Approach to Care for Cancer Patients
Cancer is a disease characterized by the growth of abnormal cells that invade healthy tissues and spread to other organs through blood vessels. Cancer cells come from normal cells whose DNA has been damaged. Instead of the cells dying or getting repaired, they produce other abnormal cells. Cancer can be diagnosed through various methods. One of the methods is biopsy, which involves taking a tissue sample from the area suspected to be cancerous through surgical excision or with a fine tipped needle. The tissue is then examined using a microscope to find out if it contains cancerous cells (National Cancer Institute, 2014). Another method is endoscopy. This is an imaging technique in which the suspected area is observed by doctors by inserting a flexible tube that is fitted with a camera on one end into the body cavities such as the colon (National Cancer Institute, 2014). Another method of diagnosing cancer is through sentinel node biopsy. This process involves the surgical excision and examination of the closest nodes to the area suspected to be affected (National Cancer Institute, 2014). Cancer can also be diagnosed through blood tests. Some cancerous tumors produce substances referred to as tumor markers and these can be detected through blood tests.
Pap tests can also be used to diagnose certain cancer types such as cervical cancer by examining cells from the cervix using a microscope (National Cancer Institute, 2014). Respiratory cancers such as lung cancer can be diagnosed through the analysis of bronchial secretions and sputum under a microscope. Bone marrow biopsy is used to test whether the bone marrow is affected by blood cancers. Various imaging techniques such as CT scans, X-rays, ultrasound and MRI scans can be used in the diagnosis of cancer in different areas of the body (National Cancer Institute, 2014). MRI and CT scans are use to create a clearer image of the cancer through computer images. X-rays enable doctors to take pictures of the body and identify abnormal areas. Computerized axial tomography creates clear computerized pictures of the body so that the affected areas can be identified. An ultrasound is used to determine whether the suspected lumps are fluid or solid.
Cancer staging refers to the process of determining the severity of an individual’s cancer on the basis of the size and reach of the initial tumor and if the cancer has spread to other parts of the body (American Cancer Society, 2014). Staging is important in determining the patient’s prognosis and developing a treatment plan. The factors considered during staging include the location of the original tumor and cell type, the extent and size of the tumor, number of tumors, involvement of nearby lymph nodes, and the tumor grade. The tests used in cancer staging include imaging studies, physical exams, laboratory tests, surgical reports and pathology reports (American Cancer Society, 2014). Staging results in the grouping of cancer cases into categories such as in situ, localized, distant, regional and unknown. The in situ category means that abnormal cells are only located at the site where they developed. Localized category means that the cancer has not spread from the organ where it began. The regional category of cancer is used to describe a situation whereby the cancer has extended from the original site to nearby tissues, lymph nodes and organs. Distant category means that the cancer has spread to distant lymph nodes, organs or tissues. The unknown category refers to a situation where it is difficult to determine the stage of the cancer due to insufficient information.
The TNM system is very common in cancer staging. T refers to the tumor and it is used to describe its size and if it has spread to tissues nearby. N refers to node and is used to determine whether the cancer has extended to the lymph nodes nearby. M refers to metastasis and is used to determine if the cancer has extended to distant body parts (American Cancer Society, 2014). Each letter is assigned numbers and the higher the number the more severe is the cancer. For example, T1, T2, T3, describes the tumor size and the higher the number the bigger its size. Cancers range from stage 0 to stage IV. Stage 0 refers to cancer that has not extended to nearby tissues and can be cured through removing the tumor. Stage I cancer is in the early stages and it has not invaded the lymph nodes and other body parts (American Cancer Society, 2014). Stage II and III cancer has deeply invaded other tissues and has extended to lymph nodes. Stage IV cancer is in advanced stages and has spread to other body parts.
