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Benchmark – Nursing Process: Approach to Care NRS 410V

Benchmark – Nursing Process: Approach to Care NRS 410V

Benchmark – Nursing Process: Approach to Care NRS 410V

The nursing process aims at providing patient-centered care in five stages including assessment, diagnosis, planning, implementation, and evaluation. The first thing nurses ought to do as they interact with patients is to assess their health needs. The assessment approach depends on the presenting illnesses in the patients; though, taking history and the objective data is important for all conditions. The outcomes in the subsequent steps depend on how well the assessment was conducted. The assessment helps the nurses to identify the correct diagnosis for the patients. Cancers are a major threat with minimal survival rates especially when the condition is diagnosed late. Thorough assessment allows the nurses to apply critical thinking skills so that they can detect cancer diseases at their early stages. On the other hand, the patients with advanced cancer disease require palliative care, with the most focus being on emotional and spiritual wellbeing. The side effects of the cancer treatments can be overwhelming and so the patients must be reassured all the time. The current study explores the role of the nursing process in managing cancer patients.

The scourge of cancer has been increasingly affecting the patients, their families, and even the community at large. Its prevalence has been increasing, the effects are increasingly being experienced and reported, and the healthcare burden has been worrisome. The global incidence of cancer was 23.6 million as of 2021 with 10 million deaths occurring annually worldwide making it the second leading cost of death in the world only bested by cardiovascular deaths (Sung et al., 2021). The United States is not exempted from these impacts with the annual new cases being approximately 1.75 million and estimated deaths being 0.6 million annually (Cancer data and statistics, 2022). In addition, the affected patients also develop psychosocial effects and physical impacts of the disease that might be debilitating. Due to these high burdens of cancers, the healthcare systems have conducted studies to help in understanding the etiologies of cancer, the reasons for increasing healthcare burden related to disease, and even the preventive healthcare strategies that can be employed in reducing the burden. The objective of this paper is to provide insight into cancer by describing how it is diagnosed and staged, complications arising during its treatment, and the roles that nurses perform in managing cancers.

The Diagnosis and Staging of Cancer

Many cases of cancer have been missed due to poor patient assessment. Therefore, the diagnosis begins with an appropriate assessment and analysis of the patients’ signs and symptoms. The assessment involves determining the presence of tissue growths and lumps in the affected areas. For cancer affecting internal organs, imaging techniques such as endoscopy and laparoscopy are used. Subsequently, the sample from the tissue mass or fluid in the affected areas is drawn for cytological and histological tests. Cancer is characterized by the abnormal growth of the body cells; therefore, the diagnosis is based on analyzing the size, shape, and other morphological characteristics of the cells. On the other hand, there are also cancer antigen markers used in the diagnosis. Though, caution must be taken to avoid reporting either false-negative or false-positive results. The common cancer antigen markers include the prostate-specific antigen, the prostatic acid phosphatase, the CA 125, carcinoembryonic antigen alpha-fetoprotein, the human chorionic gonadotrophin, and CA 19-9. These biomarkers are normally produced by the body cells; however, elevated readings may indicate abnormal cell growth in the specific regions.

The cancer staging depends on the size of the mass, and whether the cells have metastasized or not. The staging helps in determining the treatment method to use as well as the survival rate. Commonly, the staging is based on the TNM system. The TNM is an acronym for the tumor, node, and metastasis (Cancer staging, n.d.). The tumor is graded from 0-4 depending on the size. On the other hand, the node is graded from 0-3 depending on the number of lymph nodes affected. Finally, the metastasis is graded from 0 to 1 depending on whether the cancer cells have spread to other parts of the body. Based on the TNM score, cancer can be categorized as either stage 1, 2, 3, or 4. At stage 1, the cancer is small and has not spread to other parts of the body. Stage II and III mean that the cancer is large and has grown to the nearby tissues and lymph nodes (Cancer staging, n.d.). In stage IV, cancer has spread to other parts of the body and this means that the treatment also becomes extremely complex.

The Complications and Side Effects of Cancer Treatment

Cancer is characterized by abnormal cell division; therefore, the treatment options involve eliminating the uncontrollably dividing cells. In a localized tumor, the cancerous cells can be removed surgically. On the other hand, in cases where the mass is large and has spread to other parts of the body, the patients are subjected to chemotherapy and radiotherapy. The first side effect of treatment is alopecia; a condition characterized by hair loss. In addition, the patients may have other skin complications including dryness and redness. The second side effect is anemia  (Momenimovahed & Salehiniya, 2019). Patients undergoing chemotherapy and radiotherapy are likely to have anemia because the treatment inadvertently kills the healthy red blood cells in the blood system. Thirdly, cancer patients experience a lot of pain during the treatment (de Pauli et al., 2019). Pain can interfere with the patient’s quality of life and contribute to other emotional and physiological problems. Furthermore, nausea and vomiting is a common side effect for the people receiving cancer treatment.

