergo when inhibited by the right carcinogens, and learning the process of metastasis (growth/spread of cancer to other parts in the body). At the beginning of the senior project, I didn't believe that my research skills were adequate enough, but throughout the senior project I have improved my research skills and feel confident about the sources I get. This skill is extremely important to have because of the fact that physicians and other medical professionals constantly have to research about new treatments for cancer or health condition, guidelines to treat a certain cancers, among other things. Through the senior project, I have also gained experience of what it's like to be in a hospital setting very frequently, but also what goes on in a speciality department. I feel like this experience has opened the doors for me in regards as to what to except in medical school/ hospital, which is a feeling that I enjoy very much. 

Senior Project Update!

Today, I had the amazing opportunity to talk with Dawn Holman, a behavioral scientist at the Centers for Disease Control and Prevention, located in Georgia. During this conversation, she really highlighted  the importance of educating youth about cancer prevention, and the preventative measures one should take! Dawn received her undergraduate degree in science from the University of Georgia and went on to receive her Masters degree in public health at Emory University. She became interested in skin cancer prevention due to the experiences she had as a research assistant at Emory University. Dawn has been working at the CDC since 2009.

Dawn works in the CDC's Division of Cancer Prevention and Control's Epidemiology and Applied Research Branch.

Blog 25: Mentorship

Content:

    Literal

·     Mentorship Log

·     Odette Van Der Eb, (626) 815-6063

Interpretive

 What is the most important thing you gained from this experience? Why? 

• The most important thing that I have gained from this experience is gaining  an insight into the medical field, especially from the perspective of a specialty department.Commencing the senior project, I knew I wanted to do something that pertained to the medical field, and the experience garnered only wants me to pursue my passion of actually being in the medical field. From this experience, I been associated with the materials commonly found in a hospital, such as gauzes, CHUX, various needles, and bacitracin ointment. I have also seen the interactions among the various staff members that have shown me that you are only as good as your team, which is an important skill to have for future references. I have learned how to communicate with doctors, nurses, and other pertinent staff members, and know that a professional and friendly demeanor is essential.  I dedicated the amount of hours I did for service learning not because I wanted to get so many hours, but because I truly enjoy being in the hospital setting and interacting with patients, doctors, nurses, and other staff members. 

Applied 
How has what you’ve done helped you to answer your EQ?  Please explain.

•  This experience has helped me answer my essential question , "What is the best way to treat skin cancer in adults?" because I had the opportunity to observe skin cancer very candidly, and the treatment process that is most commonly used for basal cell and squamous cell carcinoma.Through this experience, I was able to attain my first answer, which is proper diagnosis for best treatment. When practicing the Mohs procedure, the physician would extract some of the cancerous tissue and present it to the pathologist, who would then see if the doctor removed all of the cancerous tissue, or if he/she needed to get more. This process is vital because it ensures that the physician remove all the cancer. while leaving healthy tissue intact. I was also able to get my second answer, excellent follow-up care, through this experience because when the doctor schedules the a follow-up visit for the patient, the primary reason is to check for the recurrence of cancer. 

Melanoma Awareness Month!

May is officially deemed as Melanoma Awareness Month! According to the National Cancer Institute, it is estimated that 82,770 men and women (48,660 men and 34,110 women) will be diagnosed with and 12,650 men and women will die of cancer of the skin (excl. basal and squamous) in 2013!  Below you will find a picture that depicts the necessary precautions one should take in order to avoid skin cancer.

Blog 24: Exit Interview Questions

Content:  

(1) What is your essential question?  What is the best answer to your question and why?
My essential question is " What is the best way to treat skin cancer in adults?". The answers to my essential question are proper diagnosis for treatment, excellent follow-up care, and preventative education via high school curriculum. The best answer to my essential question is preventative education through high school curriculum because if we can educate our youth to be mindful of the sun's damage, they will practice precautionary measures to avoid skin cancer. Thus, the number of people that acquire skin cancer will eventually be lowered. A study done by the University of California, Irvine medical students reinforces this answer because of the survey results they achieved.  A total of 3 surveys were given to students in grades 6-12; one before a presentation given about skin cancer, one immediately after the presentation, and the final survey given 3 months after. The results showed that the presentation left lasting effects on the students about skin cancer and how critical it is to protect yourself. 

