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The diagnosis and staging of cancer
Cancer treatment and management of symptoms is a complex process that relies on the level of accuracy afforded by the clinician during diagnosis and the presumptive development of the care plan. In the first or initial point of meeting the patient, the clinician will focus on the physical examination, history examination and more importantly the history of the symptoms (MacLeod, MacLeod & Vella-Brincat, 2012). Thus, the cancer diagnosis can be categorized into two major sections which however seek to achieve similar objectives and that is to provide the presumptive evidence that is vital in the treatment and management. These include the diagnosis process and the cancer staging process. Essentially, these two are conducted simultaneously and in most cases the results of one will directly influence the other (Faull et al., 2012).
Diagnosis in itself comprises of the assessment of the symptoms and their history over time, especially the timeline between diagnosis and the first initial symptoms. On the other hand, the clinician will seek to develop a comprehensive family history examination of the patient which is critically essentially in determining whether there is a genetic link to the illness or the condition (Yeh & Bickford, 2009). This familial link could provide a more reliable plan for determining the best approach that can be adopted in the management by relying on the information available from any other family member who has been diagnosed previously and how the process ended, successfully or otherwise (Golant, Altman & Martin, 2003).
Cancer staging on the other hand is the process in which the clinician focuses on the progressiveness of the disease along a patho-physiological line. In this case therefore, staging focuses on the extent or severity of an individual’s cancer (MacLeod, MacLeod & Vella-Brincat, 2012). The doctor or clinician has to understand how deep the cancer has prevailed in the patient’s body since this is the only way a comprehensive care plan can be developed while also enabling one to estimate the patient’s prognosis. This staging is based on the physical exams, imaging procedures and data, surgical results as well as pathology reports (Ganz et al., 2004).
Staging is this based on the knowledge and ability to detect the cancer progression. Usually cancer begins as a mass of cells and divides and distributes extensively over the adjacent tissues and cells into a tumor. On the other hand, the condition may progress from the tumor and into other body tissues and organs which in essence signals a spread from the primary site where it begins to form new tumors in those other regions a process called metastasis (Yeh & Bickford, 2009). Thus understanding the development from the cells, to the tumor to the metastasis stage would help develop the most appropriate and effective treatment and management plan. The first staging is done when the illness has first been diagnosed and this is referred to as the clinical staging, while the staging performed after a surgery or biopsy is referred to as the pathology staging. Finally, the two processes are combined with the surgical results and any other results or data of new developments in progression and continually added to the original staging data (MacLeod, MacLeod & Vella-Brincat, 2012).
Complications of cancer, the side effects of treatment
The treatment and management of cancer is as complex as understanding the progression of the illness. However, if the staging and diagnosis process are done as accurately or closely accurate as possible, then there are high chances of prevention or effective management. There are several methods that are employed in prevention, management and treatment of the cancer. Surgery has been one of the most effective methods of treatment and management as well as prevention and most of the populations who have cancer have had a surgery at one time or another. This involves the physical removal of the tumor and surrounding cells to help avert the possibility of further spread and metastasis. Chemotherapy and radiotherapy on the other hand are effective in the management of cancer. Chemotherapy entails the use of powerful medicines that can be used to eliminate or alter the growth and progression of the tumor especially away from the primary location. Radiotherapy on the other hand, focuses on the use of strong radio waves to alter the growth of the tumor (Yeh & Bickford, 2009).
Within all these methods of treatment, many patients have reported cases of side effects upon treatment. These side effects could range between psychological and physical side effects. Surgery for instance could lead to unprecedented levels of pain which on the other hand could increase the patient’s bed rest or hospital stay. The initial instance of surgery could also prove a psychological torture to the patient especially with the common belief associated with surgery as a last resort for patients with life threatening conditions (Golant, Altman & Martin, 2003).
On the other hand, radiotherapy could lead to the damage of surrounding cells which in all essence could not have been affected by the tumor. In the case where these radio waves affect or later the structure of cells of vital organs, the patient could develop other complications further leading to poor recovery rates, increased stays in hospital and higher costs of treatment (Yeh & Bickford, 2009). Chemotherapy on the other hand could lead to damage of the cells that were not initially targeted since the spread of the medicine in the body as well as the strength of the chemotherapy drugs in at times uncontrollable depending on each individual patient. An alteration could occur on a vital organ which on the other hand could lead to further secondary complications.
