Introduction
Cancers are diseases that result from abnormal cell growth. Diagnosis involves the use of blood tests, CT scans, endoscopy and x-rays. Cancer may be categorised into different stages and this is important during the planning of treatment and management of the disease. These stages are described depending on the size of the growth, presence of cancerous cells in lymph nodes and other parts of the individual’s body. Several complications (physical and psychological) are experienced by cancer patients and several side effects may be experienced during treatment. However, these effects may be managed effectively.
Diagnosis of Cancer
Cancer may be suspected depending on the individual’s symptoms. The symptoms may present themselves during physical examinations or screening tests. In other instances, a physician may notice some abnormalities from unrelated x-ray examinations. When a medical practitioner suspects the presence of cancer in an individual, he would need to perform computed tomography scans, ultrasonography or an x-ray (Kravchenko, Akushevich, & Manton, 2009). For example, a doctor might need to examine x-ray results for an individual who is experiencing weight loss and chronic cough.
Such tests may show the presence, size and location of the abnormal substance in the body. However, these tests may not prove that the cause of the abnormal mass is cancer. In order to confirm its presence, it is necessary to obtain samples of the substance through surgery or needle biopsy (Anderson & Webb, 1987). In the case of such cancers as leukaemia, only a blood sample is required. However, a piece of tissue may be required for other cancers. Tissue samples may be obtained by simply cutting out a piece of the tissue using a scalpel. A sample may also be obtained using a hollow needle. Ultrasonography and CT scans are used to guide the needle. Local anaesthetic is usually given to relieve pain experienced during biopsies. When examinations suggest the presence of cancer, tumour markers may be measured.
Staging of Cancer
Staging is the process of describing how advanced the cancer has become. This describes the extent to which the cancerous mass has grown and how far the cells have spread. Staging cancer is important for several reasons. Most importantly, it helps during the planning of treatment for an individual and during the prediction of the individual’s chance of recovery. Staging is usually determined by three factors.
- The size and growth of the tumour
- Presence of cancerous cells in the lymph nodes
- Presence of cancerous cells in other parts of the body
Staging is done using diagnostic tests. The importance of staging includes the prediction of prognosis. It is also necessary in order to predict the risk of recurrence of the cancer. It would also help in determining effectiveness of treatment. Staging may also be important when it comes to research because comparisons may be done with larger populations with the same diagnosis. This may help when it comes to the evaluation of new and more effective treatments.
One of the tools used in staging is the TNM staging system. This system examines the three factors described earlier. The size and location is denoted by the letter ‘T’. The presence of the cancer in the lymph nodes is denoted by ‘N’ and the letter ‘M’ is used to represent the presence of tumour in other parts of the individual’s body.
The cancer stages can be described as shown below:
- Stage 0 – this describes cancer that is still located in the place of origin (in situ).
- Stage I – this is used to describe a small tumour that has not invaded the lymph nodes or neighbouring tissues. It is an early-stage cancer.
- Stage II and III – at this stage, the cancer is quite large and has grown into neighbouring tissues and lymph nodes. However, they may not be located in other parts of the body.
- Stage IV – this is usually the advanced stage of cancer. This is said to have occurred when the tumour has spread to organs and other areas in the body.
Complications of Cancer
Cancers usually present several complications. For example, it may cause nausea and vomiting. This occurs to about 30% of all cancer patients. About 20% of cancer patients experience vomiting (Jemal, Bray, Center, Ferlay, Ward, & Forman, 2011). For effective treatment of this complication, it is necessary to first diagnose the cause. If possible, it would be prudent to correct the reversible causes. If treatment is required, the health practitioners could select a first line anti-emetic. Complications of prolonged nausea and vomiting should be managed. If vomiting persists, a second line anti-emetic could be used or added to the previous one.
