Cancer Care as a Nursing Process

Introduction

The term “cancer” is used to describe a range of diseases associated with the uncontrolled intense growth of cells that tend to form tumors. Certain factors can cause changes in genes that provoke cancer, and these factors can lead to replicating cells in one of the organs. If these atypical cells invade other organs, this phenomenon is known as metastasis. The types of cancer include breast, lung, prostate, and skin cancer among others (Tobias & Hochhauser, 2015). While discussing possible factors that can provoke cancer, researchers focus on stress, ecology, and genetic issues (Gaur & Srivastava, 2014). The problem is that specific causes of different types of cancer are understudied to be effectively predicted and addressed. The purpose of this paper is to describe the approach to caring for cancer, focus on diagnosing this condition, describe stages of cancer, determine its complications, analyze side effects of treatment, and examine methods of responding to physical and psychological effects.

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Diagnosing

In many cases, cancer can develop in the organism without specific symptoms and pain, and these aspects make the process of diagnosing cancer complicated. As a result, cancer can be diagnosed at the metastatic stage. In order to diagnose cancer referring to patients’ symptoms, healthcare professionals use the blood test to identify cancer markers pointing out the presence of cancer cells, and conduct tests to examine the possible mutation in genes (Miller et al., 2016). Furthermore, they also use screening, X-rays, Magnetic Resonance Imaging, and computed tomography to diagnose lung and breast cancer, for example, and they conduct a biopsy.

The focus on cancer markers like BRCA1, 2 for breast cancer, or CA-125 for ovarian cancer is important at the initial stage of developing the disease or when a patient wants to know his or her susceptibility to this or that type of cancer. Screening and different types of imaging are effective when it is necessary to identify possible tumors in different organs and examine metastases (Gaur & Srivastava, 2014). A biopsy is traditionally used for examining cells when solid tumors are present (Tobias & Hochhauser, 2015). In addition, innovative techniques are created by scientists in order to propose more effective methods of diagnosing cancer at the first stage of its development.

Staging of Cancer

There are four stages of cancer that differ in terms of the size of a tumor and the speed of cancer cells’ growth and spread. Stage 1 is associated with the initial stage of growing cancer cells and with a small tumor. At this stage, cancer is not spread to other organs. Surgery at Stage 1 is highly effective to remove tumors (Benitez-Majano, Fowler, Maringe, Di Girolamo, & Rachet, 2016). Stage 2 is associated with the further growth of a tumor or the number of cancer cells in the organ, but at this stage, cancer does not spread to other tissues (Tobias & Hochhauser, 2015). However, depending on the type of cancer, Stage 2 is also related to the initial spread of cancer cells to lymph nodes.

Stage 3 indicates that a tumor is large and cancer cells can be found in the tissues surrounding the affected organ. Stage 4 is associated with metastases as cancer cells are spread to other organs and grow there. There is also Stage 0 which is known as “carcinoma in situ,” and that means the presence of atypical cells in a patient’s body (Tobias & Hochhauser, 2015). This condition can potentially lead to the development of cancer in the future, but at this stage, cancer cells do not form a tumor.

Complications of Cancer

Complications of cancer are various, and they can affect different body systems depending on the type of cancer and its stage. The first type of complications to focus on includes endocrine abnormalities. The development of cancer, the associated treatment, and the emotional state of the patient cause changes in hormone levels that lead to such problems as adrenal insufficiency, hypercalcemia, and hypoglycemia among other conditions. The associated condition is the development of hematologic problems and risks of thrombosis (Tobias & Hochhauser, 2015). The second possible complication is the problem with the gastrointestinal tract leading to nausea, vomiting, and bleeding. The third group of complications should include interchanged problems, such as pain, fatigue, and mood disorders. Patients suffering from cancer usually experience significant pain, their state causes continuous fatigue, and all these factors lead to the development of mood disorders like anxiety and depression (Gaur & Srivastava, 2014). Depending on the stage of the disease, these complications can have different symptoms and effects on a patient’s physical and emotional state.

