Write a paper (1,250-1,750 words) describing the approach to care of cancer. In addition,
include the following in your paper:
Describe the diagnosis and staging of cancer.
Describe at least three complications of cancer, the side effects of treatment, and methods
to lessen physical and psychological effects.
Approach to Care
Introduction
Cancer is a disease that arises when changes occur in a group of normal cells leading to
uncontrolled growth that forms a tumor. This manifested in all cancers except cancer of the
blood (leukemia). If untreated, tumors can grow and spread into the surrounding normal cells or
other body parts through the lymphatic system or the bloodstream affecting the nervous,
digestive, and circulatory systems. Globally, cancer has a high incidence and its burden is set to
rise. Research by Brennan et al., (2014) indicated that cancer kills more people compared to
malaria, AIDS, and TB combined. Clinicians have been at the forefront in the fight against
cancer. They have put in place important strategies that have aided them in understanding the
extent of cancer during diagnosis which has proven to be an important determinant of the future
care plan as well as the patient outcome.
Diagnosis and Staging of cancer
The diagnosis of cancer relies on physical examinations, blood tests, biopsies, and
diagnostic imaging tests such as CT scans, X-rays, and MRIs. Once an individual has been
diagnosed with cancer, the next procedure conducted is cancer staging. The staging process
entails categorizing the level of development of cancer. This practice is of great significance
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since it informs on the therapeutic measures that will be undertaken. The most common staging
system used across the globe is the TNM system. This system classifies tumors in relation to
their size (T), the degree of metastasis to the regional lymph nodes (N) as well as the degree of
metastasis to other body parts (M). In addition to this anatomical approach of staging, the
systems may also consider some prognostic aspects such as serum or histology tumor markers.
In the TNM system, the extent of the primary tumor is assessed and assign a value
ranging from T x, T 0, T is , T 1, T 2, T3 to T 4 depending on the size of the tumor. The absence or
presence of a tumor in regional lymph nodes is assessed and assigned a value of Nx, N0, N1, N2,
or N3 in relation to the degree of spread. Distant metastasis on the other hand is assessed and
values of Mx, M0, and M1 used to denote the extent of metastasis. Staging is an essential step in
the process of cancer management. For instance, if the staging is local the interventions that will
be effective in its management are radiation or surgery. If the disease has advanced and
metastasized to other parts of the body, a process that occurs through the lymphatic and the
blood stream, chemotherapy is considered to be the most effective approach for its management.
Most cancers are at stage four which is the most severe whereas some cancers have stage 0
whereby the carcinoma is in situ.
Complications of Cancer
Usually, cancer is associated with a number of complications that require proper
assessment and minimization in the process of caring for individuals suffering from cancer. Pain
has been ranked as one of the most common complication of cancer. Generally, pain is classified
as somatic pain which localized within a specific region, visceral pain which arises due to an
injury to a body organ, and neuropathic pain which arises when the central nervous system is
injured. In cancer, the pain arises as a result of the pressure that is exerted on nerves as the tumor
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grows and spreading into surrounding tissues. The pain can be minimized through the use of
analgesics such as ibuprofen or nerve blocking agents that are injected into the nerve or spine.
Weight loss is also another common complication that patients with cancer go through. Usually,
cancerous cells consume nutrients meant for the growth and maintenance of normal body weight.
These cancerous cells are extremely competitive. They deprive essential nutrients from normal
cells leading to poor growth. This complication can also arise during cancer treatment. This is
because treatment approaches such as chemotherapy can result to side effects such as nausea and
vomiting which in turn interfere with the eating habits of patients. Patients with cancer may also
suffer from dyspnea, a complication associated with breathing difficulties. A number of several
factors cause dyspnea. Some of these factors include hypoxemia, reduced erythrocyte count,
obstruction or narrowing of the airway, and anxiety. Dyspnea can however be managed through
the administration of oxygen to patients, use of lifestyle modifications such as living in well
ventilated buildings, and administration of anti-anxiety agents.
