Cancer Care Approaches and Decision-Making


Cancer is a serious condition that accounts for 24 and half-million deaths across the U.S. (CDC, 2018). The development and structuring of knowledge about different aspects of cancer is a paramount task that requires zealous academic work. Due to the grave nature of this condition and its high mortality rate and prevalence, this paper will discuss the process of diagnosing, staging cancer, complications, side effects, and methods to mitigate them.

Diagnosis and Staging

One of the most significant problems with cancer is the fact that it may manifest through a variety of symptoms. Cancer itself does not produce any adverse and visible body reactions that could be recognized, yet thy surface from tumors cancer develops in the body. In many forms of cancer, the location and character of pain may help diagnose it. Apart from a physical examination that might help identify certain cancer types, such as breast cancer, doctors utilize a variety of techniques. Among them are blood, urine tests, CT, X-ray, MRI, PET scans, and certain other types of analyses depending on the type of suspected cancer.

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There are two major methods of staging cancer including Tumor-Nodes-Metastasis (TNM), and the 0-IV system. While the TNM method allows for a more detailed description of cancer, the 0-IV system is for more general and patient-oriented needs. Thus, within TNM, Tumor can describe the size and location of the main tumor within TX -T4 diapason. The same parameters apply to N that describes lymph nodes. M communicates whether the metastasis can be measured, confirm or disprove the fact of their presence in other body parts.

Within a more straightforward system, stage zero means that cancer cells are present, but have not affected organs or tissues. Stage one through three communicates the size and the number of metastases. Stage four denotes a situation when cancer has spread to multiple distant parts of the body and caused significant damage.

Possible Complications

Among the possible complications, there are a plethora of adverse conditions, including pain, weight loss, and nausea. Pain may vary in location and magnitude depending on the type of cancer from which an individual is suffering. The pain may be either chronic or acute depending on the time and conditions under which the patient experiences it. Acute pain may be caused by a single event such as applied pressure on the cancer-affected tissue or organ and last for a short period.

Chronic pain is more persistent and is defined as pain that lasts for three or more months in a row, and may result from continuous pressure on nerves, bone tissue degradation, or come from other sources (American Cancer Society, 2015).

Weight loss is another possible complication in the development and treatment of cancer. To develop, cancer cells may deprive normal cells of nutrients that the body absorbs with food, which decreases its fitness and results in multiple conditions such as fatigue and weight loss (Macasa & Jarrett, 2016). It is also paramount to mention that having a more nutrient-rich diet does not help reduce this particular adverse effect of cancer. Among the physical effects of weight loss are the decreased mobility, weakness, and dependency on others to fulfill daily functions.

Nausea is “an unpleasant sensation of the need to vomit and is associated with autonomic symptoms” (Sandoval & Rice, 2015, p. 490). As the researchers argue it may arise not only from treatment but from cancer itself. Certain types of brain cancer of metastases to the brain can cause this feeling as well. Loss of electrolytes such as sodium and potassium could also be a reason for nausea.

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Side Effects of Treatment

All three above-mentioned cancer complications can be the treatment side effects, as well as the range of other unpleasant consequences such as hair loss, fever, skin problems, and more. Hair loss can be identified in people undergoing multiple chemotherapy or radiation therapy sessions. Yet, not all drugs used in chemotherapy cause hair loss. Radiation therapy can become a reason for hair loss if a substantial amount of it is administered.

Hormonal therapy with drugs such as Afatinib, Cetuxima, Erlotinib, and a range of other pharmacy solutions could result in this condition (“Hair loss or alopecia,” 2011). Fever can become a result of a chemotherapy-induced condition called neutropenia which results in the patient’s reduced resistance to infections. When infection enters the body, the latter elicits a response which is indicated by elevated temperature. Skin issues may arise in different forms including dryness, itchiness, or color change. Similar to the above-mentioned issues, adverse skin conditions are caused by chemotherapy, radiation therapy, or hormonal therapy depending on the type of cancer, the condition of the patient, and the combination of chemicals.

Methods to Reduce Physical and Psychological Side Effects

About the patient’s type of cancer assigned a treatment plan, and reaction to it, a doctor could recommend one or another side effect management therapies. Pain, as one of the most common physical side effects of treatment, is often reduced by painkillers, yet, a prior assessment should be conducted and a pain management plan developed. To device such a plan, there is a need to establish the cause, type of pain, the medicine to mitigate it, dosage, as well as safety procedures (Mosher, Ott, Hanna, Jalal, & Champion, 2015).

It could also be beneficial to have a pain diary to which a patient, using a scale from one to ten, writes down his or her sensations. Other parameters such as location, duration, character, factors of impact should also be captured. Such information could help caregivers to adjust pain management plans.

About psychological coping strategies, each person is unique in their reactions to such diagnosis and, therefore, there is a variety of ways to manage side effects. According to Mosher et al. (2015) among lung cancer patients, 52% experience anxiety and depression associated with their diagnosis. Religion, loved ones, hope, seeking support and other sources of coping may be exercised by patients. Here, it is important, that caregivers demonstrate full support of the patient’s decision and assist him or her in implementing their method. However, corrective action may be required if the oncologist’s prognosis changes.

Conclusion

All in all, cancer is a condition that requires a systematic approach and informed decision-making. Each aspect of the treatment, starting from diagnosis and psychological coping needs to be carefully managed using only evidence-based strategies and techniques. Each cancer case is different, and nurses and physicians need to be attentive to the patient’s needs and concerns and well as physiological and psychological symptoms to be able to timely address changes.

References

American Cancer Society. (2015). Facts about cancer pain. Web.

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Center for Disease Control and Prevention (CDC). (2018). NPCR and SEER incidence – U.S. cancer statistics public use databases. Web.

Hair loss or alopecia. (2011). Web.

Macasa, E., & Jarrett, P. (2016) The impact of weight loss on patients with cancer. Nursing Times, 112(11), 20-22.

Mosher, C. E., Ott, M. A., Hanna, N., Jalal, S. I., & Champion, V. L. (2015). Coping with physical and psychological symptoms: A qualitative study of advanced lung cancer patients and their family caregivers. Supportive Care in Cancer, 23(7), 2053-2060.

Sandoval, M., & Rice, T. (2015) Nausea and vomiting in cancer: It’s not always the chemotherapy. Emergency Medicine, 47(11), 490-492.

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