Introduction
The American Cancer Society (2017) estimates that over one million people are diagnosed with cancer each year. It is difficult for both patients and their families to understand the diagnosis and know how to deal with it. The approach to the care of cancer should include physical and psychological treatment, appropriate diagnosis procedures, education for patients and their families, as well as personalized tools and strategies that will allow treating patients according to their needs.
Cancer Diagnosis and Staging
While cancer causes many symptoms to manifest themselves, it is not cancer per se that influences the appearance of symptoms; rather, it is the presence of benign tumors and other problems linked to the condition. If the patient has experienced symptoms similar to those that occur in cancer, he or she must immediately inform the doctor who will then order lab tests, scans, and other procedures for the accurate detection and diagnosis of cancer. Body fluids (blood, urine, etc.) lab tests are used for detecting the levels of certain substances in the organism. While either low or high level of specific substances in the human body can be the sign of cancer, lab tests are not the only methods of detection and cannot be used alone for the diagnosis of cancer (NIH, 2015).
Imaging procedures and biopsies are reliable tools that health care providers use for cancer diagnosis. Imaging is used for creating pictures of areas inside the patient’s body to help doctors see whether any signs of tumors are present. Such pictures can be taken with the help of CT scans, nuclear scans, ultrasound, MRI, x-rays, and PET scans (NIH, 2015). Also, in the majority of instances, doctors need a biopsy performed to diagnose cancer. During the procedure, the doctor removes a tissue sample, which is then given to a pathologist for further investigation. The sample of tissue can be removed with a needle, an endoscope, or through surgery (NIH, 2015).
The TNM system (developed and approved by the American Joint Committee on Cancer, AJCC) is used for describing stages of cancer. According to the system, doctors use the test result for answering the following questions:
- Where is the primary tumor located and how large is it? (T, tumor).
- Have the lymph nodes been affected by the tumor? If they have, then how many? (N, node).
- Has the disease spread to other parts of the patient’s organism? If yes, where and to what extent? (M, metastasis).
After getting results from the TNM test, doctors determine the stage of cancer that a patient has. While each type of cancer has accurate staging information, the list below applies to the majority of cancers:
- Stage 0. This stage of the disease describes cancer in place. Cancers of stage 0 are located in the place they originated and have not spread to any other tissues. Because of this, stage 0 of cancer is highly curable, predominantly through the surgical removal of the tumor (“Stages of cancer,” 2015).
- Stage I. This stage is characterized by a small tumor that has not grown too deeply into the adjacent tissues. Also, cancers of stage I have not spread to the lymph nodes or other parts of the organism. This stage of cancer is often referred to as early-stage cancer.
- Stage II and III. These two stages of cancer are indicative of larger tumors that have grown deeply into the adjacent tissues. The tumors may also spread to lymph nodes but not other body parts.
- Stage IV. This stage of cancer means that the disease has spread to other parts of the body; it is also called metastatic or advanced cancer (“Stages of cancer,” 2015).
While the TNM system mentioned above is predominantly used for describing cancers that form solid tumors (e.g., lung, colon, breast cancers), doctors also use other staging systems for classification. These stages are the following:
- Cancers of the blood. The TNM system cannot be used to describe the characteristics of leukemia, lymphoma, or multiple myeloma because these types do not form solid tumors (“Stages of cancer,” 2015).
- Childhood cancers. The staging system approved by the AJCC does not include childhood cancer (“Stages of cancer,” 2015). Most childhood cancers are staged separately to cater to specific situations.
- Brain tumors (central nervous system tumors). Because cancerous brain tumors only affect the spinal cord and the brain, only the “T” description of the TNM system applies (“Stages of cancer,” 2015). At the moment, there is no one unified staging system used for determining stages of brain tumors.
To conclude, the staging of cancer is an essential process that allows healthcare providers to plan treatment (surgery, chemotherapy, radiation therapy, etc.), predict the chance of possible recovery or the return of cancer, determine the effectiveness of treatment, and talk about cancer.
