Approach to care

Answer

Describe at least three complications of cancer, the side effects of treatment, and methods to lessen physical and psychological effects.

Approach to cancer care

Cancer is a leading killer in the world today. According to the Atlanta based American Society of Cancer report (2013), the disease is the second highest killer among the non-communicable diseases in developed countries, but ranks first in underdeveloped countries. The same report also estimates cancer related deaths in the United States to be about 1.5 million worldwide, annually since 2012 (American Society of Cancer, 2013). The disease thrives among individuals living sedentary lifestyles, and with increasing mortality directly attributed to cancer, attention of stakeholders is shifting towards cancer prevention. This paper describes the multidisciplinary approach to cancer care specifically focusing on diagnosis, complications, side effects, and management of physical and psychological effects. Consequently, and owing to the complexities involved in the management of cancer, the multidisciplinary approach to cancer care.

Cancer is a general term for a multiple of diseases, which culminate in abnormal cell growth, with the potential to spread to affect other normal cells as well (Torre, Siegel & Jamal, 2015). Whereas each particular cancer type is exemplified by a unique set of symptoms, medical professionals opine that certain symptoms uniquely define all cancer cases. Some of these symptoms include unprecedented weight loss, fever, fatigue, and skin changes as may relate to specific cancers (Torre, Siegel & Jamal, 2014). The emergence of any of the symptoms above, along with screening test results could compel medics to recommend diagnosis of cancer. Cancer diagnosis typically involves examination of family health history, physical examination, laboratory tests, imaging procedures, and biopsy. Basic inquiries into family history can provide useful, but only a cursory diagnosis of cancer. It may be necessary, for purposes of accuracy in diagnosis, to order a physical exam, by the medic to obtain objective data (Cho, 2010). Better still, laboratory tests are more useful as they can, to a large extent, relate the abundance of certain substances in body fluids to the presence of cancer cells. For instance, tumor marker tests may be used to monitor levels of chemicals produced by cancer cells (tumor markers) in the blood. The most common tumor marker tests are the CA15-3 and CA19-9 for breast and gastrointestinal tumors respectively (Cho, 2010). Weaknesses inherent with lab tests demand for confirmatory tests, which typically involve scans. Scans are an imaging procedure for producing visual representations of internal body tissues and organs to determine the presence of cancer. Among these procedures include Computer Tomography (CT) scans for detailed images of organs; Radionuclide scans which employ tracers to identify areas of high radioactivity as cancer cells tend to congregate in such areas. Ultrasound, which produces inaudible sound waves to reconstruct images after bouncing off tissues and organs, and X rays are useful for exposing cancerous activities. Finally, Biopsy may be preferred in instances where the patient is a minor or likely to suffer from adverse effects of other diagnoses. Biopsy involves the removal of cancerous tissue, and may include the use of a needle, endoscope, excisional and incisional surgery depending on the severity of the case (Cho, 2010).

In order to prefer a treatment plan, upon diagnosis, it is essential that medics conduct cancer staging to understand the severity (or stage) of the individual cases. Staging, as a diagnostic tool, is only useful insofar as it can aid the acquisition of five sets of data. These are physical examination data, imaging test results from  CT scans and X rays, laboratory test results, pathology reports on critical aspects such aspects such as size of tumor, cancer type, and surgical reports. While the first three data sets have been discussed albeit under diagnosis of cancer, they remain fundamental in determining the extent of cancer progression in a body tissue (Nguyen, Lawley, Hansen, Bowma, Clarke, Duhig & Colquist, 2010). Symbolic rule-based classification of lung cancer stages from free-text pathology reports. Journal of the American Medical Informatics Association, 17(4), 440-445..