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The complications and side effects can be reduced by eating a light meal before the procedure and eating a balanced diet. The light meal helps in reducing nausea while the balanced diet reduces the likelihood of developing anemia. Also, the patients require a lot of counselling and emotional support to reduce the emotional torture associated with the expectation of pain especially when they are about to undergo the treatment procedure. On the other hand, patients experiencing hair loss may need to cover their heads to avoid sunburns and

Factors Contributing to Incident and Mortality Rates of Various Cancers

The onset and progression of cancer depend on various factors. Lifestyle and behavioral patterns are major determinants of the incident and mortality rates for various cancers (Momenimovahed & Salehiniya, 2019). For example, people who smoke are more vulnerable to lung, pharyngeal, laryngeal, and oesophageal cancer. Lung cancer is the leading cause of cancer in the United State. Also, occupation may expose one to cancer. People working in the chemical industries and inhale the chemical materials may also develop lung cancer. The chemicals are also linked with skin cancer. Also, the mortality rates depend on the economic status. People from low-income families are unlikely to afford all the cancer treatments.

American Cancer Society

The American Cancer Society can provide education and cancer support to cancer patients through national cancer day programs. Also, they may develop campaign programs such as the fight against lung cancer and HPV and so educate the public on the causes, and prevention measures for the various cancers. Further, the education should promote regular screening and inform the public where they can seek help to promote early diagnosis and treatment of the cancer cases. Moreover, it is recommended that ACS offer support groups and access to care through financial support programs especially among the vulnerable populations; the services will help reduce the burden of cancer.

Utilization of Nursing Process Across the Life Span

According to Bates et al. (2018), the nurses touch patients at different levels of care delivery. In this case, the nursing process has an important role in identifying the health needs of the patients at the assessment level and developing appropriate remedies at the assessment and diagnosis levels. At the planning phase, the nurses develop new methods of addressing the patients’ needs. For example, the emergency telehealth system can be effectively implemented to improve the treatment outcomes for cancer patients. In such cases, the nurses ought to interact with their patients, understand their psychosocial and economic needs and come up with methods that will increase their level of access to medical services courtesy of the telehealth system. The new treatment methods are then implanted and customized to the patient’s setting. Finally, the effectiveness of the intervention is analyzed at the evaluation phase to determine its effectiveness in promoting the patient’s health outcome.

Contribution of Liberal Art and Science Studies to Nursing Knowledge

The human system is unitary and so spiritual healing is an important component that determines the patients’ treatment outcomes. Therefore, the understanding of art and science studies helps in understanding how the patient’s environment affects their wellbeing. Art has been significantly integrated into the healing process because of the calming effects they have on the patients. Patients with terminal illnesses such as cancer can significantly benefit from the serene and holistic environment creates through the artistic works (Kooken & Kerr, 2018). The liberal art improves the communication skills among the nurses and interacts with highly diversified populations accordingly. Also, mathematics, social and physical sciences, and science studies are part of the interdisciplinary research area with significant contributions to nursing care delivery.

Conclusion

Cancer patients require holistic care and a lot of social and emotional support because of the complications and side effects associated with cancer treatment. The nursing process approach of care illustrates the role of nurses as they interact with the patients from assessment, diagnosis, planning, implementation, and evaluation. In addition, integrating the skills from liberal art and sciences equips the nurses with relevant competencies to address the complex needs of the patients.