(2) What process did you take to arrive at this answer?
To arrive at my best answer,  I did an analysis of each of my answers. To get to my first answer, I first read research articles that taught me about skin cancer and the treatment options that are available to treat this disease, such as 'What are Basal and Squamous Cell Carcinomas?" by the American Cancer Society and a lecture given by Dr. Trisal. Next, with every medical procedure that it done, it is important for the physician to follow-up with the patient to make sure there are no recurrences of cancer and for the overall health of the patient. Finally, it is important to practice sun-safety by putting sunscreen with an SPF of 50 with protection for both UVA/UVB, wearing a hat, seeking shade, etc. Considering the fact that most skin cancers occur within the later stages of life due to a prolonged period of time of being out in the sun or having the exposure to UVA/UVB, it is important for youth to be aware of methods that protect them from the sun. After analyzing each of my answers, I selected preventative education via high school curriculum because even though proper diagnosis and excellent follow-up care are good ways to treat skin cancer, some of the characteristics of each could result in the patient having a poor quality of life, so by practicing sun-safety methods, you will avoid skin cancer and end up having a good quality of life.

(3) What problems did you face?  How did you resolve them?
The first problem that I faced was trying to find mentorship during the summer, especially considering that I wanted to do something in the medical field. Since hospitals begin accepting volunteers in early April until early June, I felt that I was late in the ballgame, so to say. Nevertheless, I went to countless hospitals, such as Pomona Valley Hospital, San Dimas Community Hospital, Huntington Hospital in Pasadena, and  East Valley Hospital/Medical Center, until Kaiser Permanente in Baldwin Park accepted me as a volunteer. The second issue that arose during the course of the senior project was a sudden topic change in the middle of second semester. When talking to Dr. Lee for my fourth interview, she told me that my topic was too general. Dr. Lee advised to me change  to change my topic to either skin cancer or thyroid cancer. Since I felt most comfortable with skin cancer, I decided to stick with this topic for the remainder of the senior project. Thus, I had to attain more research about my topic to fully educate myself about skin cancer and prevention methods.

(4) What are the two most significant sources you used to answer your essential question and why?
My first significant source was my first independent component, where I had the opportunity to observe the physician practice the Mohs procedure to remove either basal or squamous cell carcinoma, two of the most common types of skin cancer. This was my very first experience with skin cancer, even if my topic wasn't centered around that in the first place, which led me to experience the treatment that is used and the follow-up that the patient receives. My second significant source is the National Cancer Institute's webpage about skin cancer. This webpage has helped me tremendously by educating me about the different types of skin cancer, how cancer is staged, the treatment options, as well as the follow-up care that the patient should be receiving. 

(5) What is your product and why?
My product is learning how to work in a team, especially if I plan to work in the hospital setting later in the future. For my mentorship and my first independent component, I was able to observe how close the relationship is between the physicians and the nurses, as well as with the other staff working in the HNS department.  It is very important to have a professional, friendly demeanor with your fellow co-workers because they are the ones who are going to help you, especially during the procedures! Being a student at I-poly has really emphasized this skill for me, where for 3 years, you have to learn how to work in a team in order to fulfill the goal, and learn how to communicate with people to meet the goal.

Blog 23: 2014 Interview

Content:

1.  Who did you interview and what house are they in?
Jazmin Castro, East

2.  What ideas do you have for your senior project and why?
Jazmin has an interest in focusing her senior project on cosmetology. She has an aunt that works in the field, and she has always had a special interest to learn what encompasses cosmetology. I told her that there were a couple of people in the senior class that were focusing their senior project on cosmetology, so I would give her their contact information so she could know where they did their mentorship, or any other pertinent information.

3.  What do you plan to do for your summer 10 hour mentorship experience?
To complete the 10 hours of mentorship, Jazmin plans on mentoring with a person she meet on Career Day. On Career Day, Jazmin was able to meet a person who works in the cosmetology field, who was willing to be her mentor her the senior project. She's a bit unsure as to what she will be doing to complete the 10 hours, but I advised her that once she has a secure mentorship site and/or mentor then, she will most likely be with her mentor learning the tools of the trade.

