- April 17, 2020
Approach to Care of Cancer
Approachto Care of Cancer
Approachto Care of Cancer
Cancerrefers to the unregulated development and multiplication of cells inspecific parts of the body. Cells are the building blocks of thebody. The formation of new cells by the body is a continuous processthat aims to replace the aging cells (Stewartand Wild, 2016).However, this process may become faulty leading to the production ofexcessive cells which ultimately form tumors that are characterizedas either being malignant or benign. Malignant tumors are regarded tobe cancerous and have the capability of spreading to other organs inthe body. This process is referred to as metastasis (Malanchietal.,2012).Human beings are affected by different types of cancers which arenamed depending on the initial site of infection. They also vary inhow they are diagnosed and treated. There are other lifestyle factorswhich play a significant role in cancer development, some of theseinclude smoking, obesity, alcoholism, non-engagement in physicalactivities and also poor diets. Genetic alterations may be initiatedas a result of these factors, thereby contributing to cancerdevelopment. Genetic defects may also be passed from one generationto the next.
Peopleare usually encouraged to go for cancer screening clinics on aregular basis. It’s mostly done after attaining a certain age.Medical practitioners rely on certain kinds of symptoms to determinea diagnosis. First, the medical history of the patient is studiedbefore being examined for physical clues. The type of cancer andorgan affected by cancerous cells determines the specific tests to beconducted (Wardle etal.,2015). Determination of the electrolyte levels in the body and doinga complete blood count are some of the earliest tests to be done.Imaging tests are fundamental in outlining the internalabnormalities. Some of these include magnetic resonance imaging,Computer Topography scans, X-rays, and ultrasound. These allow forthe visualization of cancerous tissues. Some organs in the bodycannot be easily visualized, for instance, the bones (Tsuzuki etal.,2016). This thus necessitates for the utilization of radionuclidescanning. Presumptive evidence detailing the existence of cancer canbe determined through localization of abnormalities.
Abiopsy is the preferred diagnostic technique adopted for nearly allcancer patients. In this method, small portions of tissues aresurgically obtained and later processed for microscopic observation.This facilitates easier the determination of whether a tumor existspending its characterization as either benign or malignant.Endoscopy, the needle, and surgical biopsies are some of the methodsused for tissue removal. There are two categories of surgicalbiopsies. These include incisional and excisional biopsies. In theincisional technique, only a smaller portion of the tumor is obtainedwhereas the excisional biopsy necessitates for the removal of thewhole tumor.
Internalstructures can be observed through the endoscopy technique. Itinvolves the use of a small tube with lights attached to facilitatethe ease of taking pictures and tissue acquisition for investigation.For the needle biopsy, the tissue sample is obtained through the useof a needle.
Followingthe tumor removal process, the microscope is then used to determinecancer aggressiveness. There’s a similar appearance between thenormal tissues and differentiated tumor cells. There’s a minorresemblance between the normal tissues and the undifferentiated tumorcells. There’s also a possibility of non-similarity. The nature ofaggressiveness is different between differentiated andundifferentiated tumors.
Thisis determined once the diagnosis has been completed. This process iscrucial in determining the magnitude of infection. Thedecision-making process in treatment is heavily reliant on thestaging process. This, therefore, eases the treatment procedures,especially where communication is mandatory between medicalpractitioners concerned with patients’ disease prognosis. Moststaging systems focus on tumor size, the participation of the lymphnodes, the site of the main tumor and the amount of tumors involved.Additionally, other factors for consideration include similaritiesbetween the uninfected tissues and cancerous tissues, presence, andabsence of metastasis.
Stagingcan be categorized into four different types. The first one is theclinical stage which gives priorities to the degree of infection asprovided for by the physical examination of the patient, use ofimaging techniques in addition to the acquisition of biopsies. Thisstage acts as a guidance to the treatment initiation process.
Thenext stage is known as pathological staging which incorporates theuse of clinical and surgical outcomes. This stage is most beneficialto patients who have undergone surgical operations. The treatmentresponse and prognosis of the disease can also be determined.
Thethird stage is referred to as the post-therapeutic stage. It isusually crucial in instances where surgery is yet to be performed ornot done at all due to radiative and systemic treatment. It may alsobe referred to as post-neoadjuvant therapy.
Thefinal one is the restaging type. This is commonly vital indetermining the degree of cancer following the reoccurrence of thedisease, hence providing the ultimate treatment alternative.
TheRoman numeral staging and the TMN staging are widely adopted systems.
