Cancer: Approach to Care

Introduction

Cancer represents a group of diseases afflicting various parts of the body that are characterized by an abnormal growth of cells. This results in adverse health effects for the patient and can be fatal. Cancer has a tremendous impact and continues to be a burden for societal health. As of 2018, over 1.7 million people are diagnosed annually, and approximately 609,000 will die from the disease (National Cancer Institute, 2018a). It is one of the most prevalent and well-known conditions in the United States. It has led to significant investments in the scientific and medical study of the condition. This report will focus on investigating the diagnosis, complications, and treatment of cancer through the concept of approach to care for patients with the disease.

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Diagnosis and Staging of Cancer

Cancer can cause a variety of symptoms in the human body. Some of them are almost exclusively linked to cancer, while others may be common with other less serious conditions. Cancer symptoms are characterized by lasting for more than two weeks. Despite the devastating nature of the disease, early stages symptoms can be difficult to notice and lack the pain associated with later stages. Symptoms can include skin changes, lumps, change in the shape of body parts, cough, irregular bowel movements, unexplained weight changes, discharge, or fatigue (National Cancer Institute, 2018b).

If one or more of these symptoms persist, a physician may choose to run tests and procedures to determine if it is cancer. A laboratory test of blood or urine is used to measure the levels of blood count, protein, or tumor markers. These can be primary diagnostic procedures done on a patient if cancer is suspected. However, they are not completely reliable in indicating the presence of the disease. Imaging procedures such as a CT scan, MRI, PET scan, or ultrasound are used to determine the visual presence of a tumor in a specific part of the body. Furthermore, a biopsy can be withdrawn from suspected cancerous tissue to analyze the sample in a laboratory setting to confirm whether it is benign or malignant (National Cancer Institute, 2015).

Cancer staging is the process of establishing the extent that the disease has spread through the body. Laboratory and imaging tests are used to detect the growth of cancer cells within the body and organ tissue. Additional aspects such as histological test results and risk factors are used to establish the staging of cancer along with the traditional approach based on the spread of the disease. Cancer staging usually occurs before treatment (clinical) and afterward (pathologic) (National Comprehensive Cancer Network, 2018). It is critical for physicians to determine and keep updated information on the stage of cancer in order to properly form and adjust any treatments and the prognosis.

The most widely utilized staging structure is the TNM classification system maintained by the American Joint Committee on Cancer and the International Union for Cancer Control. It is based on current knowledge of the disease and is updated periodically based on evidence from research. Using the TNM system, each cancer is prescribed a letter and a number based on its characteristics. The numbers describe the size, location, and spread area of cancerous cells. Meanwhile, letters indicate the type of cancer:

  • T – primary tumor;
  • N – nodes indicates whether cancer has spread to lymph nodes
  • M – metastasis, an indication of whether cancer is present in distant areas from the original tumor location (American Cancer Society, 2015).

Complications of Cancer

Complications of cancer are acutely present and increase in severity with the progression of the disease. One of the primary complications arising from cancer is pain. Pain can occur due to the growth of tumors in various areas of the body, creating pressure on nerves and organs, with some secreting chemicals with lead to pain for the individual. If cancer has spread to the bone tissue, it can lead to skeletal complications, with the process of bone resorption is increased rapidly (Pierce, 2017). As bones, particularly large ones such as the spinal cord, become thin and weak, it can lead to fractures and nerve damage, which is significantly painful for the patient.

Nausea and vomiting is also a prevalent complication of cancer. This occurs both due to the impact of the disease as well as the result of some treatments. It is a result of direct pressure or stimulation of the central nervous system. A tumor can create meningeal irritation, intracranial pressure, or abdominal and pelvic stretching and obstruction. Another complication that can occur is the obstruction of the superior vena canal. Most prevalent in lung cancer and lymphoma, it results in swelling of the face and neck. Patients also experience breathlessness and severe coughing as the breathing and heart pathways become obstructed due to tumors (Chambers & Mansi, 2017).