4.  What do you hope to see or expect to see in watching the 2013 2-hour presentations?
Jazmin expects to see examples or deep explanations of what the senior's subject is and what specifically they did.

5.  What questions do you have that I can answer about senior year or senior project (or what additional information did you tell them about senior year or senior project)?

• For your mentorship, what do you have to do?

It depends on what you want to do for your topic. For example, my topic is skin cancer and at the hospital I just follow the nurses around and help out whenever I can. But in your case, since you want to do cosmetology and your aunt works in that field, then maybe she could let you practice on someone or something along those lines. If you can get first-hand experience in your topic, then that's better than following someone around because you are getting first-hand knowledge about your subject

• In your 2-hour what will you go over?

Basically the foundation of the essential question, the answers that answer your E.Q, and the product, which is what you hope to accomplish at the end of the senior project. For example, depending on the topic, you can say that you are going to attend college and specifically focus on your topic, or go attain a job in this field. Some of the time consists of the senior explaining what they did for their mentorship or their independent component. If your explaining your Answer 1 and you have a really cool story/experience that relates to it, then you have the opportunity to do so. 

Blog 22: Final 3-Column Chart

Final 3-Column Chart

Independent Component 2:Update

Here are the notes for lecture 2 of Biology of Cancer class! in this lecture, angiogenesis was discussed. angiogenesis is the growth of blood vessels to the tumor, which causes the tumor to receive nutrients, oxygen,etc. and thus causes the tumor to grow/spread. I also learned about the vascular endothelail growth factor (VEGF), which is the most potent proangiogenic pathway to get nutrients and other materials to tumor cells.
                         

Blog 21: Independent Component 2

LITERAL
(a) Statement saying: “I, Cynthia Garcia, affirm that I completed my independent component which represents 30 hours of work.”
(b) The sources that helped me complete the independent component were the Head and Neck Surgery Dept. at Kaiser Permanente BP, and the Biology of Cancer class taken at Cal Poly Pomona. 
(c) Independent Component 2 Log * see Sheet 2
Dr. Alas email:alas@csupomona.edu
Odette Van Der Eb: (626) 851-6063
(d) The 30 hours were completed by going to the hospital to do extra mentorship. There, I had to restock the exam rooms with the materials needed, such as gauzes, OR towels, CHUX, needles, etc. I am more familiarized with the materials used, so when aiding the medical assistants in Mohs, I can give them the exact material that they need. I have also completed the 30 hours by attending my college class, Biology of Cancer every Monday and Tuesday with Dr. Alas from 4-6pm. There I get to learn about the different processes a tumor takes to infect the body with this disease.  Explanation of what you completed.    

INTERPRETIVE 
Defend your work and explain how the significant parts of your component and how it demonstrates 30 hours of work.   Provide evidence (photos, transcript, art work, videos, etc) of the 30 hours of work.  
The work that I did for my Independent Component represents 30 hours of work because although I did not get the opportunity to attend Mohs Night as often as I would have liked, I was able to complete the 30+ hours by volunteering more at the Head and Neck Department. My experiences there have truly been worthwhile because it is fun interacting with the staff, since you learn so much from them. Considering the fact that I have been going regularly to the hospital, the medical assistants have gained more trust in me. When I was able to stay for Mohs Night, the medical assistants that I was observing had me put materials in the room or put surgical instruments in the "cleaning room." I also had the opportunity to converse with Jennifer Lee an M.D at the HNS department, who guided me into a more specific topic for my senior project.  The Biology of Cancer class that I am currently taking is an extremely important part of my Independent Component because it aids in my understanding of how a tumor develops and the process that it takes to metastasis. Learning biology, even more so the biology of cancer, can be difficult to the memorization that is needed for tests and reports, so it is vital for me to take through notes. As you can see from the blog posts below, these are alot of notes, but I learn something new everyday. This two hour, upper division course at Cal Poly has really tested my ability to memorize, but also retain information, as i just had my midterm this past Wednesday, so we will see how that goes. 