 

 

References

Bates, R. A., Blair, L. M., Schlegel, E. C., McGovern, C. M., Nist, M. D., Sealschott, S., & Arcoleo, K. (2018). Nursing across the lifespan: Implications of Lifecourse theory for nursing research. Journal of Pediatric Health Care32(1), 92-97. https://doi.org/10.1016/j.pedhc.2017.07.006

Cancer staging. (n.d.). National Cancer Institute. https://www.cancer.gov/about-cancer/diagnosis-staging/staging

de Pauli Paglioni, M., Araújo, A. L. D., Arboleda, L. P. A., Palmier, N. R., Fonsêca, J. M., Gomes-Silva, W., … & Santos-Silva, A. R. (2019). Tumor safety and side effects of photobiomodulation therapy used for prevention and management of cancer treatment toxicities. A systematic review. Oral oncology, 93, 21-28. https://doi.org/10.1016/j.oraloncology.2019.04.004

Kooken, W. C., & Kerr, N. (2018). Blending the liberal arts and nursing: Creating a portrait for the 21st century. Journal of Professional Nursing34(1), 60-64. https://doi.org/10.1016/j.profnurs.2017.07.002

Momenimovahed, Z., & Salehiniya, H. (2019). Epidemiological characteristics of and risk factors for breast cancer in the world. Breast Cancer: Targets and Therapy, 11, 151. doi: 10.2147/BCTT.S176070

 

The scourge of cancer has been increasingly affecting the patients, their families, and even the community at large. Its prevalence has been increasing, the effects are increasingly being experienced and reported, and the healthcare burden has been worrisome. The global incidence of cancer was 23.6 million as of 2021 with 10 million deaths occurring annually worldwide making it the second leading cost of death in the world only bested by cardiovascular deaths (Sung et al., 2021). The United States is not exempted from these impacts with the annual new cases being approximately 1.75 million and estimated deaths being 0.6 million annually (Cancer data and statistics, 2022). In addition, the affected patients also develop psychosocial effects and physical impacts of the disease that might be debilitating. Due to these high burdens of cancers, the healthcare systems have conducted studies to help in understanding the etiologies of cancer, the reasons for increasing healthcare burden related to disease, and even the preventive healthcare strategies that can be employed in reducing the burden. The objective of this paper is to provide insight into cancer by describing how it is diagnosed and staged, complications arising during its treatment, and the roles that nurses perform in managing cancers.

Cancer Diagnosis and Staging

Diagnosis

            Cancer can either be diagnosed at routine screening or during the diagnosis. The screening tests are preferred by the healthcare stakeholders because it guides in the early detection of cancer before it manifests and is therefore associated with a better outcome of care. In contrast, diagnostic tests are employed to identify specific cancer when the patient has presented with the signs and symptoms suggestive of certain cancer. Diagnosis, therefore, begins with history taking and physical evaluation of the patient whose results will guide the specific diagnostic tests to order for. For instance, patients who present with chronic cough and hemoptysis with a history of cigarette smoking can be diagnosed with lung cancer as opposed to another who presents with hematuria, flank pain, and flank mass who would be diagnosed with renal cell cancer (Koo et al., 2020). In either of these cases, the diagnostic tests done are different. These tests can however be broadly considered as imaging studies, laboratory tests, and histological tests.

The laboratory tests that have been employed in cancer diagnosis utilizes specimen such as those that have been collected through biopsy. During the assessment, the structures of the collected samples are compared with the normal structures to identify any abnormalities at the cellular (cytological) or tissue (histological) levels (Wilkinson, 2021). Given the advancements in diagnosis, there is a recent application of molecular studies in the diagnosis of cancers where the molecular characteristics of the oncogenic cells can be identified through immunohistochemistry or flow cytometry to not only help in the qualitative diagnosis of specific cancer but also quantification of the oncogenic cells (Sung et al., 2021). The biopsy and visual tissue inspection are the gold standards for the diagnosis of cancer given the high cost and unavailability of molecular studies. The molecular studies are however more accurate.

Imaging studies complement the laboratory studies in the diagnosis of cancers. They help in structural visualization and may guide in assessing the local effect of cancer or even its spread. Some of the imaging tests include CT scan, colonoscopy, esophagoduodenoscopy (OGD), MRI, and PET scans. During some of these imaging studies, targeted specimen collection can be done for the affected structures thus increasing the yield of the specimen (Koo et al., 2020). Incorporating both laboratory and imaging studies in cancer diagnosis is encouraged as it promotes accuracy in diagnosis.

Staging

            After the diagnosis of cancer has been made, the oncologist helps with the cancer staging to explain the extent of its spread and determine its prognosis. Different staging classification has been in use although most of them are done based on the size of the tumor (T), the number of nodes involved in tumor spread (N), and the presence of metastasis of the tumor to the local or distant structures (M). These TNM staging that employs the three parameters is further subdivided into stages I, II, III, and IV where stage I signifies a disease that is limited locally without metastasis as opposed to stage IV which is advanced cancer with metastasis to the other structures (Padilla-Leal & Medina-Franco, 2019). The stage IV tumor has a poor prognosis and may only be addressed palliatively as compared to stage I which has a better prognosis.