Side Effects of Cancer Treatment

Radiation and chemotherapy are the key types of treating cancer that have numerous side effects. Radiation therapy often causes skin irritation and dryness, tiredness, nausea, diarrhea, difficulties when swallowing, numbness, and problems with teeth among many others that differ with reference to the type of cancer and affected organs. Side effects associated with chemotherapy include hair loss, nausea, bleeding, fatigue, anemia, constipation, difficulties when swallowing, diarrhea, numbness, kidney problems, and changes in weight among others (Miller et al., 2016). Women can suffer from premature menopause and problems with fertility (Tobias & Hochhauser, 2015). It is important to note that not all patients may observe these side effects when being treated with the help of radiation therapy or chemotherapy, and the presence of side effects depends on the response of a patient’s immune system to the selected therapy. Moreover, one should note that surgery also has side effects, including chronic pain after removing a tumor or tumors.

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Decreasing Physical and Psychological Effects

Physical effects of cancer include chronic pain and significant changes in a patient’s and his or her family’s lifestyle. Thus, patients can suffer from pain because their cancer cannot be untreated or as a result of surgery. Moreover, persons with cancer or after treating it can be prescribed to take medicines causing side effects and change their habits regarding their daily life (Tobias & Hochhauser, 2015). Moreover, the immune system of persons surviving cancer is often affected, causing the development of chronic diseases or frequent cases of infections. These physical effects are usually addressed with the help of prolonged pharmacological therapies and rehabilitation programs that are directed toward improving individuals’ health after surviving cancer (Miller et al., 2016). Therapies oriented to relieving pain are used in cases when individuals suffer from untreated types of cancer.

There are also multiple psychological effects of cancer. They include stress, anxiety, depression, suicidal ideations, and a sense of hopelessness among other problems. In order to address these conditions, patients with cancer usually work with psychologists, counselors, or therapists to learn how to cope with distress and overcome fear associated with their state (Tobias & Hochhauser, 2015). From this perspective, psychologists and therapists apply a range of methods to work with their patients, including exercises in relaxation, talk therapy, group therapy, training in coping with side effects of treatment, and drug therapy to address depression (Gaur & Srivastava, 2014; Miller et al., 2016). As a result of these methods and strategies, individuals with cancer or surviving it can cope with psychological stress, anxiety, and fear while receiving emotional support and required education.

Incidence and Mortality Rates

The most common types of cancer are breast cancer, lung and bronchus cancer, and prostate cancer. As of 2018, the cancer incidence rate is 440 per 100,000 males and females annually (National Cancer Institute, 2018, para. 5). The cancer mortality rate is 162 per 100,000 males and females annually (National Cancer Institute, 2018, para. 6). The breast cancer incidence rate is 124.7 per 100,00 females, whereas the colon and rectum cancer incidence rates are 45.2 per 100,00 males and 34.3 per 100,000 females (American Cancer Society, 2019, p. 7). The incidence rate of lung and bronchus cancer is the highest for males (71.3 per 100,000 men). Per 100,000 females, the breast cancer mortality rate is 20.6, and the colon and rectum cancer mortality rate is 11.9. Per 100,000 males, the colon and rectum cancer mortality rate is 16.9, and the lung and bronchus cancer mortality rate is 51.6.

Some new cases of cancers could be prevented by reducing risk factors. In fact, approximately 20% of cancers are caused by excess body weight, poor nutrition, a lack of physical exercise, and smoking (American Cancer Society, 2019, p. 1). Specifically, lung cancer is mainly provoked by tobacco use and exposure to second-hand smoke, radon gas, and carcinogens. Excessive exposure to the sun, fair skin (which provides less protection from UV radiation), high-altitude climates, and moles are regarded as factors that increase the risk of skin cancer. The main risk factors for breast cancer are being a woman and getting older.

The key factor contributing to the yearly incidence and mortality rates of various cancers in Americans is a lack of access to health care services, which is especially the case for racial and ethnic minorities. Among behaviors that account for an increase in cancer incidence and death rates are engaging in risky sexual activities and drinking alcohol (Centers for Disease Control and Prevention, 2018). Finally, people who are treated at low-volume hospitals are more likely to die because of cancer than those treated in high-volume hospitals.

American Cancer Society: Education and Support

As an organization whose mission is to lead the fight for a world without cancer, the American Cancer Society (ACS) can provide support and education to people diagnosed with cancer and their families. ACS offers a 24/7 helpline to answer questions and address the concerns of those who need assistance. Also, the organization has programs and services to help those struggling with cancer manage their lifestyle by providing psychological and emotional support. For example, the Reach to Recovery program provides volunteers who call or visit women with breast cancer to get them through their own cancer experience. The program can be recommended to women diagnosed with breast cancer as it offers useful online training. It assists people in coping with various aspects of the disease, including how to talk with their family about cancer and how to work with this condition (American Cancer Society, n.d.). The National Resource program may be recommended to patients whose reproductive function is impacted by cancer. This is because it provides information about how to preserve fertility when diagnosed with cancer and allows patients to seek fertility preservation services in their area.