Independent Component 2 Update
Lecture Notes
Lecture 2 Notes
Mentorship Update


APPLIED
How did the component help you answer your EQ or support one or more of your answers.  Please include specific examples to illustrate how it helped. 
This component,specifically my college class, helped with with my overall senior project because it  helped me understand the biological process of cancer. Before taking this course, for my senior project I was only focusing on the type of tumor, stage, and possible treatment for the patient. With the new information that I have acquired through this class, I have learned that there is so much more to cancer than the type and treatments for it. For example, in lecture 2,  I learned about angiogenesis, the formation of blood vessels to the tumor cells in order to have nutrients and oxygen supplied to the infected area. Since the tumors form vasculature that connects them with the circulatory system, the tumor is transported to other parts of the body, known as metastasis. Metastasis plays an important factor in the treatment for the patient because metastasize is included in the staging of cancer. The staging of cancer plays a determining factor for the treatment the patient receives. The guest lectures have also aided me when closely examining the answers to my essential question, especially Dr. Trisal. Since I am now focusing my senior project on skin cancer, when he was lecturing, he enlightened about what I need to focus on regarding skin cancer, and the best treatment: prevention! This is my third answer to my essential question, but from analyzing the information that I have received from the guest lecturers, this answer is possibly my best answer. Surgery and follow-up care can only do so much for the patient, but prevention will lead people to have a lower risk of developing skin cancer, especially the most dangerous one, melanoma. 

Independent Component 2: Update

Today,a very special guest came by to discuss skin cancer. Dr. Vijay Trisal, from City of Hope, is a general surgeon, but received his fellowship in surgical oncology. Here is a link of his biographical information.  In today's lecture, Dr. Trisal discussed about the types of skin cancers, from the the most common (basal, squamous cell carcinoma, melanoma) to the most rare (merkecl cell carcinoma). He also discussed the staging of skin cancer, treatment options, and preventative measures one should take to avoid skin cancer.
Please excuse the pictures, they are not of the best quality.

Here is Dr. Trisal!

Independent Component 2: Update

Here are the notes from the first lecture of my Bio of Cancer class! We are currently in Week 3 of the class. These are all ALOT of notes, but they prove to be very informative. This first lecture was about the history of cancer, benign and malignant tumors, and the creation of tumor cells in the body.

Independent Component 2: Update

The Biology of Cancer class has finally begun! Before actually taking the class however, I had to get  permission from the professor and also from the Biology department due to the fact that it is an upper-division course offered at Cal Poly. Due to my standing, I had to do the over-ride process so I could actually enroll in the class. Here is my young scholar permission form, which officially allows me to take the course.

Blog 20: 3 Column Chart

Content:
3 Column Logic Chart

Mentorship Update 3/25/2013

The last time that I went to the Head and Neck Surgery department (3/14/2013), I took pictures of the new materials list that they have posted in every exam room. This list shows the materials needed in each room, and also the quantity. Before, I would restock the exam rooms based on what I had learned when I first restocked an exam room. I also took a picture of one of the posters that they have in the exam rooms, detailing the anatomy of the ear,nose, and throat in this case.

Blog 19:Senior Project and ESLR's

Content:

1.  What ESLR have you excelled in most in your senior project?
The ESLR that I have excelled in most during my senior project is Effective Learner.
2.  Please explain why you think you have excelled in this ESLR.
I believe I have excelled most in this ESLR is because I have proven, through me working bibliography, that I have an understanding about my senior project, and I have used the information from my research in presentations. Also, the research that I have gotten is from credible sources,mostly from academic journals, such as the American Journal of Otolaryngology. I have also done research outside of the selected research check dates, amounting to the articles that I have so far. To learn about my topic, I have diligently gone to my mentorship, where on certain days, I can see cancer first hand, which helps me understand how cancer can be extracted and what the doctor does during the procedure.
3.  Provide evidence from your senior project to support your claim (evidence is a photo of something you are doing, photo of something you made, etc).
The evidence shown is a link  of my up to date working bibliography, which shows that I have amounted 73 articles so far. Cancer of the Head and neck is one of the book articles that really aids my understanding of my topic, and gives me a great description of head and neck cancer physically and also pathologically.