Complications, Side Effects, Physical and Psychological Effects
Complications from cancer and its treatment are not only related to side effects that will be discussed later; they can take many forms depending on the characteristics of the human organism. For example, a patient can have unusual reactions of the immune system. In some cases of cancer, the immune system can react to cancer attacking healthy cells, which is called paraneoplastic syndrome. While it is a rare reaction, it can lead to such adverse health effects as difficulties walking and recurring seizures (Mayo Clinic Staff, 2015). Furthermore, cancerous tumors can affect the brain and nervous systems through pressing on nearby nerves, thus causing pain and the loss of function of one part of the body. Apart from experiencing physical problems when dealing with cancer, patients are also under immense psychological pressure to cope with the problem.
When it comes to the treatment of cancer that predominantly includes chemotherapy, the side effects can take over the daily life of a patient. Such side effects include nausea and vomiting, fatigue, hair loss, pain, difficulty breathing, weight loss, digestion problems, and chemical imbalance. Nausea and vomiting are the two most frequent side effects of chemotherapy (Janelsins et al., 2014) that subsequently interfere with the compliance of cancer therapies and the quality of patients’ lives. Fatigue is an issue that affects cancer patients daily: at least 32% reported fatigue upon their admission to the hospital, 40% on discharge, and 36% six months later (Horneber, Fischer, Dimeo, Rüffer, & Weis, 2012). Hair loss among cancer patients is linked to the chemotherapy damaging hair follicles (American Cancer Society, 2015).
It is crucial to mention that mental problems go hand-in-hand with cancer treatment. Distress, depression, and anxiety are the three most common mental conditions that cancer patients experience. Distress is a short-term condition that may occur when a cancer diagnosis is not expected; it is also common for patients to experience distress during treatment (Stein, Syrjala, & Andrykowski, 2008). Depression and anxiety are long-term and can affect patients that struggle with emotionally recognizing their condition. The prevalence of depression in cancer patients has been estimated to range between 10% and 50%; the prevalence of anxiety can range between 6% and 23% (Stein et al., 2008). PTSD is another important contributor to long-term depression and anxiety and can range between 0% and 32% among cancer survivors (Stein et al., 2008).
Dealing with the mentioned psychological and physical effects of cancer is possible through designing and implementing an integrative and multidisciplinary approach to improve the health outcomes of patients diagnosed with this complex condition. Apart from treating patients physically (through treatment and the management of side effects), psychological support should be provided to cancer patients who tend to experience severe emotional distress when dealing with the side effects of their treatment. Also, lifestyle changes can benefit in alleviating the physical and psychological burden of cancer.
Conclusion
Therefore, health professionals from different fields (nutritionists, psychologists, radiologists, physicians, surgeons, etc.) should work cooperatively to establish an effective approach to care for patients diagnosed with cancer. Beginning from correct diagnosis and ending in recovery, patients must be sure to rely on the multidisciplinary team of professionals that will combine their efforts to create a multi-faceted approach towards care for cancer patients. Such work can have a great impact on the recovery of patients and contribute to offsetting the sadness, which still prevails when the topic of cancer arises.
References
American Cancer Society. (2015). Hair loss.
American Cancer Society. (2017). Cancer facts and figures 2017.
Horneber, M., Fischer, I., Dimeo, F., Rüffer, J., & Weis, J. (2012). Cancer-related fatigue: Epidemiology, pathogenesis, diagnosis, and treatment. Deutsches Ärzteblatt International, 109(9), 161-172.
Janelsins, M., Tejani, M., Kamen, C., Peoples, A., Mustian, K., & Morrow, G. (2014). Current pharmacotherapy for chemotherapy-induced nausea and vomiting in cancer patients. Expert Opinion on Pharmacotherapy, 14(6), 757-766.
Mayo Clinic Staff. (2015). Complications. Web.
NIH. (2015). Diagnosis. Web.
Stages of cancer. (2015). Web.
Stein, K., Syrjala, K., & Andrykowski. M. (2008). Physical and psychological long-term and late effects of cancer. Cancer Supplement, 112(11), 2577-2592.