Introduction: Generally, cancer refers to a group of diseases causing a disturbance in cellular growth. A cellular disease, cancer can affect any tissue, resulting in clinical manifestations due to uncontrolled proliferation and maturation of cells. It is the leading cause of death globally, with 1 in every 6 deaths. In 2020, it accounted for almost 10 million deaths (WHO, 2022). The most common ones are breast, lung, colon, prostate, and rectum cancers (WHO, 2022). This essay intends to discuss various aspects of cancer, such as diagnosis, staging, complications, side effects due to treatment, physical and psychological management of side effects, and the application of the nursing process in the care of cancer patients.
Cancer diagnosis and staging
Diagnosis of cancer involves a physical exam and various techniques to visualize and evaluate primary tumors. Flexible and rigid endoscopes are used to visualize the upper airway and gastrointestinal tract (Gress et al., 2017). Endoscopic evaluation is used concomitantly with barium swallow and radiography. 3D imaging with magnetic resonance imaging (MRI) and computed tomography (CT), and positron emission tomography (PET) supplement clinical evaluation and can stage the primary tumor and regional lymph nodes (Gress et al., 2017). Gress et al. (2017) recommend tissue biopsy after locating the primary tumor. They contend that the accuracy of interpreting cytologic findings relies on the pathologists’ skill and experience.
Cancer staging refers to the classification of the anatomic extent of the disease and is based on the ‘TNM’ system. T is the extent of the primary tumor by the invasion of the adjacent tissues, depth of invasion, or size. N stands for the absence of or extent of metastasis in the regional lymph nodes. M stands for the absence or presence of distal metastasis (Gress et al., 2017). Clinical TNM is the classification of a tumor upon diagnosis using clinical examination and imaging techniques. Pathological TNM is a cancer classification after a surgical excision based on histopathological findings. While both categories can determine the prognosis, clinical TNM determines the approach to investigation and therapy, while pathological TNM determines the use of adjuvant treatments.
Complications Of Cancer
Cancer patients tend to be immunocompromised given the uncontrolled proliferation and maturation of cells. As a result, sepsis is common among this population leading to high mortality and morbidity rates. WHO (2022) estimates the in-hospital cancer patients’ mortality rates at 40%. Pneumonia is also an aggressive compilation in cancer patients and can be classified as healthcare or community-acquired. It is among the leading causes of hospital admission in cancer patients (Jairam et al., 2019). Patients with lung cancer are more likely to develop post obstructive pneumonia. According to Jairam et al. (2019), another common complication in cancer is acute kidney injury.
Side Effects Of Cancer Treatment
Treatment-related complications in cancer therapy are grouped according to specific illnesses. For instance, the most prevalent side effects of treatment in hematologic malignancies are anaemia, neutropenia, and sepsis. Patients receiving bone marrow transplants are highly susceptible to complications such as transplant rejection, with rehospitalization of up to 40% within one month after discharge. In gastrointestinal, head, and neck malignancies, dehydration is common. Mucositis (in 80% of patients) seen in head and neck malignancies impairs oral intake, leading to dehydration (Jairm et al., 2019). The study documents bowel obstruction as a long-term side effect of radiotherapy, which is also prevalent in gynecologic and gastrointestinal malignancies.
Methods To Lessen Physical And Psychological Effects
Complementary health approaches have demonstrated significant positive outcomes in cancer patients. Research indicates that complementary psychological and physical techniques, such as mindfulness-based stress reduction, yoga, and acupuncture, can lessen cancer therapy’s physical and psychological effects.
Clinical practice guidelines recommend acupuncture to manage poorly controlled side effects of chemotherapy. The main side effects include pain, cancer-related fatigue, peripheral neuropathy, nausea, and vomiting. Integrative therapies help alleviate pain during and after breast cancer treatment.
Mindfulness-based stress reduction can help patients with cancer cope with depression, stress, anxiety, and fatigue, thus improving their quality of life. Various studies recommend mind and body modalities as part of a multidisciplinary approach to managing the side effects of cancer treatment. Meditation has demonstrated significant benefits in alleviating stress and anxiety in breast cancer patients.