Another complication that comes with cancer is fatigue. This is said to have occurred when an individual lacks the capacity to sustain force. There is usually also a reduced capacity to perform mental tasks over time. This presents malignant and non-malignant conditions such as muscle dysfunction, unidentified organic disease and immune dysfunction. Fatigue could be caused by dyspnoea, infections, anaemia, dehydration or changes in skeletal muscle protein stores. Tools used to assess fatigue include the VAS Scale and POMS (Profile of Mood State). Treatment or management may include the correction of the metabolic causes and energy conservation. The patient could also adopt a limited exercise program or undergo depressive illness management.
Another complication that is brought about by cancers is breathlessness (dyspnoea). This may be described differently by individuals depending on their condition. Some individuals experience difficulty breathing (physical). Some have sensations concerning the upper airway. Other individuals, on the other hand, complain of low energy levels. Impaired performance may be experienced in terms of decreased effective lung volume (pneumothorax, effusions and ascites), increased lung stiffness (pulmonary oedema and fibrosis) or decreased gas exchange (pulmonary emboli). For treatment, drug therapy may be used. For example, opioids, oral bronchodilators and diuretics may be used. Other methods include physiotherapy and brachytherapy.
Cancer can also cause brain and nervous system problems. This may occur when the growth presses adjacent nerves and cause loss of function of certain areas of the body. This may lead to headaches and stroke-like symptoms. Management of pain may be done using painkillers. However, proper management is required to avoid further damage to the nervous system.
Side Effects of Treatment
The treatment of cancer may be accompanied by several side effects. For example, chemotherapy drugs may damage healthy cells nearby. Pain is also a side effect since some procedures are painful. Nausea and vomiting is another side effect that is experienced during treatment. Lymphoedema may result from surgery or radiation therapy (Sobin & Gospodarowicz, 2009). This causes lymph fluid to accumulate under the skin causing swelling. Cancer treatment may also have fertility and sexual side effects in men and women. Chemotherapy and radiation therapies also increase an individual’s risk of developing a different cancer. Therefore, cancer treatment may eventually lead to second cancers.
Addressing Physical and Psychological Effects
Physical effects of cancer may be effectively managed. For example, individuals experiencing fatigue may participate in exercise programs whereby qualified physiotherapists would carefully monitor their conditions and recommend adjustment to the intensity of their exercise. Nausea and vomiting, on the other hand, may be managed using medication such as ganisetron, ondansetron or palonosetron. Pain is another physical effect of cancer that may be managed using prescribed pain medication. It may also be managed using physical therapies. Such therapies include massages and the use of ice packs and hot water bottles. The loss of hair is also common for cancer patients undergoing treatment. Since this is only temporary, an individual may wear a wig or scarf. In the case of affected sexuality, there are available medication and support for such individuals. Lymphoedema may also be managed through complex lymphatic therapy, self-management techniques, compression bandaging, kinesiology taping and manual lymph drainage (MLD).
Psychological effects experienced by cancer patients include shock, fear, grief, depression, vulnerability and frustration (Adler & Page, 2008). Such individuals may be encouraged to talk about their feelings by reaching out to family and friends. These individuals can also focus on what they can change and not what they cannot change. Relaxation therapies such as energy therapies and laughter therapies are also beneficial to such individuals.
Conclusion
Diagnosis of cancer is necessary when its presence is suspected. Biopsy, endoscopy, x-rays and CT scans may be used. When presence of cancer is confirmed, treatment should follow. However, several side effects may be experienced. The cancer may also present physical and psychological effects that require proper management.
References
Adler, N., & Page, A. (2008). Cancer care for the whole patient: Meeting psychosocial health needs. Washington, DC: National Academies Press.
Anderson, J., & Webb, A. (1987). Fine-needle aspiration biopsy and the diagnosis of thyroid cancer. The British Journal of Surgery, 74(4), 292-296.
Jemal, A., Bray, F., Center, M., Ferlay, J., Ward, E., & Forman, D. (2011). Global cancer statistics. Cancer Journal for Clinicians, 61(2), 69-90.
Kravchenko, J., Akushevich, I., & Manton, K. (2009). Cancer mortality and morbidity patterns in the U.S. population: An interdisciplinary approach. Berlin: Springer.
Sobin, L., & Gospodarowicz, M. (2009). Classification of malignant tumours. Oxford: Wiley-Blackwell.