Approach to Care in Cancer Patients - Essay Sample

Cancer takes many forms and hence involves various strategies in dealing with it. It is perceived that the number exceeds 200 and is treated using different methods. Most of them can be cured while others can be controlled. The pain symptoms associated with most of them can also be treated with modern forms of medication. It is important to note that various factors determine the behavior of cancer in addition to the time that it was discovered and the treatment (Alterio et.al, 2014).

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Describe the diagnosis and staging of cancer

If the test from screening indicates the presence of cancer or if one detects some its symptoms, a medical practitioner may try to find out whether the signs indicate cancer or emanate from other causes. Some aspects to consider in the diagnosis include family history, and the medical history before conducting a physical exam. The doctor may also conduct tests and scans to identify the condition (Alterio et.al, 2014).

For the lab test, low or high amounts of particular elements in the body may be associated with the development of cancer. Therefore, substances such as urine, blood, and other fluids may be of great help during diagnosis. It is important to note that some tests may present abnormal results which may not imply that the condition is present and hence the doctor has to employ various forms of tests to be sure of the condition. The doctor may carry out imaging procedures in the diagnosis that involves developing images on various parts of the body to identify if the tumor is present or not. The images may be created using a CT scan, a nuclear scan, ultrasound, MRI, a pet scan and X-rays (Ost et.al, 2014).

It is important to note that doctors often conduct biopsies in diagnosing cancer. It entails obtaining a sample of the body tissue and then using a microscope to check whether there are any signs of cancer. The sample may be collected by using a needle, an endoscope that involves a certain tube in any opening in the body (mostly the mouth) and then obtaining fluid or tissue through the tube and also through surgery. The surgery may be either incisional or excisional. Incisional surgery entails removing part of the tumor while excisional entails removing the whole tumor (Ost et.al, 2014).

Staging refers to the degree or prevalence of cancer in an individual. It involves aspects such as the largeness of the tumor and whether it has spread to other areas. Staging allows the medical practitioner to comprehend the seriousness of the condition and the opportunities for survival, to develop an effective treatment plan and look into clinical trials that provided the best options in regards to treatment. It is important to note that cancer is often identified on the stage that the diagnosis took place regardless of whether it spreads or becomes worse. New content may be added with time as the cancer changes on its initial stage. The stage remains the same, but cancer might change. The stage may be determined through lab tests, X-rays and any appropriate procedure (Ost et.al, 2014).

There are various systems that describe stage and are used in various forms of cancer. It is important to note that there are specific systems that deal with particular cancers. The information that most staging systems require include; the location of the tumor in the body, the types of cell that are involved, the dimension of the tumor, whether Cancer has affected the lymph nodes, if cancer has affected other areas of the body and the grade of the tumor in regards to the nature of cells in terms of abnormality and the growth and the frequency of the spread of cancer (Ost et.al, 2014).

The most common system used in staging cancer is the TNM system. Most of the medical institutions employ the system whereby it is the main technique used for reporting cancer. The information about the cancer is mostly included in the pathology report. Other systems may also be employed analyzing blood cancers, and spinal cord and brain tumors.

The T in the TNM system refers to the spread and the size of the original tumor or rather the primary tumor. The N involves the number of lymph nodes that have been affected by cancer while the M entails assessing is the condition has metastasized or rather if cancer has exceeded from the primary tumor to various parts of the body (Ost et.al, 2014).

The system allows a comprehensive analysis of cancer. However, it is important to note that combinations in TNM are categorized into five simple stages for various cancers. The first stage is stage 0 that entails the presence of abnormal cells which have not yet spread to other tissues. The stage is also referred to as carcinoma in situ (CIS) by which cancer is not present but risks the chances of developing. The second stage includes stage I, stage II, and stage III whereby the cancer is already in the body. A high number of the cancer cells implies that the tumor is large and that the cells have spread to the tissues that are nearby. The last stage is stage IV whereby cancer has spread into other areas of the body; further from the primary tumor.

Another staging system puts cancer in one of the most identified categories which are five in number. The system is mostly employed by the registries when compared to doctors. Some common terms used in describing cancer include; in situ whereby, the abnormal cells are in the body but have not yet moved to other parts of the body; localized where cancer is only present in the affected area; regional where Cancer has spread to the nearby areas; distant where cancer has moved to other parts of the body and unknown where there is less information in identifying a stage (Ost et.al, 2014).