The Nursing Process

The nursing process functions as a systematic guide to provide safe and effective care for cancer patients. Due to the enormous impact of the condition on a person’s physical and mental quality of life, the nursing process is imperative in oncology services. At the assessment stage, a nurse uses a thorough framework to collect both subjective and objective data about a patient to make a complete assessment of their needs regardless of the reason for a patient’s visit. At the diagnosis stage, clinical judgment is made based on the data collected in patient history. The nursing diagnoses should be validated by a nurse’s ability to link the patient’s characteristics to related factors. At the planning stage, a nurse clearly formulates goals and expected outcomes that impact patient care. In agreement with a client, a nurse creates a care plan to address or mitigate each of their problems.

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At the implementation stage, a nurse makes all the interventions outlined in the care plan. This phase requires that a nurse establish a close relationship with a patient and their family, apply direct or indirect care, and medication administration. It is important that tasks should be appropriately delegated and monitored. Finally, at the evaluation stage, a nurse assesses the progress in reaching the defined goals and desired outcomes. Depending on the new assessment data, a nurse may return to the third phase to adopt a plan of care.

Undergraduate Education

Nursing is challenging, as it requires a great amount of critical thinking, decision-making, and communication. Social sciences encourage students to think in a different way. By reflecting upon and giving their opinion on various social matters, pupils learn how their actions and feelings may impact patient care. Liberal arts help people develop their intercultural competence and ethical reasoning, which are crucial to the provision of patient-centered care. Usually, nurses take a basic math course, such as algebra, in order to accurately administer medications and customize each dosage to a patient. Math skills are thus especially crucial at the planning and intervention stages of the nursing process. Learning physical sciences and science studies helps future nurses develop a better understanding of the world of nursing. Moreover, to understand biology, the key science for nursing, one needs to know some fundamentals of physics. This science gives nurses a clear understanding of how life-saving techniques work. In summary, interdisciplinary research areas help students fill the gaps in their knowledge.

Conclusion

The care or treatment of cancer depends on timely diagnosis and the selection of the most effective option for this or that cancer type. As it has been stated in this paper, the process of diagnosing cancer is challenging in many situations when this condition is asymptomatic. Therefore, it is important to use different approaches to diagnosing, such as screening, a biopsy, and the test with the focus on cancer markers in order to determine tumors at their first stages of growth. There are four stages of cancer that differ in the development of cancer and its spread in the body. Consequently, diagnosing cancer at the first or second stage is a primary goal for physicians and oncologists. The paper has also provided a description of typical complications of cancer that need to be taken into account while choosing an appropriate treatment plan. Furthermore, therapies and surgery used for treating cancer also have side effects that should be addressed to improve patients’ state. Finally, while developing treatment plans for individuals with cancer, it is also necessary to include therapies oriented to relieving their pain and improving their emotional state.

References

American Cancer Society. (n.d.). Reach to recovery. Web.

American Cancer Society. (2019). Cancer facts & figures 2019. Web.

Benitez-Majano, S., Fowler, H., Maringe, C., Di Girolamo, C., & Rachet, B. (2016). Deriving stage at diagnosis from multiple population-based sources: Colorectal and lung cancer in England. British Journal of Cancer, 115(3), 391-400.

Centers for Disease Control and Prevention. (2018). Factors that contribute to health disparities in cancer. Web.

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Gaur, R. L., & Srivastava, R. (2014). Diagnosis and treatment of cancer—Where we are and where we have to go! In A. Tiwari (Ed.), Advanced healthcare materials (pp. 37-47). New York, NY: John Wiley & Sons.

Miller, K. D., Siegel, R. L., Lin, C. C., Mariotto, A. B., Kramer, J. L., Rowland, J. H.,… Jemal, A. (2016). Cancer treatment and survivorship statistics, 2016. CA: A Cancer Journal for Clinicians, 66(4), 271-289.

National Cancer Institute. (2018). Cancer statistics. Web.

Tobias, J. S., & Hochhauser, D. (2015). Cancer and its management (7th ed.). Hoboken, NJ: John Wiley & Sons.

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