Working Bibliography

This is a CT scan of nasopharyngeal cancer. The image also shows the tumor related to other anatomy located next to the pharynx, specifically the nasopharynx.

Mentorship Update

These are the forms that the receptionists and the surgery scheduler use for the patients when they first check in, or when they are in need of a surgery. The first form is completed by the receptionists when the patient is checking in, and it is then given to the either to HNS (Head and Neck Surgery), Speech, or Audiology. It is then taken by the appropriate department so the patient can receive the proper care. It is used by the nurses, doctors, audiologists, etc. to see what the patient came in for, and they receive the best care possible.








This form is used by the surgery scheduler of the department, who is in charge of scheduling the surgeries for ALL the head and neck surgery doctors! This form is inside the surgery packet (pictures are up on an earlier blog post) and it contains the necessary information for the patient to schedule their surgery. The surgery scheduler discussed the importance of patients scheduling their surgery on time, and she also mentioned that everything has to be correct, and to the doctor's orders. Sometimes, a doctor might need an instrument that isn't available in the OR, so the surgery scheduler has to make sure that what the doctor requested in included in the case report. This way, when the day of the surgery comes along, the doctor will have the necessary instrument to perform a successful surgery.

Blog 18: 2-Hour Meeting Answer #3

1.  What is your essential question?
My essential question is "What is the best way to treat head and neck cancer in adults?"
2.  What is your third answer to your essential question (write your third answer in a complete sentence)?
My third answer to my essential question is awareness about head and neck cancer through various mediums such as high school classes, education at the hospital via classes, etc. Education through these mediums, especially about factors that could cause head and neck cancer (smoking, alcohol consumption, sun exposure,etc) would help prevent head and neck cancer for the patients who are susceptible to it.
3.  What are three details to support or justify your third answer (details are examples or facts)?
The three details that justify my third answer are:

• "Reduced odds of head and neck SCC were found for the fruit, vegetable, and lean protein pattern.The fried foods, high-fat and processed meats, and sweets pattern was positively associated only with laryngeal cancer.These findings underline the importance of a dietary pattern rich in fruits and vegetables and low in high-fat and processed meats and sweets for prevention of head and neck cancer." Bradshaw, Patrick T., Anna Maria Siega-Riz, Marci Campbell, Mark C. Weisser, William K. Funkhouse, and Andrew Olshan. "Associations Between Dietary Patterns and Head and Neck Cancer: The Carolina Head and Neck Cancer Epidemiology Study."American Journal of Epidemiology 172.12 (2012): 1225-233. Print.
• "Our results thus show that even cancer patients with multi-drug abuse and heavy nicotine dependence can quit smoking successfully with structured support. This indicates that cancer could be a ‘teachable moment’ for patients with H&N cancer.The results of our study indicate that H&N cancer patients are interested in quitting smoking if support and help is being offered, even if it is possible that some patients felt obliged to accept participation to please the treating staff. However, a majority of the patients who stopped smoking during RT remained smoke-free during the first year after diagnosis, which indicates that their interest in quitting smoking was sincere." Sharp, L., Johansson, H., Fagerstrom, K. and Rutqvist, L.E. (2008), Smoking cessation among patients with head and neck cancer: cancer as a ‘teachable moment’. European Journal of Cancer Care, 17: 114–119.
• “Compared to subjects without family history, nonsmokers, and non or moderate drinkers, the OR was 42.6 for current smokers, heavy drinkers with family history. History of oral and pharyngeal cancer and laryngeal cancer is a strong determinant of oral and pharyngeal cancer risk, independent from tobacco and alcohol.” Garavello, W., Foschi, R., Talamini, R., La Vecchia, C., Rossi, M., Dal Maso, L., Tavani, A., Levi, F., Barzan, L., Ramazzotti, V., Franceschi, S. and Negri, E. (2008), Family history and the risk of oral and pharyngeal cancer. Int. J. Cancer, 122: 1827–1831.