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Side-Effects of Treatment

Cancer treatments are usually significantly invasive and detrimental procedures focused on removing cancerous tissue from the body. Inadvertently, this affects healthy tissue as well and the overall well-being of a patient. Side effects depend on individual factors but are usually discomforting at least and can become severe, impacting a person on various fronts. Some of the common treatments for cancer include chemotherapy, radiation therapy, immunotherapy, and surgery. Common physical problems can include fatigue and nausea, anemia, hair loss, diarrhea or constipation, osteoporosis, and tremendous pain.

Many organ systems and hormone levels are impacted as well. Patients may experience gastrointestinal obstruction, malignant pleural effusion, cardiovascular issues, and nervous system defects. Men may show signs of hormone deprivation while women experience menopausal symptoms. Dental health, appetite loss, and hearing problems can also occur. Cognitive functions suffer as the patient may experience issues with attention span, memory, and thinking processes. In rare cases, mental confusion and delirium are possible (American Society of Clinical Oncology, n.d.).

Due to the deadly nature of the disease and the tremendous burden of fighting it, cancer patients may experience psychological defects such as significant depression, hopelessness, and instability. Most often, the news of a cancer diagnosis is shocking to the patient as well as their family members. As a result, subsequent emotions may follow with anger, guilt, grief, vulnerability, and isolation (Cancer Treatment Centers of America, n.d.). The psychological and emotional components of cancer are complex and difficult to predict. However, they become a critical aspect of the patient treatment process.

Methods to Lessen Effects

A variety of interventions exist to manage and lessen the side-effects of cancer treatment. Most commonly, doctors prescribe medications and therapies to mitigate the side-effects along with the treatment itself. Furthermore, due to the widespread prevalence and public awareness of cancer, many hospitals have specialized facilities that offer specialists and palliative care departments to help patients and their families with specific outcomes. The multi-modal approach to cancer treatment, as well as the variable complications of the disease and treatments, require a systematic approach to lessen the effects on the patient.

Medications are effectively used to manage common effects such as pain and nausea. Anti-nausea drugs block serotonin receptors that cause fatigue and vomiting as a result of chemotherapy. Neuropathy and pain are treated through medicative measures, providing relief to the patient throughout the treatment process. It is possible that long-term management may be necessary to treat chronic pain (CURE, 2012).

Psychological effects can be managed through coping techniques and therapy. For example, as a result of chemotherapy, many patients experience hair loss which is often disheartening and impacts positive self-image. People are encouraged to embrace this as a natural occurrence and do whatever is comforting to them through the use of hats, wigs, or short haircuts. Psychotherapy and counseling can be beneficial to deal with concepts of fatality of the disease. Psychological care is a healthy and integral part of cancer treatment (Cancer Treatment Centers of America, n.d.). A more positive outlook and emotional state can contribute significantly to the well-being of the patient.

Conclusion

Cancer is a prevalent and impactful disease. It carries a tremendous burden for society in the United States and worldwide. Cancer is diagnosed based on symptoms and a combination of laboratory and imaging tests. Staging is a classification system that plays a critical role in determining the prognosis and treatment of the condition. Cancer causes significant complications for the patient. These arise due to the severity of the disease as well as the adverse side-effects of invasive treatments necessary to eradicate it. Side-effects are both physical and psychological. It is essential that all available methods are utilized to lessen the impact of these effects on the patient.

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References

American Cancer Society. (2015). Cancer staging. Web.

American Society of Clinical Oncology. (n.d.). Side effects. Web.

Cancer Treatment Centers of America. (n.d.). Emotional/psychological. Web.

Chambers, J. B., & Mansi, J. (2017). Complications of cancer. In D. Sprigings & J. B. Chambers (Eds.), Acute medicine: A practical guide to the management of medical emergencies (5th edition) (pp. 605-611). Hoboken, NJ: Wiley-Blackwell.

CURE. (2012). Management strategies for cancer therapy side effects. Web.

National Cancer Institute. (2015). How cancer is diagnosed. Web.

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

National Cancer Institute. (2018b). Symptoms of cancer. Web.

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National Comprehensive Cancer Network. (2018). Cancer staging guide. Web.

Pierce, S. (2017). Possible complications of advanced breast cancer. Web.

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