TheRoman numeral staging system
Insituations where cancer is restricted to the location of origin,hence no spread has occurred, it is branded as stage zero (0). Insome instances, adjacent tissues are affected but to a lowermagnitude. However, other organs are excluded, for example, the lymphnodes are not affected. This is referred to as stage one (1) cancer.In the second and third stages, the spread of cancer leads to theinfection of adjacent tissues. They are commonly denoted as stage 2and stage 3 respectively. In the final stage (stage 4), distantlylocated organs are affected as a result of the spread of cancer andalso due to the advanced state.
TheTMN staging system
Inthis system, numbers or letters are used in categorizing the numeroustypes of cancers, hence easing the depiction of the metastases, node,and tumor. The letter T is used to denote the primary tumor while thelymph nodes are indicated by the letter N to indicate the degree ofinfection in these organs. Letter M is used to designate themetastasis, an indication of the spread of cancerous cells to distantorgans.
Thedegree of growth and size of the tumor is described through the useof letter T. Therefore, the letters TX is employed in circumstanceswhere the primary tumor is hard to assess. T0 is used in the absenceof a primary tumor. The precancerous state is denoted by the Tisalternatively known as “in situ.” The growth of the cancerouscells only occurs within the superficial layers and not the deeplylocated tissues. The size of the primary tumor and degree ofinfection are classified as T1, T2, T3 and T4 (Asare etal.,2015).
LetterN is used to show whether the nearby lymph nodes have been affected.NX indicates the failure to determine the extent of infection whereasN0 denotes the nonexistence of the disease within the lymph nodes.The site, size, and quantity of lymph nodes affected are indicated byN1, N2, and N3. As initially stated, M denotes the infection ofdistant organs. M0 is used in instances where cancer cannot bedetected in the distant organs whereas M1 denotes for the infectionof these distant sites (Asare etal.,2015).
Complicationsassociated with cancer
Numerouscomplications act as a hindrance to the effective treatment ofcancer. One of the major complications is referred to as dyspnea.This relates to the breathing difficulties encountered by cancerpatients. Blockage of both small and large airways contributes to thecompromised performance. This is further worsened by lung stiffnessand the reduced gas exchange system (Lokich, 2012). In the managementof this complication, the patient has to be given certain drugs, forexample, benzodiazepines, diuretics, and opioids.
Theaffected individual may encounter general body weakness (fatigue) asa result of weak muscles and the inability of the body to generateenergy. Patients may encounter episodes of memory loss hence theirmental capacities is lowered. Changes in the protein stores found inthe skeletal muscles is a major contributory factor of fatigue thatis further worsened by the tumor necrosis factor (TNF). Additionalfactors leading to fatigue include dyspnea, malnutrition, and generalbody dehydration (Lokich, 2012). As a remedy, patients may engage inphysical activities, in addition to the utilization ofpsychostimulants and antidepressants.
Anothercommon complication is the loss of hearing which results from the useof chemotherapeutic drugs, more specifically those that are platinumbased. One of the examples is cisplatin which can lead to thepermanent loss of hearing. The receptiveness to sound waves declinesfollowing the damage to the hair cells. Severely affected patientshave to be provided with cochlear implants.
Finally,nausea and vomiting may also complicate matters for cancer patients.Stimulation may be initiated by anxiety which initiates higher centerstimulation. Vomiting may result from radiative treatment of the headand elevation of intracranial pressure. Blockage of the intestines,bronchial discharges, constipation and coughs emanate fromsympathetic and vagal afferent stimulation. Hypercalcemia and uremiaare linked to stimulation of the chemoreceptor activator region.Counseling of the patient and administration of benzodiazepine arepreferable remedies for higher center stimulation. Dexamethasone andcyclizine are preferred therapies for vomit center stimulation(Lokich, 2012). For afferent stimulation (vagal and sympathetic), thepreferred treatment is still dexamethasone. Constipation, bronchialdischarges, and coughs are cleared using cyclizine. Haloperidol andlevomepromazine are preferred when it comes to inhibiting stimulationof the chemoreceptor zone.
Lesseningthe physical and psychological effects
Cancerpatients are likely to be stressed due to the emotional, social andpsychological impacts of the disease. For stress management, mostpatients are likely to engage in alcohol consumption hence furtherworsening their condition. To lower the levels of depression andanxiety, patients have to adopt suitable strategies for managingtheir condition. It’s, therefore, vital for patients to relax andadopt effective stress management practices. Patients should embracethe use of antidepressants, engage in physical activities, counselingsessions, and also meditate.
Asnoted in this paper, it is evident that cancer ranks as one of thehighest causes of mortality and morbidity. Healthy individuals andpatients have to be at the forefront in managing the disease throughavoiding lifestyle risk factors. There is a need to incorporateevidence-based strategies in dealing with cancer and interveningbefore it progresses to the last stages. People should be encouragedto screen regularly to facilitate earlier detection, therebyincreasing the likelihood of cure.
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