4.  What source helped you prove this answer is justified for your essential question?
The source that has helped me prove that my 3rd answer is justified for my essential question is taking to Mark Dome, the physician assistant at the Head and Neck Department. When discussing my essential question with him, they told me that the the best way to prevent head and neck cancer, or any other form of malignancy, was for the patient (s) to stop smoking, reduce or stop their alcohol consumption, have dietary measures, and look at the family history because if it is a trait shared in the family, they are more likely to attain some type of head and neck cancer. The details listed above also helped me find justification about it is  imperative for adults to educate themselves about head and neck cancer.
5.  What do you plan to study next and why?
I plan to study the effects of not undergoing the proper procedure during treatment and diagnosis for head and neck cancer, specifically if the patient continues to smoke or practices activities that could increase their risk of developing secondary malignant tumor and/or serious malformations to the face.

Mentorship Update

The great thing about this packet is that it comes in both  English and Spanish, which benefits patients  in the understanding of their surgery.

Today that I went to do my regular hours at the Head and Neck Department, I was mainly restocking the exam rooms with supplies, but I was also completing surgery packets, which are shown below. These packets are given to patients requiring surgery either to remove a malignancy or other problems that require the treatment of surgery. In my opinion, the packet is very helpful to the patient because it explains the process of what the patient is going to go through and has the names and numbers of the person you can contact if you have any pending questions about your surgery.

Blog 17: Fourth Interview Questions

Content:
Post 20 open-ended questions for approval you want to ask an expert in the field of your senior project.  The first question should be your essential question and the other 19 must help you answer your essential question.   Once you have possible answers, you may want to ask questions to help you get a more in-depth understanding of your answers.


1.What is the best way to treat head and neck cancer?
2.What is the procedure for diagnosing head and neck cancer?
3.What can the doctor do to help the patient with the psychosocial effects of cancer?
4.What is the most dangerous head and neck cancer to have? Why?
a.What treatment would you recommend for the patient and why?
5.Does the follow-up care depend on the treatment and/or cancer of the patient?
6.How would you conduct a follow-up for the patient?
7.Is it necessary for a patient to receive follow-up care if they have stage 1 cancer or noncancerous tumors?
8.What are the advantages or disadvantages of each treatment option? Again does it depend on the type of cancer?
9.What are the complications that could arise during treatment or when having head and neck cancer?
10.Is different treatment prescribed for patients who have recurrent head and neck cancer, or is the same treatment given to the patient?
11.How can one reduce their risk of developing head and neck cancer?
12.What should patients talk to their doctor after the treatment ends?
13.What risks do patients runs when they have HPV or any other immunosupressed deficiency?
14.What are the health habits that patients can practice after treatment and beyond?
15.How do the various departments combine to ensure the best care for the patient?
16.What would be the “ultimate cure” of the patient?
17.Depending on the type of cancer, some patients may need reconstructive surgery. How would you go about doing that?
18.What is the most challenging anatomical site to reconstruct?
19.Can you explain what disease –free survival means?
20.What are the health habits that patients can practice after treatment and beyond?

Blog 16: 2-Hour Meeting Answer #2

Content:

1.  What is your essential question?
My essential question is "What is the best way to treat head and neck cancer in adults?"
2.  What is your second answer to your essential question (write your second answer in a complete sentence)? My second answer to my essential question is that the patient receive follow-up care after they have completed treatment.
3.  What are three details to support or justify your second answer (details are examples or facts)?
Follow-up care is extremely important after a procedure,  especially if the patient experiences head and neck cancer.