Other staging classifications are dependent on the system affected by the tumor and may be based on other parameters. These stagings include the International Federation of Gynecology and Obstetrics (FIGO) staging for cancers gynecologic cancers, Manchester staging employed for breast cancer, and the Ann-Arbor staging system for lymphomas and leukemias (Sung et al., 2021). Either of these staging criteria helps in determining the severity of cancer, and its prognosis and may therefore influence the choice of therapy to be employed.

Complications resulting from Cancer, Side Effects of Drugs Used, and Methods that can be Employed in Reducing the Physical and Psychological Impacts of Cancer

Cancer Complications

            The complications related to cancer can either result from cancer itself or the adverse effects of medications that are used in its treatment. Most of these complications usually present late although their symptoms depend on the affected organs. The organ-specific complications include increased intracranial pressure in brain tumors, jaundice and ascites in liver cancers, hydronephrosis in stage 3 cervical cancer, and anemia due to cancers of the bone marrow (Koo et al., 2020). In contrast, the systemic complications are usually unrelated to the cancers and may include malnutrition, cachexia, and infections. Malnutrition in cancer usually results due to reduced food intake or increased nutrient demand due to the cancer-mediated hypermetabolic state (Jairam et al., 2019). The reduced weight in malnutrition is therefore different from cachexia in which it is due to increased production of cytokines such as tumor necrosis factors that encourage. Malnutrition is responsible for reduced immunity, in addition, to the myelosuppression due to cancer that reduces the leucocyte levels in the body (Padilla-Leal & Medina-Franco, 2019). These impacts of cancer complications would increase the risk of infections.

Side Effects of Drugs used in Cancer Treatment

            Chemotherapeutic drugs pose risks to the organs they act on and even other systems due to their toxicity. The drugs especially cell cycle nonspecific agents usually affect the cell cycle of normal body cells thus resulting in their adverse effects. These adverse effects that occur regardless of the agent type include myelosuppression, tumor lysis syndrome, fatigue, mucositis, and hair loss.  Myelosuppression, in which the drug suppresses the bone marrow, is responsible for reduced production of blood cells and therefore presents as anemia, increased risks of infections, and bleeding tendencies in patients who are on care (Jairam et al., 2019). Tumor lysis syndrome, on the other hand, occurs especially in the treatment of cancers with high cell turnovers such as leukemias and lymphoma because the increased cell destruction causes electrolyte imbalances such as hyperkalemia, hyperuricemia, and hypercalcemia that may then affect other systemic functions (Nurgali et al., 2018). Organ-specific effects are usually due to toxicity and are also specific to the agents used such as hemorrhagic cystitis, pulmonary toxicity, and cardiotoxicity in patients on cyclophosphamide, bleomycin, and doxorubicin respectively (Sung et al., 2021). These side effects can be addressed by discontinuing the therapy and lowering the drug doses, before managing the complications that the patients present with. For instance, blood transfusion and administration of granulocyte-macrophage colony-stimulating factor (GM-CSF) may be appropriate for myelosuppression whereas adequate hydration and administration of allopurinol are indicated for the management of tumor lysis syndrome (Prieto-Callejero et al., 2020). They should therefore be anticipated, diagnosed promptly, and addressed appropriately to minimize the adverse impact on the patients.

Nursing Interventions to Minimize Physical and Psychological Impacts of Cancer

            The physical complications of cancer and the effects of its treatment as well as the consequential psychological impacts should be addressed appropriately to improve patients’ wellbeing. Some of the interventions employed for managing these effects include the administration of analgesia, teaching the patients on relaxation techniques, and even meditation to help them relieve the pain they experience (Tuominen et al., 2019). Family education can also be done to promote their involvement in patient care, improve the psychosocial support system and therefore address psychological effects such as loneliness and depression that are experienced by neglected cancer patients (Wilkinson, 2021). Further, the patients may be linked with social support groups and other healthcare professionals such as nutritionists and clinical psychiatrists to provide other necessary social support and healthcare services (Tuominen et al., 2019). These interventions will strengthen the patient’s physical and psychological status thereby enhancing the outcome of care.

Reason for the Increasing Yearly Incidence and Mortality for Various Cancers in the US.