Three complications of cancer

One of the complications associated with cancer is the neurologic complication. It is important to note that the peripheral nervous system (PNS) and the central nervous system (CNS) tend to be at risk of being affected by cancer and the associated treatment (Giglio & Gilbert, 2010). The most common effects include tumors in the spinal cord and the brain. Cancer imposes harm on the nervous system such that it may result in morbidity in the system in addition to mortality. The complication may be direct whereby cancer involves the PNS, spine or the brain directly. It may also be indirect especially in the paraneoplastic neurologic syndromes. It is also important to note that the treatment of cancer may cause harm to the nervous system (Giglio & Gilbert, 2010).

Giglio & Gilbert (2010) state, Metastases to the brain from systemic malignancies are the most common direct form of nervous system involvement by cancer. It is estimated that in the United States as many as 200,000 cases of brain metastases (BMs) are diagnosed each year. The most common cancers resulting in BMs are lung, breast, and melanoma. The brain metastases are not common in cervical and prostate cancers. Cancers such as lymphoma and leukemia are perceived to bring about leptomeningeal metastases. The brain metastases mostly take place in the cerebral hemisphere due to high flow blood in the supratentorial compartment (Giglio & Gilbert, 2010).

In regards to treatment, it is perceived that radiation treatment imposes damages on the peripheral nervous system and the central nervous system. The damage of the glia and the vascular damage present serious effect of cancer on the brain and spinal cord. When the radiation therapy is being conducted, patients may develop acute injury whose signs include nausea, headache, and vomiting. Chemotherapy is also associated with complications in the neural system through the introduction of the chemicals to the body. The methods to lessen the effects caused by radiotherapy and chemotherapy is regulating them and employing treatment that deals with aspects such as vomiting and headaches (Giglio & Gilbert, 2010).

Another complication associated with cancer entails oral complications. The mouth is perceived to be the most common area affected by complications due to both chemotherapy and radiotherapy (Sonis & Fey, 2002). The complications are associated with toxicity in the mouth due to the medication. The common complications related to the mouth include xerostomia, mucositis, and osteoradionecrosis. Among the three that is quite prevalent is mucositis in regards to quality of life, outcomes on health issues, breaks associated with treatment and the limitation of dosage. Populations that are at high risk of getting mucositis include, patients receiving conditioning regimens for bone marrow transplant, particularly those including total-body irradiation; patients receiving induction therapy for leukemia; and patients who are being treated with fluorouracil (5-FU) infusional therapy for colorectal cancer (Sonis & Fey, 2002). Also, cancer patients who require radiation therapy due to the tumors present in the neck and the head are at high risk of obtaining mucositis. The risks become higher when chemotherapy is also involved. It is important to note that patients with poor hygiene suffer more from mucositis when compared to those who are keen on their hygiene. The side effects include loss of the sense of taste and development of periodontal diseases. Adequate hygiene and intake of antibiotics are some of the methods used in lessening the physical effects of the complications. Guidance and counseling are also necessary for the patients to continue with the medications (Sonis & Fey, 2002).

The other complications associated with cancer include gastrointestinal complications (National Cancer Institute, 2017). The complications include diarrhea, constipation, bowel obstruction and impaction are quite common among the cancer patients. The extent of cancer and the growth of tumor are often affiliated with the complications. The most common gastrointestinal complication is constipation. Constipation entails difficulty in the bowel movements due to the hardening of stools such that patients feel pain when relieving themselves. If the time spent on transit in the large intestine is long, fluids get absorbed and hence causing the hardening of stools. To reduce constipation, patients are advised to ingest soft foods and food with roughage. It is often affiliated with immobility and plenty of inactivities. Psychological problems such as anxiety and depression also bring about constipation. Counseling comes in handy for cancer patients to reduce constipation (National Cancer Institute, 2017).

References

Alterio, A., Maddox, D., Uy, K., Graeber, G., & Quadri, S. (2014). Logistics of Lung Cancer Diagnosis and Staging for Patients in an Academic Medical Center. Chest, 146(4), 548A.

Giglio, P., & Gilbert, M. (2010). Neurologic Complications of Cancer and its Treatment. Current Oncology Reports, 12(1), 50-59. http://dx.doi.org/10.1007/s11912-009-0071-x

National Cancer Institute. (2017). Gastrointestinal Complications. National Cancer Institute. Retrieved 9 May 2017, from https://www.cancer.gov/about-cancer/treatment/side-effects/constipation/GI-complications-hp-pdq

Ost, D. E., Niu, J., Elting, L. S., Buchholz, T. A., & Giordano, S. H. (2014). Quality gaps and comparative effectiveness in lung cancer staging and diagnosis. CHEST Journal, 145(2), 331-345.

Sonis, S., & Fey, E. (2002). Oral Complications of Cancer Therapy. Oncology. Retrieved from http://www.cancernetwork.com/review-article/oral-complications-cancer-therapy-0