• Follow-up care is important because it helps to identify changes in health. The purpose of follow-up care is to check for recurrence (the return of cancer in the primary site) or metastasis (the spread of cancer to another part of the body).  www.cancer.gov
• Follow-up care visits are also important to help in the prevention or early detection of other types of cancer, address ongoing problems due to cancer or its treatment, and check for physical and psychosocial effects that may develop months to years after treatment ends. www.cancer.gov
• The frequency and nature of follow-up care is individualized based on the type of cancer, the type of treatment received, and the person’s overall health, including possible treatment-related problems. In general, people return to the doctor for follow-up appointments every 3 to 4 months during the first 2 to 3 years after treatment, and once or twice a year after that.   www.cancer.gov

4.  What source helped you prove this answer is justified for your essential question?
The source that helped me prove this answer was one of my research articles, number 38, which is "Esophageal pathology in patients after treatment for head and neck cancer", by the journal Otolaryngology- Head and Neck Surgery. This article illustrated the importance of having follow-up care because of the fact that some patients could develop serious medical conditions after they receive treatment for cancer. In this article, the majority of patients had oropharyngeal cancer, and after undergoing treatment, they developed esophageal problems.  The authors recommended that the patients needed to be diagnosed quickly after the treatment because the physician has to take into consideration how the patient feels when performing simple acts, such as swallowing. The physician has to perform tests to check if everything is functioning normally after a major procedure. The authors also highlighted that the results must not be based on patient symptoms alone; it is necessary for the doctor to perform routine examinations so the problem could be detected early, and there are no other complications with the patient.

5.  What do you plan to study next with your second answer and why?
What I plan to study next with my second answer is how doctors can provide the best follow-up care for the patient, depending on the type of cancer and the treatment that they have. By doing research about my second answer, I can see if follow-up care is one of the ways that the patient can receive the best treatment. I also want to learn the different ways that can follow-up care can have an impact on the patients. For example, if the patient were to develop psychosocial effects, how would the physician outline the care needed for the patient.

Blog 15: Independent Component 2 Approval

CONTENT:
(1) Write a description of what you plan on doing for your independent study component.
For my second Independent Component, I plan on continuing to go to Mohs Night, at the Head and Neck Surgery department at Kaiser Permanente Baldwin Park. Before, in my first independent component, I studied how the doctors practiced the Mohs technique and what were the procedures that the nurses followed during the procedure. Now, I want to examine how the doctors interact with the patients because that is an important step in the and well being of the patient during and after the procedure. I am also going to volunteer more and have the opportunity to take a college class at Cal Poly Pomona. The class that I am going to be taking is Biology of Cancer on Mondays and Wednesdays from 4:00-6:00pm (starting 4/2/2013).
(2) Describe in detail how you think your plan will meet the 30 hours work requirement.
My plan will meet the 30 hours work requirement because I will go every Monday or Thursday for 3 or 4 hours for several weeks to observe the doctors and medical assistants. On some occasions, they conduct Mohs on Wednesdays, so there is a possibility that I might attend that day so I can complete the 30 hours requirement. I am also going to go more often to volunteer and attend classes regularly.
(3) How does your independent study component relate to your working EQ?
My independent  component relates to my essential question, which is, What is the best way to treat head and neck cancer in adults, because from this experience I did not only get knowledge about the Mohs procedure, but I will also see how each of the different doctors interact with each patient and the methods they use to ensure that both the surgery and the patient are well. This relates to my EQ because treating a patient does not only involve the best treatment for them, but also the follow-up care they receive and what the outcome is for the patient. The Bio of Cancer class will also aid my understanding  about how patients acquire cancer and the effects that the tumor cells have on the body.

Blog 14: Independent Comp. 1

Content:

LITERAL
(a) Statement saying: “I,Cynthia Garcia, affirm that I completed my independent component which represents 30 hours of work.”
(b) Odette Van Der Ed
(626) 851-6063
 *specify MOHS Night
(c) Independent Component 1 Log
(d) During MOHS night, I would observe the doctors and the medical assistants perform the Mohs techinque for skin cancer. For the Mohs technique, the doctor would surgically extract the skin cancer from where the tumor is located, and the tumor is then taken to the pathologist so he/she could examine it. After the pathologist studies the cancerous cells, the doctor either has to take out more, or he/she can sew the skin back in place. Depending on how much the doctor has to take out, and where the tumor is located, the doctor may have to do reconstructive surgery. Not only would I observe, but I would also "assist" them by getting the items they needed such sutures, gauzes  and tape! I also got the opportunity to take a picture of the patient before the procedure.
INTERPRETIVE