            CDC (2022) reports that there is an upward trend in the incidence and mortality rates of cancer in the US with 0.6million deaths and 1.6million new cases reported annually. It further projects the new cases to rise by up to 49% by 2050 which is approximately a 2.2million new cases annually, especially in the aging population. Some studies suggest that this trend is a consequence of the increasing size of the aging population and lifestyle changes (You & Henneberg, 2018). The lifestyle change includes an increased sedentary lifestyle, more cases of cigarette smoking and alcohol use as well as increased incidences of implicated infections.

Advanced age is a risk factor for most cancers because the aging process is associated with increased cellular damage and decreased effectiveness of repair mechanisms thus more risk of accumulation of defective cells (Koo et al., 2020). This predisposes individuals to cancers. The increased aging population which has quadrupled from 4.1% in 1900 to 16% in 2019 may therefore explain the increased incidences of cancer (Abeliansky et al., 2020).

The sedentary lifestyle that has increasingly led to obesity is also implicated in the upwards trend. Obesity is a risk factor for endometrial, colorectal, and breast cancers, and thus increased incidence of obesity to 41.9% in 2020 up from 30.5% 20 years earlier may be responsible for the increase in the incidences of these cancers (Sung et al., 2021). On the other hand, increased cases of cigarette smoking may have led to increased incidences of laryngeal, lung, throat, and oral cancers in which cigarette smoking is a risk factor. Further, for the cancers which are associated with infections such as Epstein Bar Virus (EBV) and nasopharyngeal cancer, and Burkitt’s lymphoma, increased cases of EBV especially in low socioeconomic status may result in increased incidences of the related cancers (Wilkinson, 2021).

Strategies that address the factors that are responsible for the increased incidences and mortality rates of cancer may guide in reducing both the new cases and their related mortality. Individuals should be encouraged to adopt physical exercise, nutritional modifications, and other weight reduction measures to prevent obesity (Koo et al., 2020). They should also be encouraged to reduce alcohol use and avoid cigarette smoking. Further, healthcare strategies such as screening for infection and prompt treatment of patients may also be adopted (Wilkinson, 2021).

American Cancer Society Education and Support

Patient education is a key component of the fight against cancer. The American Cancer Society is a supporting group that is a non-profit organization (NGO) that contributes to the fight against cancer by offering patient education. Their mode of education is by using flyers and brochures to enlighten the public on cancer prevention measures and encourage them to adopt routine screening and early diagnosis (Prieto-Callejero et al., 2020). Through this enlightenment, the organization prevents disinformation that is responsible for delays in health-seeking by the public.

I noticed that the organization has not been involved in financial support for the patients or research institutions. My recommendation is therefore that they offer financial support to the cancer patients to assist with transport and purchase of drugs, therefore, improving their adherence to therapy sessions. Further, financing research will improve knowledge on how to prevent cancers and treat the patients effectively.

Nursing Processes that are Applied in the Care of Cancer Patients

            Management of cancer patients requires a multidisciplinary approach. The nurses are therefore engaged in the care process through their nursing processes including the assessment, diagnosis, planning, implementation, and evaluation (ADPIE). When the patient reports to the facility, the nurses can provide an initial assessment that would help in making the nursing diagnosis that guides patient care (Wilkinson, 2021). The implementation process includes administration of prescribed drugs, monitoring of patient’s vitals, and cooperation with other healthcare professionals during patient management (Jairam et al., 2019). The nurses may also engage in patient education that would increase the acceptance of the diagnosis and enhance their adherence to therapy.

Contributions to the Undergraduate Education in Liberal Arts and Science

            Holistic care of the patients not only requires the understanding of medical knowledge but also an understanding of other patient factors that may influence patient care. Liberal art and sciences help the nurses to incorporate other patient-specific characteristics such as their racial factors and socioeconomic status during the care process. Training the nurses in these fields, therefore, equip them with knowledge and skills that they can apply in predicting how socioeconomic factors or the geographical origin of the patient affects their disease presentation and outcome of care (Abeliansky et al., 2020). It may also help the nurses to modify these characteristics to improve the outcome of care.

Conclusion

            Cancer is a malady that has been increasing in incidence and impact due to the increased size of the aging population and lifestyle changes. Early diagnosis and screening may help in better management of patients and prevention of cancer complications although the side effects and toxicity of the chemotherapeutic agents should also be considered and appropriately managed. Among the interventions that the nurses can employ include family education and pain management to promote the physical and psychological well-being of the patients. Their care process should incorporate the knowledge of liberal arts and sciences to promote holistic care for cancer patients.