Cancer patients may experience a number of complications as a result of the disease. Some of them include depression and anxiety, pain, metastasis and nausea and vomiting (Mayo Clinic, 2014). Many cancer patients develop depression and anxiety as a result of the diagnosis and treatment of the disease. These emotional complications may become very serious and interfere with the patient’s ability to go through treatment. This may also lead to the patient committing suicide. These complications can be treated with antidepressant medication, support group therapy and psychotherapy to enable the patients to cope with the disease and lead normal lives. Pain is one of the physical complications that cancer patients go through as a result of the growth of the tumor (Mayo Clinic, 2014). Pain can either be somatic, visceral or neuropathic. It can be as a result of damaged tissues, central nervous system injury or pain affecting a certain area of the body. Cancer patients can manage pain through medications such as opioids and nonsteroidal anti-inflammatory drugs. Metastasis is another cancer complication which refers to the spread of cancer cells to different body parts such as the liver, lungs, bones and the brain (Mayo Clinic, 2014). This mostly leads to death. Metastatic cancer is not easy to treat but some tumors can be removed through surgery. Nausea and vomiting is another complication occurring in many cancer patients, especially in the advanced stages of the disease (Mayo Clinic, 2014). This complication can be treated with atypical antipsychotics such as risperidone and olanzapine. Ondansetron can also be used if other medications fail to work.
Cancer treatment has several side effects on the patients. Procedures such as chemotherapy and radiation affect patients both physically and emotionally and their quality of life is adversely affected (Stein, Syrjala, & Andrykowski, 2008). Patients may experience hair loss, anemia, nausea, pain, appetite loss, skin reactions and fatigue as a result of cancer treatment (American Society of Clinical Oncology, 2014). Receptors in the central nervous system and the gastrointestinal tract coordinate nausea and vomiting. Specific receptor antagonists have been identified and this has facilitated the development of effective drugs for the treatment of nausea and vomiting resulting from chemotherapy. Nausea can be treated with anti-nausea drugs as well as avoiding environments with noxious stimuli, utilizing relaxation techniques and adopting a bland diet. Anemia resulting from chemotherapy can be treated through drugs such as Aranesp and Epogen. Most cancer patients experience fatigue when undergoing chemotherapy and radiotherapy treatments. Cancer patients may be unable to overcome fatigue even after resting because of the impairment of this restorative ability. Fatigue can be managed by doing lighter tasks, resting, doing exercise and taking a proper diet. They should undergo radiotherapy and other activities during times when they have high energy levels and schedule rest times when there is severe fatigue (Stein et al., 2008). They should also delegate most of their routine activities in order to reduce fatigue. After discontinuing radiotherapy, fatigue disappears.
Cancer patients also experience skin reactions such as redness, peeling, dryness and breakdown as a result of radiotherapy. These reactions may last for a short time but skincare interventions such as colloidal soap, vitamin E cream and aloe can be used to alleviate them. Hair loss can be managed by cutting off the hair prior to the treatment and covering the head with wigs and hats. Appetite loss can be managed through eating one’s favorite foods often, taking meals in a pleasant environment and making food more appealing with condiments and spices (American Society of Clinical Oncology, 2014). Emotional side effects include depression, distress, fear and anxiety. Emotional side effects can be treated through counseling and medication (Stein et al., 2008).
References
American Cancer Society. (2014). Staging. Retrieved January 17, 2014 from http://www.cancer.org/treatment/understandingyourdiagnosis/staging
American Society of Clinical Oncology (ASCO). (2014). Managing side effects. Retrieved January 17, 2014 from http://www.cancer.net/all-about-cancer/treating-cancer/managing-side-effects
Mayo Clinic. (2014). Cancer: Complications. Retrieved January 17, 2014 from http://www.mayoclinic.org/diseases-conditions/cancer/basics/complications/CON-20032378
National Cancer Institute. (2014). Screening and testing to detect cancer. Retrieved January 17, 2014 from http://www.cancer.gov/cancertopics/screening
Stein, K. D., Syrjala, K. L., & Andrykowski, M. A. (2008). Physical and psychological long‐term and late effects of cancer. Cancer, 112(11), 2577-2592.
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