Approach to Care of Cancer

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Approachto Care of Cancer

Approachto Care of Cancer

Uncontrollablegrowth and reproduction of cells in a particular part of the body isclassified as cancer. The carcinogenic cells can attack andobliterate adjacent tissues, including organs. Cancerous cells mayundergo metastasis whereby infection begins from one part of the bodyand spreads to other areas. Numerous types of cancer affect humanbeings, and they vary in diagnosis and treatment approaches. Some ofthe factors that lead to the development of cancer include the use oftobacco, poor diet and obesity, lack of physical exercises, alcoholconsumption and exposure to radiations. These factors lead to geneticchanges in cells which ultimately lead to cancer (Stewart and Wild,2016). Children may inherit genetic defects from their parents. Thispaper intends to focus comprehensively on cancer diagnosis and howthe magnitude/stage of cancer is determined. The staging of cancer isa critical aspect for consideration when establishing the treatmentplan, the outcome of disease and patient response to treatment.Additionally, the complications from cancer, the side effects oftherapy and the mechanisms to reduce both physical and mental effectsof the disease have been outlined in this paper.

Diagnosisof cancer

Thediagnosis of most types of cancers occurs during the regularscreening checkups. These tests are usually conducted at a particularage. Discovery of different types of cancers occurs after presentingto a health facility with specific symptoms. The first step indiagnosis involves performing a physical examination and obtaining anelaborate medical history of the patient, particularly the history ofthe symptoms. Some of the initial tests will be determined by thealleged location of cancer in the body and the particular type. Theinitial tests include performing a complete blood count anddetermining the electrolyte levels. Abnormalities in the body aredetermined using imaging studies. These tools include ultrasound,X-rays, MRI and CT scans. The suspected cancerous tissues can bevisualized. Radionuclide scanning is incorporated in areas that aredifficult to visualize such as inside the bones. Localizingabnormalities are essential in the diagnosis of cancer as it providespresumptive evidence (Stewart and Wild, 2016).

However,in all cancer patients, the ultimate diagnosis is based on tissueexamination through a procedure referred to as a biopsy. It involvesmicroscopic examination of a small tissue obtained through surgicalremoval. This test will determine the existence of a tumor andcategorize it as malignant or benign. Removal of tissues for a biopsyis conducted through surgical biopsy, endoscopy and needle biopsy.Surgical biopsy is categorized into two an excisional and incisionalbiopsy. The entire tumor is usually removed during the excisionalprocedure while simply a small piece of the tumor is obtained duringan incisional procedure (Stewart and Wild, 2016). During anendoscopy, the internal body organs can be observed through the useof a thin, lighted tube that can take pictures and obtain tissues forinvestigation. A needle biopsy involves the insertion of a needleinto the affected area so as to obtain a tissue sample.

Afterthe removal of the tumor, the ‘aggressiveness’ of cancer has tobe determined, and this is done under the microscope. Welldifferentiated tumor cells are similar to the normal tissues fromwhich they were derived. Undifferentiated tumor cells have either aslight resemblance to the ordinary tissue from which they werederived, or they may lack any similarity. Undifferentiated tumors aremore aggressive as compared to differentiated tumors.

Stagingof cancer

Thenext stage after the diagnosis of cancer is to perform the stagingprocess. It determines the extent to which the disease has spread inthe body. The results of the staging process are significant in thetreatment decisions. The prognosis of disease and communicationbetween health professionals regarding the health of the patient ismade easier. The common elements incorporated in some of the stagingsystems include the size of the tumor, the involvement of the lymphnodes, the location of the primary tumor, the number of tumors, theresemblance of the cancerous cells to the normal tissues and theexistence or non-existence of metastasis (Lokich, 2012).

Typesof staging

Fourmain types of staging exist

  • Clinical staging

Thisstage focuses on the extent of cancer as determined by the physicalexamination, imaging tests and conducting tumor biopsies. The besttreatment option can be committed to the clinical stage. It alsoprovides a comparative platform for establishing the treatmentresponse.

  • Pathologic staging

Itinvolves a combination of both the surgical results and the clinicalstaging results. Patients who have undergone surgery are the biggestbeneficiaries of the pathologic stage. It also provides accurateinformation to determine the response to treatment and prognosis.

  • Post-Therapy/Post-Neoadjuvant Therapy Staging

Thisis important before surgery is performed or in instances wheresurgery is not done following systemic and radiative therapy.

  • Restaging

Ifa cancer reoccurs after treatment, its extent is determined throughrestaging. It offers the best treatment option for the disease.


Thestaging system is divided into two main categories, TMN staging andthe Roman numeral staging.

TheTMN staging system

Lettersor numbers are assigned to a particular type of cancer to aid in thedescription of the tumor, node, and metastases. The main tumor isdenoted by letter T, while nodes are represented by letter Ndepicting the extent of cancer in the adjacent lymph nodes.Metastasis is represented by letter M representing the infection ofdistant organs by cancerous cells. The primary tumor as depicted bythe T category provides a description of the size and extent ofgrowth. In instances where evaluation of the main tumor is difficult,it is categorized as TX. Lack of a primary tumor is classified as T0.Tis refers to the pre-cancer state, also referred to as in situ. Thecancerous cells only grow in the superficial layers disregarding thedeeper tissues. The extent and size of the original tumor arecategorized as T1, T2, T3 and T4.

