Cancer is one of the top leading causes of death worldwide. According to the World Health Organization, the number of people who died from cancer globally reached 8.2 million in 2012 (IARC, 2014). It is considered an imminent “human disaster” because in the next two decades, deaths from cancer can reach as high as 18 million a year with the number of cases reaching 22 million (Hume & Christensen, 2014). This disease affects not only the patients but also their families. Studies have documented the physical and psychological effects of cancer treatments. Thus, it is important to determine the side effects of treatments to be able to provide the most appropriate care for cancer patients. This paper provides an overview of cancer care including a description of cancer stages, the disease complications, and recommendations to alleviate side effects of cancer treatments.
Diagnosis and Staging of Cancer
Cancer is a disease of cells that can affect any part of a person’s body. It is also referred to as a malignant tumor or neoplasm. Most prevalent are cancers of the lung, liver, stomach, colorectal, breast, and esophageal (WHO, 2014). Diagnosis of cancer requires the conduct of a biopsy to determine whether a person has cancer. Based on the results of the biopsy the staging of cancer can then be done. Staging means the rating that the doctor gives to the current condition of the cancer. Before the cancer stage can be determined, the doctor gets the TNM scores firs. The TNM system is utilized by the American Joint Committee on Nursing and the Union for International Cancer Control. In this system, the doctor would assess the tumor (T), nodes (N), and metastatis (M).
T scores. This rating is an assessment of the primary tumor. The doctors look at the size of the tumor and whether there are extensions of the tumor. The score of T0 means no primary tumor while TX means the primary tumor cannot be checked. The scores of 1-4 indicate how large the tumor has become, and a higher number means a larger tumor (NCCN.org).
N scores. This rating refers to the spread of cancer cells in the surrounding lymph nodes. N0 means no cancer in lymph node and NX means the area cannot be checked. Scores are from 0-3 and higher scores means more areas are affected (NCCN.org).
M scores. This rating refers to metastatis or the spread of cancer cells to other sites beyond the nearby lymph nodes. Metastatis is the major cause for the death from cancer (WHO 2014).There are only 2 scores for this criterion. The cancer can either be M0 (not spread) or M1 (has spread or metastasized.
After determining the TNM scores, the doctor can now identify the cancer stage of the patient. It is important to know the stage of the cancer because this will assist in planning the appropriate treatment for the case. The staging likewise predicts the chances of recovery for the cancer patient (ASCO, 2013). There are four cancer stages and these are enumerated below.
Stage 0. The cancer cells at this time have not spread to other sites. This is a condition means it is highly curable by the removal of the entire tumor (ASCO, 2013)
Stage 1. This is referred to as the early stage cancer. Here, the primary tumor has not grown deeply in the tissues surrounding the primary tumor. It has not spread to the lymph nodes or to other parts of the body (ASCO, 2013).
Stages 2-3. In this stage the tumors are larger and have already spread into the lymph nodes. The higher number means the spread is wider, although the cancer cells have not spread to other parts of the body yet (ASCO, 2013).
Stage 4. This is referred to as the metastatic cancer. This condition means that the cancer cells have spread to the lymph nodes as well as to other organs of the body (ASCO, 2013).
The cancer staging described above which uses the TNM system, is applicable only to cancers cells that are manifested through the formation of solid tumors, such as those in colon cancer, breast, and lung cancers (ASCO, 2013). For other types, for example cancers in the blood and brain, there are separate staging systems used. Childhood cancer also has a separate staging system.
Complications of Cancer
Cancer can cause bone complications, oral complications, malignant effusions, and anorexia/ cachexia. Bone complications include bone loss and bone pain. Malignant effusions refer to the spread of cancer cells to other parts of the body affecting other vital organs. Anorexia, cachexia, and malnutrition are likewise cancer complications that affect at least 40 percent of patients.
Methods to lessen side effects of care
The treatment of cancer can cause side effects that affect the quality of life of the patient. These effects include CINV, fatigue, and pain. Methods to lessen each of the identified side effects are discussed below.
CINV. Chemotherapy-induced nausea and vomiting (CINV) has been observed among cancer patients for decades. The physiological effects of this condition include “fluid and electrolyte imbalance, dehydration, anorexia, decreased absorption, and renal elimination of medication” (p.416). Nausea or the condition of “feeling sick” and vomiting or the act of “throwing up” can either be acute CINV, delayed CINV, or anticipatory CINV. Anticipatory CINV can only occur when the patient has already experienced either the acute or delayed. Acute CINV happens immediately after the chemotherapy drugs are administered while the delayed CINV takes place a day after the chemo therapy drugs have been given. Measures to address this side effect include changes in the diet, counseling to determine fear and anxiety, and alternative treatments like acupuncture.
Fatigue is also a common side effect of cancer treatments.
Pain results both from the cancer disease and the treatment mechanism as well.
Hume, T. & Christensen, J. (2014, Feb 5). “WHO: Imminent global cancer ‘disaster’ reflects aging, lifestyle factors. CNN.com. Retrieved from http://edition.cnn.com/2014/02/04/health/who-world-cancer-report/.
Kearne, N. & Richardson, A. (2006). Nursing Patient with Cancer: Principles and Practice. London: Elsevier Ltd.