Approach to cancer care
Cancer is a group of diseases that are characterized by unregulated cellular growth. The uncontrolled cellular division leads to malignant tumors that invade and destroy surrounding organs and tissues. It may eventually spread to other far parts of the body from where it started through the bloodstream and the lymphatic system. Basically, there are three forms of cancer depending on the affected body parts: carcinomas (surface tissues such as the breast), sarcomas (soft tissue or bone) and lymphomas that affect the bone marrow or the lymph nodes (Pories, 2009). The disease accounts for 25% of total mortality annually in America and is the leading killer globally. The most common types in men are prostate, lung and colorectal cancers while breast, lung and colorectal are the most common in women. It has various causal factors such as alcohol and tobacco use, hereditary factors, occupational risk, age, infections and poor diets.
Cancer has extensive physical and psychological effects on the patients. Therefore, care for patients must serve to counter these effects. Initially, cancer care entails health promotion to reduce the controllable risks. This is done through raising awareness about the symptoms and causal factors associated with cancer, regular medical checkups and screening. If a case is detected, care shifts to treatment. Care for diagnosed cases is complex and requires the involvement of multiple specialists. These include surgeons, medical oncologists, radiation oncologists and nurses. For effective care to patients, the specialists work together as a team to decide on the best approach to pursue. This is because cancer patients are varied and there cannot be a standard approach to care. A good approach to care should also address other issues that come with cancer such as coexistent diseases and patients’ health behaviors (Josephine et al, 2010).
However, patient care should be individualized and patients should be involved in making decisions about their treatment and care. They should also be respected and their opinions taken into account. A good approach should also ensure that communication between the team, patient and other interested parties such as the patient’s family is upheld. It should also incorporate an advocate of the patient so that the patient’s concerns are handled properly. The advocacy role is usually relegated to the nurse who also uses empathy and knowledge to detect and control physiological suffering. The nurse is usually the contact person to the patient and therefore must have the ability to communicate effectively and in a caring manner in order to meet the information needs of their clients and their families.
Diagnosis and staging of cancer
Early diagnosis of cancer is important for treatment. The diagnosis varies with the type of cancer. Some types, such as breast and prostate cancer, can be detected through routine physical examinations or screening in case the disease is suspected. Majority of cancers are detected and diagnosed by feeling a tumor or when other symptoms are noticeable.
Cancer diagnosis requires comprehensive physical examination as well as a complete medical history. Diagnostic tests can then be used to detect any abnormalities and also confirm the presence of cancer. In case a tumor is detected, various imaging tests such as X-ray, Magnetic Resonance Imaging, Computer Tomography and ultrasound assist to determine the location and the size of the tumor. A biopsy is then performed to confirm the presence of cancer cells (Pories, 2009).
Staging occurs after confirmation of the presence of cancer. It entails the description of the extent of the cancer depending on how it has spread in the body. Staging assists physicians to design the appropriate treatment and further to estimate the appropriate prognosis. Wrong staging would lead to improper treatment.
There are many staging systems. However, they have some common elements that they consider such as the size of the primary tumor, the level of involvement of the lymph nodes, the size of the tumor and whether metastasis is present or absent.
One of main systems used is the TNM system. It is widely recognized and many medical facilities use it as their main method of reporting. The system is based on the size of the tumor, involvement of the lymph nodes and the presence of metastasis. This system is used for majority of cancers with the exception of brain hematological cancers. These can be staged through the UICC system. However, staging differs with the different types of cancer. Another system of staging is the Overall Stage Grouping that utilizes roman numerals to indicate the extent of spread of cancer. Under this system, cancer is classified into the following groups:
- Stage 0- abnormal cells are present but only in the layer that they developed (In situ).
- Stage I: the cancer is localized. It has not gone beyond the organ it developed from.
- Stage II: cancer has progressed beyond the primary site.
- Stage III: the cancer has progressed to distant organs or lymph nodes.
- Stage IV: the cancer has metastasized and spread to various organs all over the body.
Complications of cancer
Depending on the stage of cancer, complications can be painful or even fatal. Among the most common complications are sleep disorders, excessive pain and depression. Other complications of cancer include:
- Mental and emotional complications
Cancer patients are susceptible to depression. This is because they experience anxiety and grief upon realizing that they have cancer. The treatment process is also painful, tedious and requires a change in lifestyle. Depression predisposes cancer patients to suicidal thoughts and they are more likely to commit suicide than people without cancer. Patients with mental and emotional complications require psychotherapy and use of anti-depressants.
- Physical complications
The spread of the tumor to surrounding organs presses against nerves leading to pain. This pain can be treated with anti-inflammatory medications and opioids.
Metastasis is the main cause of death among cancer patients. This is because it leads to failure of vital organs such as the brain and the lungs. Metastatic cancer is hard to treat and highly reduces chances of survival.
Side effects of cancer treatment
Chemotherapy and radiation which are used for cancer treatment have adverse effects on the patient’s quality of life. Chemotherapy leads to weakening of the patient’s immune system which predisposes him to attack by other diseases. It also leads to loss of hair and nausea. Radiation is normally used to treat internal and exterior tumors and has such side effects as throat pain and skin irritation. In the long term, it can lead to more adverse effects such as damage of salivary glands.
Lessening physical and psychological effects
Cancer and its treatment have physical and psychological effects on patients and their families. One of the methods of reducing these effects is informing the patients of the expected effects. This enables them to prepare mentally which helps them to cope during treatment. Physical effects can be lessened through the use of medication and physical exercise. Psychotherapy is advised for patients with depression or other mental problems due to cancer. Patients are also encouraged to join sharing groups where they hear the experiences of others and share their own.
Care to cancer patients is different due to the nature of the disease. An integrated approach to cancer care is the most effective. It takes into account the effects of cancer and its treatment and also other factors arising from the disease such as psychological problems.
Jessica Corner, C. D. (2009). Cancer nursing: Care in context. Hoboken, NJ: John Wiley & Sons.
Josephine Tonks N. Fawcett, A. M. (2010). Perspectives on cancer care. Hoboken, NJ: John
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Kerryn Phelps, C. H. (2012). Cancer general practice: The integrative approach series.
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Pories, S. E. (2009). Cancer. California: ABC-CLIO.