Progression of cancer and subsequent increase in severity invariably yield complications which may require more aggressive interventions. These complications could include Central Nervous System (CNS) complications such as may result from brain tumor-related epilepsy, bone metastases, endocrine issues - related to hypoglycemia -, Hematologic disorders, malignant effusions, and gastrointestinal challenges as may result from  colon cancer. Three main treatment methods of cancer are radiotherapy, chemotherapy, surgery, immunotherapy, among others.  Radiotherapy, one of the traditional methods employed in cancer treatment, uses electromagnetic waves to destroy cancer cells by irradiating them (McPhee &  Papadakis, 2010). Because high energy radiation is required to kill cancerous cells, there is he inherent risk of destroying healthy cells as well. Consequently, and owing to this fact, common complications arise from the specific parts which were exposed to radiation. Radiotherapy on the head and neck for instance is associated with mouth and gum sores, jaw stiffness and tooth decay. Exposure of the chest to radiation may lead to soreness of the breasts, shoulder stiffness and difficulty in swallowing. Radiotherapy procedures on the pelvic area may expose men to erectile dysfunction. In certain instances, and depending on the nature of cancer, drugs may be used in cancer treatment, in a process known as chemotherapy (McPhee & Papadakis, 2010). For instance, the Doxorubicin drug used in the treatment of acute lymphoblastic leukemia is associated with hair loss, loss of appetite, fatigue, redness of urine, and fever. In instances where surgery is employed to treat cancer, for example in the treatment of prostate cancer, may result in discomfort in the testes. Further, hormones have been used to control growth of hormone sensitive cells, in a process known as hormone therapy. However, risks of decreased sex libido, weight loss, and persistent hot flashes persist (Schierbeck, Rejnmark, Tofteng, Stilgren, Eiken, Mosekilde,  & Jensen, 2012)    . The preceding considerations reveal the physical and psychological effects of cancer, it is important for a cancer patient to appreciate the nature of side effects. First, the patient should consider the impact of fatigue, and consider ways of managing it through regular physiotherapy sessions. In certain instances of chemotherapy, physical symptoms such as vomiting and nausea may be contained through timely relief medications. Other aspects such as pain should be managed through regular uptake of pain-relieving drugs, and therapeutic therapies such as use of ice packs, and body massage. Cancer is known to cause psychological stress in patients, drawing responses such as anxiety, anger, depression, and fear among others.

The multidisciplinary approach to nursing care entrenches the patient-centered approach to nursing care. Owing to the intricacies of cancer care, there is need for several health professionals to work harmoniously and synergistically in reviewing individual patients, and recommending best medical interventions to employ (Litton, et.al, 2010). Further, a multidisciplinary team tends to prop standardized protocols for managing patients, thus enhancing quality. Additionally, the unique circumstances of cancer patients even in situations where they suffer from the same type of cancer may require different models of treatment. Upon diagnosis, the multidisciplinary team will be involved in diagnosing and treating cancer, management of symptoms and side effects, psychosocial support during care. The composition of this team ensures that there is a surgeon, general practitioner, oncologists – cancer specialists, radiologists, specialist nurses, palliative care service providers, and counselors (Schierbeck, et,al,.2012). Effect of hormone replacement therapy on cardiovascular events in recently postmenopausal women:  Finally, the multidisciplinary approach to nursing care considers, and ensures that the patient is part of the team. For all practical purposes, social and religious beliefs of the patient are considered, in the scheduling and management of cancer (Scieberk, 2012). As a team member, the patient will be educated on their illness, aided in symptoms management by focusing on issues such as pain, gastrointestinal disturbances, and coping through psychological and spiritual support. Proper healing should include management of psychological impacts as well. This can be achieved through encouraging cancer patients to focus on bettering themselves in many other static facets of their lives. Cancer patients should also be encouraged to make positive lifestyle choices through enhancement of health, nutrition, exercise, and reflection. Finally, therapies which enhance mind and body wellness such as laugher, stress management, and relaxation should be embraced (Scieberk, 2012).

The facts so far considered points to the need for concerted efforts from all stakeholders to manage cancer. From the foregoing factors, there is need to shift focus in the management of cancer from the traditionally unitary model which extols the value of the doctor, yet eschewing the role of all stakeholders in cancer treatment and prevention. By recognizing patients’ interests such as beliefs, faith, and education on cancer as integral in a multidisciplinary approach to nursing, the momentum so far sustained by increasing prevalence and death can blunted.