Yoga has also demonstrated significant benefits in improving cancer-related fatigue, impaired sleep patterns, depression, and anxiety. Studies conducted on lung and breast cancer patients recommend its concomitant use with standard treatments due to the improved quality of life associated with its effects. Additionally, there is significant mood elevation and enhanced quality of life in patients who practice yoga.
Factors That Contribute To The Yearly Incidence And Mortality Rates Of Cancers In Americans
Cancer is among the leading causes of mortality globally. WHO (2022) documents that it affects 1 in 6 people and will cause almost 10 million deaths in 2020. The most prevalent cancers are colon, breast, rectum, and prostate cancer. A third of deaths due to cancer are caused by excessive tobacco use, obesity, excessive alcohol intake, inadequate fruit and vegetable intake, and a sedentary lifestyle (WHO, 2022).
One factor contributing to increased cancer mortalities is underinvestment in primary prevention and screening strategies. Despite efforts to ensure equitable access to cancer-prevention programs, several communities remain underprivileged as they do not access these services (Emmons & Colditz, 2017). For example, safety-net health centers provide these services. However, the high demand and availability of limited resources make it challenging to integrate new interventions into these organizations. Therefore, limited resources are an obstacle to implementing preventive strategies in populations with a high cancer burden, thus contributing to increased cancer incidence and mortality rates in those areas.
Also, failure to fully implement specific environmental and policy approaches that restrict risky behaviors contributes to the increasing incidence and mortality rates of cancer. Smoking cigarettes is among the leading risk factors associated with cancer. High taxes on tobacco, ranging from 17 cents to $4.35 per pack of cigarettes, is a strategy to mitigate smoking prevalence at the state level (Emmons & Colditz, 2017). However, studies indicate that most states have not increased their taxes in more than a decade (Emmons & Colditz, 2017). As a result, cigarettes are cheaply available to the population, which increases the prevalence of smoking and, consequently, cancer.
How American Cancer Society (ACS) Might Provide Education And Support
The American Cancer Society is dedicated to helping people diagnosed with cancer through their treatment journey. It offers various programs, resources, and physical and emotional services that improve the quality of life of cancer patients and their loved ones.
The ACS provides educational and emotional support services through an online community- the American Cancer Society Cancer Survivors Network (ACS, 2022). This platform is significant as it allows people diagnosed with cancer to share their experiences, practical tips, and hope. Newly diagnosed patients can benefit from this platform as they are encouraged not to lose hope from other people’s experiences.
The ACS also supports cancer patients by availing hair loss and mastectomy products (ACS, 2022). Chemotherapy is an intense treatment associated with significant side effects. Among them s hair loss, which has a significant negative impact on an individual’s self-esteem. Using wigs and hats can boost their self-confidence, and the ACS makes this possible by availing them. For breast cancer patients, ACS provides breast form and bras that individuals can use to improve their body image, thus enhancing their confidence levels.
The Nursing Process in Caring for Cancer Patients
The nursing process is a tool that allows nurses to identify and address individual patient problems (Toney-Butler & Thayer, 2020). Cancer patients need focused management using the nursing process to deal with treatment’s physical and psychological effects. This management entails five significant stages: assessment, nursing diagnosis, goals and outcome formulation, intervention, implementation, and evaluation.
Before surgery, the nurse assesses the patient’s environment, cultural background and beliefs, and safety. These aspects are significant in the planning of care since it is individualized. They help the nurse understand the patient’s perspective on life and their personal beliefs, thus formulating a care plan to improve their quality of life. A physical exam is also performed during the assessment to collect significant objective and subjective data, informing the medical and nursing diagnosis (Toney-Butler & Thayer, 2020). A psychosocial examination is also necessary to establish the patient’s mental and emotional states before and during treatment. Frequent and consistent reassessment of the patient is key to maintaining patient safety and enhancing health outcomes by readjusting the care plan to meet the patient’s changing needs (Toney-Butler & Thayer, 2020).