Similarly, cases of fatigue, nausea, pain, vomiting and shortness of breath are common cases associated with the process of treatment especially when chemotherapy and radiotherapy are applied. This is usually as a result of the alteration of normal body processes as the cells react to the medication or radio waves designed to alter the growth of the cancer cells. Lympedema and anemia on the other hand are common in a several cases of treatment (Ricardo Buenaventura et al., 2008). Anemia usually occurs as a result of the low number of blood cells while lymphedema is associated with the swelling of the legs due to accumulation of lymph fluid in immediate fatty tissues under the skin (Faull et al., 2012). These usually occur when the chemicals or the radio waves alter with the normal body processes of blood cells growth or lymphatic system functioning.
Methods to lessen physical and psychological effects
For the clinician, it is always important to focus on the recovery and restoration process for the primary problem while also keeping a close follow-up of the apparent physical and psychological effects that may prevail over the course of treatment and management. Thus, the care plan must not be limited to the cancer as the primary condition but rather allow for its modification to accommodate the secondary issues that are inevitable. The use of opioids, sedatives, antibiotics, diuretics, anticoagulants, steroids, inhaled/oral bronchodilators can be effective in helping manage the most common side effects (Faull et al., 2012).
The opioids and anticoagulants are effective in dealing with pain and slowing or averting the retention of fluids in the body tissues where this retention is restricted. Steroids are applied in those cases where the clinician feels the need to supplement a malfunction of the body’s defense system especially when the condition seems to attack the body mechanisms of defense. Inhalers and bronchodilators are used in those patients who report cases of SOB or any other dysfunction of the respiratory system (Mock et al., 2001). However, it is also important to limit the drug therapy to minimal levels and dosages so that the patient is not overwhelmed by the large variety of drugs especially at a time the body is also straining to maintain the normal functioning and the recovery and restoration aspects.
Most patients, especially those who have been diagnosed with cancer for the very first time, find it hard to live with the condition. In other cases the preferred methods of treatment by the patient may not be suitable for the stage of cancer they have been diagnosed. Thus, they begin to feel as though their independence is being limited by the condition and the feelings of hopelessness begin to emerge; severely limiting the chances of effective self-care (Golant, Altman & Martin, 2003). Beliefs on surgery and radiotherapy also tend to affect patients by viewing the treatment process as a one that will further dampen their chances of recovery or add further complication to their condition. Thus, the use of non-pharmaceutical therapies to help overcome these psychosocial and spiritual limitations is always necessary (Ganz et al., 2004).
The most important aspect however, is communication and explanation. The clinician must stand out and talk the patient through the diagnosis, the staging, the care pan development and the suitable treatment techniques and the apparent side-effects (Faull et al., 2012). It is always important to conceal the predictable outcomes upon treatment especially on the short term so that the clinician can gin the full support of the patient while also giving them a proactive role in managing their illness (Ganz et al., 2004). On the other hand, relaxation techniques, body positioning especially for those patient who have undergone surgery as well as using music and arts to control their emotions could prove key in remodeling the patient’s beliefs and attitudes. However, these may not be the absolute techniques and may only be applicable to a number of patients. It is the role of the clinician at all times to consider the best combination that achieves the optimal recovery and restoration levels and this too is anchored on the communication and understating developed with the patient or the caregiver (Ricardo Buenaventura et al., 2008).
Faull, C., De Caestecker, S., Nicholson, A., & Black, F. (2012). Handbook of palliative care. John Wiley & Sons.
Ganz, P. A., Kwan, L., Stanton, A. L., Krupnick, J. L., Rowland, J. H., Meyerowitz, B. E., & Belin, T. R. (2004). Quality of life at the end of primary treatment of breast cancer: first results from the moving beyond cancer randomized trial. Journal of the National Cancer Institute, 96(5), 376-387.
Golant, M., Altman, T., & Martin, C. (2003). Managing cancer side effects to improve quality of life: a cancer psychoeducation program. Cancer Nursing,26(1), 37-44.
MacLeod, J. V. B. R., MacLeod, S., & Vella-Brincat, J. (2012). The palliative care handbook. Crucila Colour.
Mock, V., Pickett, M., Ropka, M. E., Lin, E. M., Stewart, K. J., Rhodes, V. A., & McCorkle, R. (2001). Fatigue and quality of life outcomes of exercise during cancer treatment. Cancer practice, 9(3), 119-127.
Ricardo Buenaventura, M., Rajive Adlaka, M., & Nalini Sehgal, M. (2008). Opioid complications and side effects. Pain physician, 11, S105-S120.
Yeh, E. T., & Bickford, C. L. (2009). Cardiovascular complications of cancer therapy: incidence, pathogenesis, diagnosis, and management. Journal of the American College of Cardiology, 53(24), 2231-2247.
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