The hours that I have done demonstrates 30 hours of work because although it seems like a quick procedure, it is not! It ultimately depends on the tumor location, size, and whether the tumor has progressed to other tissues in the face. During the procedure, I saw the doctor remove the tumor, which takes about 20-30 minutes. Then, the pathologist examines it, which takes about 30 minutes. However, since 2 doctors perform the Mohs procedure on 2-3 patients, it's going to take more time to have the pathologist examine the cells. Once the cells have been examined and the results come back positive, the doctor is ready to end the procedure  If the results have come back negative, the doctor still has to extract more cells,and the process is repeated until there is no more cancer. For example, on my first night of Mohs, I saw the doctor extract basal cell carcinoma from the right tip of the ear of a patient, however since the cancer had spread, the M.D had to cut even more of the ear. Eventually, once the doctor was done, there was a gap in the patient's ear. Once the results came back positive, the doctor was able to sew back the tumor site. Since the patient did not have a normal appearance of the ear, the doctor, having a done a fellowship on plastic surgery, had to do reconstructive surgery on the ear. The end result was amazing! Although there was a slight difference in the ear size, the ear looked totally normal and had a great appearance  Due to confidentiality reasons, I could not take pictures of the actual procedure, but I did take pictures of the handouts that are given to the patients explaining Mohs, and the Head and Neck Surgery department logo, where they do Mohs Night.
APPLIED
 This component helped me understand the foundation of my essential question because it provided information towards the first answer of my essential question. Being that skin cancer is classified under head and neck cancer, it gave me first hand knowledge about the Mohs procedure and what the doctors do to cure the patient of the tumor. From this experience I have learned about the 2 main types of skin cancer, basal and squamous cell carcinoma, and how the doctor helps the patient through the procedure. Through out the procedure, the doctor asks the patient if he/she is feeling alright, and makes easy conversation with the patient to lessen the nerves and stress. Although the Mohs procedure is not a major one, it helped me understand how beneficial surgery is, and the effectiveness of the treatment. Since the cancerous cells are being examined during the procedure and not after, the doctor doesn't have to estimate where to take out more cancer. I also got to view Mohs from the pathologist perspective because she helped me understand what they are looking for in the slide, and from what region the doctor's can cut from. For example, the pathologist told me that they based the drawing the doctor drew as a clock. The pathologist would then write "between 3:00 and 6:00pm", meaning that the doctor had to extract more cells based on the clock and the drawing that he/she did. This illustrated the importance of accuracy and observation so the patient could have the best outcome from the surgery.

Blog 13: Rough Draft of 30 Minute Presentation

30 Min. Presentation Lesson Plan

Blog 12: Third Interview Questions

1.What is the best way to treat head and neck cancer in adults?
2.What are the most common types of head and cancers?
3.How would the doctor go about diagnosing head and neck cancer?
4.What symptoms do patients experience when dealing with a head and neck cancer?
5.What are the  physical and mental effects patients experience when they have cancer?
6.What encompasses head and neck cancer?
7.What factors affect a patients prognosis?
8.What is the prognosis of a patient if they do not decide to have treatment?
9. How do other health problems or conditions affect the patient with head and neck cancer (ex. pregnant)?
10. How would the physician or physician assistant help the patient cope with the cancer?

Blog 11: Mentorship 10 Hours Check

Content:

1.   Where are you doing your mentorship?
I am currently doing my mentorship at Kaiser Permamente Baldwin Park, specifically at the Head and Neck Surgery department.
2.   Who is your contact?
My contact is Odette VanDerEb, clercial administrator at Head and Neck Surgery
3.   How many total hours have you done?
The total hours that I have done are 128.5.
4.   Summarize the 10 hours of service you did.
The 10 hours of service that I completed at the beginning of my mentorship were concentrated on concierge service, since at the time, I was not able to go into a specific department. During my concierge work, I guided patients to the departments that they needed to go, such as the Laboratory, Cardiology, or OB/GYN. Once I moved to the Head and Neck Surgery department,  I help the M.A's restock the exam rooms with supplies that are needed, make copies, and prepare surgery packets.