Thespread of cancer to adjacent lymph nodes is categorized using letterN. Inability to evaluate the lymph nodes is classified as NX. Theabsence of cancer in the lymph nodes is classified as N0. N1, N2, andN3 are used to refer to the affected lymph nodes in regards to theirlocation, size and the number of affected nodes. The spread of cancerto distant locations within the body is categorized as M. The absenceof disease in remote areas is classified as M0 while M1 is used torefer to the spread of cancer to distant locations (Asare etal.,2015).

TheRoman numeral staging system

Stage0 cancer- there is no spread of cancerous cells and they are stilllimited to the site of origin.

Stage1 cancer- nearby tissues are infected to a smaller extent with theexemption of lymph nodes and other organs.

Stage2 and 3 cancer- nearby tissues are affected following the spread ofcancer.

Stage4 cancer- this is the advanced state and the disease has penetrateddistant organs.

Complicationsof cancer

Severalproblems emerge from the disease and treatment process. Theseinclude

  • Nausea and vomiting

Theseare likely to occur in cancer patients. Fear and anxiety may lead tohigher center stimulation. Increased intracranial pressure and headradiotherapy may also lead to vomiting center stimulation. Vagal andsympathetic afferent stimulation leading to coughs, constipation,bronchial secretions and obstruction of the intestines. Stimulationof the chemoreceptor trigger zone is linked to uremia andhypercalcemia. An example of vestibular nerve stimulation is motion.The available treatments for higher center stimulation includecounseling as the primary treatment while benzodiazepine is thesecond line of therapy. For vomit center stimulation, cyclizine isthe main treatment while dexamethasone is the secondary treatment(Lokich, 2012). For vagal and sympathetic afferent stimulation,dexamethasone is the primary treatment while cyclizine is thesecondary treatment for coughs, bronchial secretions, andconstipation. Stimulation of the chemoreceptor trigger zone istreated using haloperidol as the primary drug while levomepromazineis the secondary drug of choice. Stimulation of the vestibular nerveis treated using cyclizine as the primary drug of choice and hyoscinepatch as the secondary drug.

  • Fatigue

Lackof energy and a muscular weakness result from the reduced capacity tosustain force or power output. The ability to perform mental tasks isreduced over time leading to poor memory. Cancer patients experiencefatigue due to alterations in the protein stores within the skeletalmuscles as influenced by the tumor necrosis factor (Tsuzukietal.,2016).Other causes include dehydration, nutritional status, anemia anddyspnoea. Management involves engaging in simple exercises, use ofantidepressants and psychostimulants.

  • Dyspnoea

Cancerpatients may have difficulty breathing. Impaired performance mayresult from obstruction of both the large and small airways.Additionally, an increase in the lung stiffness and a decrease in thegas exchange system are also factors for consideration (Lokich,2012). Management involves the use of drug therapy, such as opioids,diuretics, and benzodiazepines among others.

  • The loss of hearing

Chemotherapydrugs (platinum-based) for example, cisplatin and radiation therapycan progressively lead to a permanent loss of hearing. The inner earis most affected as the hair cells are damaged reducingresponsiveness to sound waves. One of the remedies involves the useof cochlear implants for severe cases (Lokich, 2012).

Lesseningthe physical and psychological effects

Cancerpatients may be significantly affected by the physical, social andemotional effects of the condition leading to stress. Management ofstress through negative behaviors such as alcoholism may have a poorquality of life after treatment. Those who adopt appropriatestrategies to cope with the disease have reduced levels of anxietyand depression. Incorporation of stress management techniques andrelaxation are critical aspects that can be considered when it comesto reducing physical and psychological effects (McPhee etal.,2010). Management of mental stress is achieved through social andemotional support. Some of the strategies may include meditation,counseling, educational talks on cancer, exercise and use ofantidepressants. Screening of patients for any signs of distressshould be conducted early enough.


Thereis no doubt that cancer is one of the leading causes of morbidity andmortality globally. Avoiding dietary and behavioral risks among thehealthy population is mandatory. To reduce the burden of cancer, wehave to be knowledgeable about the causes, in addition to extensivemanagement and intervention strategies such as the incorporation ofevidence-based strategies. Early detection of cancer is crucial inthe treatment process as it contributes to the high chances of cure.


Asare,E. A., Washington, M., Gress, D. M., Gershenwald, J. E., &ampGreene, F. L. (2015). Improving the quality of cancer staging. CA:a cancer journal for clinicians,65(4),261-263.

Lokich,J. (2012). Complications of Cancer Therapy. ClinicalCancer Medicine: Treatment Tactics,325.

McPhee,S. J., Papadakis, M. A., &amp Tierney, L. M. (Eds.). (2010). Currentmedical diagnosis &amp treatment 2010.New York: McGraw-Hill Medical.

Stewart,B., &amp Wild, C. P. (2016). World cancer report 2014. World.

Tsuzuki,S., Park, S. H., Eber, M. R., Peters, C. M., &amp Shiozawa, Y.(2016). Skeletal complications in cancer patients with bonemetastases. InternationalJournal of Urology.

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