Care plan
For positive outcomes to be achieved in cancer management, effective strategies must be
used. Some of the important considerations that can be used in cancer management include early
diagnosis and initiation of treatment. Cancers tend to worsen as they metastasize. It is for this
reason that approaches have been designed to focus on preventing the spread of cancers which
the aim of stop the spread and removing cancerous cells. Mostly, cancer patients require a
holistic care whereby they overcome emotional, physical, psychological, and social challenges
associated with the disease (Imran et al., 2016). Provision of care that covers these characteristics
generates positive outcomes. Care givers understand well that cancer is a complex ailment that
requires integrated management which involves several medical specialties. Therefore, cancer
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patients are advised to consider attending health care institutions that provide multidisciplinary
services for efficiency. This will avoid incidents of visiting different specialists and receiving
fragmented recommendations. The care plan should also perceive patients as unique instead of
making assumptions that all patients require similar needs. Therefore, the care plan should
integrate the patient’s factors such as emotional health, physical health, age, spirituality, and
culture. The care plan should also be patient-centered whereby physicians encourage patients to
communicate freely. In addition, the patients’ preferences should be respected, patient education
optimized, and engagement of patients and their families in decision-making processes.
Side effects of Cancer Treatment
Like any other chronic disease, cancer has several side effects that can be categorized
generally as either psychological or physical. Some of the physical side effects of cancer include
diabetes, infertility or hypothyroidism. Hypothyroidism which is a condition characterized with
reduction in the secretion of thyroid hormones can arise due to the use of radiation which
destroys the thyroid gland. Patients with hypothyroidism manifest with cold intolerance, reduced
metabolism, and dry skin. However, hypothyroidism can be managed through the use of agents
that stimulate production of thyroid hormones such as iodine or administration of thyroxin or
levothyroxine. Radiation can also cause physical damage to the teeth. This is because high
radiation doses towards the neck region can interfere with the enamel exposing the patient to a
high risk of developing gum related conditions. Radiation can also kill saliva secretory cells
resulting in a condition referred to as xerostomia whereby patients present with dry mouth.
Corticosteroids such as dexamethasone and prednisolone are some of the important
agents used in treatment of cancer. These agents are used in reducing cancer-related
inflammation, boosting patient appetite, relieving sickness, and treat the cancer itself. However,
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these steroids trigger an increase in the of blood glucose resulting in diabetes. Patients that
develop diabetes are put on insulin regimen. Infertility arises in some severe cases. Research has
proven that chemotherapeutic agents that are alkaline in nature such as cyclophosphamide
damage the ovaries. In men, the use of chemotherapeutic drugs such as vinca alkaloid, methyl,
and platinum hinders the reproductive system. Fertility preservation can be achieved through the
embryo and ovarian tissue freezing.
Cancer treatment can also affect greatly the patients’ memory hindering their cognitive
ability resulting in conditions such as amnesia. This may pose a great problem especially among
students who may start experiencing learning problems. Fatigue is another common complication
results due to chemotherapy and radiation. Even the most active individuals find themselves
exhausted.
Patients who undergo surgery to have their lymph nodes removed are predisposed to the
risk of developing lymphedema a condition characterized with accumulation of lymph fluid and
may cause pain and swelling. Patients with hodgkins lymphoma may also have their spleens
removed and hence are at a high risk of serious infections since the spleen plays a significant role
in production of essential immune cells.
Chest radiation and chemotherapy can damage the lungs. Some of the drugs that have
been reported to cause lung damage include bleomycin, dexamethasone, prednisone, and
carmustin (Stewart & Wild, 2015). Surgery, radiation, and chemotherapy can affect effective
digestion of food. Moreover, radiation and surgery to the abdomen can cause scarring of tissue,
long-term pain as well as intestinal problems that may hinder digestion. Some cancer survivors
also tend to develop chronic diarrhea which reduces the ability of the body to absorb nutrients.
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References
Brennan, M. E., Gormally, J. F., Butow, P., Boyle, F. M., & Spillane, A. J. (2014). Survivorship
care plans in cancer: a systematic review of care plan outcomes. British journal of
cancer, 111(10), 1899-1908.
Imran, F. S., Andrews, C., Doerner, K., Heatherington, B., Hodes, S., Pictor, N. M., … &
Jamshed, S. (2016, January). Survey of cancer survivors’ understanding of their cancer
care and follow-up plan. In ASCO Annual Meeting Proceedings (Vol. 34, No. 3_suppl, p.
51).
Stewart, B. W. K. P., & Wild, C. P. (2015). World cancer report 2014. World.