The second step is formulating nursing diagnoses that reflect the patient’s deficits and risks, thus directing the care plan. For instance, fatigue, related to anemia, as evidenced by decreased performance, compromised concentration, and inability to maintain usual routines.
The third step is the formulation of goals and desired outcomes. The goals are SMART and are evaluated after a specific period. The fourth step is deciding on effective interventions with a scientific rationale to address the patient deficits. The interventions change as the patient goes through different stages of treatment. They include medical, nursing, and psychosocial interventions. Referrals to a community support group and contemporary techniques for pain, anxiety, and depression management apply to all cancer patients. The fifth step is implementation, where nurses ensure they collaborate with the relevant professionals and family members to implement the interventions (Toney-Butler & Thayer, 2020). Active follow-up is necessary to ensure adherence to the recommendations and treatment regimen. Evaluation of goals and outcomes is the last step, and this is where the nurse assesses how effective their interventions were in meeting the goals and desired patient outcomes. Failure to meet the purposes of the treatment plan calls for modification o the interventions.
How Liberal Arts And Science Studies Contribute To Nursing Knowledge
Integrating nursing and liberal arts and science studies can evoke a more holistic and creative approach to using the nursing process to manage cancer patients. Courses like mathematics encourage critical thinking, which is crucial in formulating appropriate interventions in the nursing process. The statistics knowledge obtained from mathematics helps nurses understand and interpret quantitative data and research and apply it in clinical situations. This curriculum reinforces the students’ ability to think critically, ask questions, assess a problem, and formulate solutions (Kooken & Kerr, 2018). These qualities are necessary for managing a cancer patient since their health condition shifts depending on the disease’s treatment and staging. Prompt decision-making is crucial to averting any adverse health outcomes.
Liberal arts provide the foundation for developing intellectual and practical abilities useful in the nursing process in clinical practice. Liberal arts education cultivates our value system based on ethical and professional principles. Social and physical sciences and science studies are particularly significant in developing these values, which helps learners apply them in diverse patient populations (Kooken & Kerr, 2018). Effective communication and the ability to integrate interdisciplinary knowledge are evident in nurses with a strong background in liberal arts. Effective implementation of the nursing process in caring for cancer patients requires active collaboration with other healthcare disciplines, which relies on effective communication. Additionally, these courses help cultivate analytic abilities and theoretical perspectives, which are vital in the critical ethical decision-making process associated with improved patient safety and outcomes (Kooken & Kerr, 2018).
Cancer patients have significant physical and psychological side effects due to the disease and treatment. Their management requires a holistic multidisciplinary approach to care to improve their quality of life and help them adjust to their new life with the diagnosis. Integrating the knowledge from liberal arts in the nursing process is key to achieving better health outcomes in these patients.
American Cancer Society (ACS). (2022). How we’re providing support. American Cancer Society. Retrieved April 14, 2022, from https://www.cancer.org/about-us/what-we-do/providing-support.html
Emmons, K. M., & Colditz, G. A. (2017). Realizing the potential of cancer prevention—the role of implementation science. The New England journal of medicine, 376(10), 986.
Gress, D. M., Edge, S. B., Greene, F. L., Washington, M. K., Asare, E. A., Brierley, J. D., … & Gershenwald, J. E. (2017). Principles of cancer staging. AJCC cancer staging manual, 8, 3-30.
Jairam, V., Lee, V., Park, H. S., Thomas, C. R., Melnick, E. R., Gross, C. P., … & James, B. Y. (2019). Treatment-related complications of systemic therapy and radiotherapy. JAMA oncology, 5(7), 1028-1035.
Kooken, W. C., & Kerr, N. (2018). Blending the liberal arts and nursing: Creating a portrait for the 21st century. Journal of Professional nursing, 34(1), 60-64. DOI: 10.1016/j.profnurs.2017.07.002
Toney-Butler, T. J., & Thayer, J. M. (2020). Nursing process. In StatPearls [Internet]. StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK499937/
World Health Organization (WHO). (2022). Cancer. Retrieved from https://www.who.int/news-room/fact-sheets/detail/cancer
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