References

Abeliansky, A. L., Erel, D., & Strulik, H. (2020). Aging in the USA: similarities and disparities across time and space. Scientific Reports10(1), 14309. https://doi.org/10.1038/s41598-020-71269-3

Cancer. (2022, June 7). Cdc.gov. https://www.cdc.gov/chronicdisease/resources/publications/factsheets/cancer.htm

Cancer data and statistics. (2022, June 2). Cdc.gov. https://www.cdc.gov/cancer/dcpc/data/index.htm

Jairam, V., Lee, V., Park, H. S., Thomas, C. R., Jr, Melnick, E. R., Gross, C. P., Presley, C. J., Adelson, K. B., & Yu, J. B. (2019). Treatment-related complications of systemic therapy and radiotherapy. JAMA Oncology5(7), 1028–1035. https://doi.org/10.1001/jamaoncol.2019.0086

Koo, M. M., Swann, R., McPhail, S., Abel, G. A., Elliss-Brookes, L., Rubin, G. P., & Lyratzopoulos, G. (2020). Presenting symptoms of cancer and stage at diagnosis: evidence from a cross-sectional, population-based study. The Lancet Oncology21(1), 73–79. https://doi.org/10.1016/S1470-2045(19)30595-9

Nurgali, K., Jagoe, R. T., & Abalo, R. (2018). Editorial: Adverse effects of cancer chemotherapy: Anything new to improve tolerance and reduce sequelae? Frontiers in Pharmacology9, 245. https://doi.org/10.3389/fphar.2018.00245

Padilla-Leal, K. E., & Medina-Franco, H. (2019). The eighth edition of the American Joint Committee on Cancer staging system: are we getting closer to the ideal classification for gastric cancer? Annals of Translational Medicine7(Suppl 1), S52. https://doi.org/10.21037/atm.2019.03.05

Prieto-Callejero, B., Rivera, F., Fagundo-Rivera, J., Romero, A., Romero-Martín, M., Gómez-Salgado, J., & Ruiz-Frutos, C. (2020). Relationship between chemotherapy-induced adverse reactions and health-related quality of life in patients with breast cancer. Medicine99(33), e21695. https://doi.org/10.1097/MD.0000000000021695

Sung, H., Ferlay, J., Siegel, R. L., Laversanne, M., Soerjomataram, I., Jemal, A., & Bray, F. (2021). Global cancer statistics 2020: GLOBOCAN estimates incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians71(3), 209–249. https://doi.org/10.3322/caac.21660

Tuominen, L., Stolt, M., Meretoja, R., & Leino-Kilpi, H. (2019). Effectiveness of nursing interventions among patients with cancer: An overview of systematic reviews. Journal of Clinical Nursing28(13–14), 2401–2419. https://doi.org/10.1111/jocn.14762

Wilkinson, A. N. (2021). Cancer diagnosis in primary care: Six steps to reducing the diagnostic interval. Canadian Family Physician Medecin de Famille Canadien67(4), 265–268. https://doi.org/10.46747/cfp.6704265

You, W., & Henneberg, M. (2018). Cancer incidence increasing globally: The role of relaxed natural selection. Evolutionary Applications11(2), 140–152. https://doi.org/10.1111/eva.12523

 

Cancer is one of the health problems that are facing a significant proportion of population in America and the rest of the world. The morbidity and mortality rate due to cancer is significantly high. The existing statistics shows that about 1806590 new cases of cancer were diagnosed in America in 2020. The population was most likely to be diagnosed with the leading types of cancers that included breast, lung, prostate, and colon and rectum cancers. The national data shows that about 43% of cancers diagnosed in the US in 2020 were colorectal, lung and prostate cancers. Nurses play an important role in the prevention and management of cancer. Nurses educate the population about the risk factors, signs and symptoms, diagnosis and importance of early treatment. Nurses also educate the public about the preventive strategies for the most common types of cancers that effect the population. Therefore, this essay examines cancer and its management using the nursing process approach. The paper examines topics that include diagnosis and staging of cancer, complications, factors contributing to the yearly incidence, role of the American Cancer Society in supporting cancer patients and utilization of nursing process in cancer management.

Diagnosis and Staging of Cancer

Diagnosis of cancer utilizes both subjective and objective assessments. The subjective assessments focus on the symptoms that patients with cancer present with to the hospital. Patients with suspected cancer presents to the hospital with a myriad of signs and symptoms. The signs and symptoms include bone pain, weight loss, fatigue, fever, changes in the skin, sores or wounds that do not heal, hoarseness that do not respond to common treatments unusual bleeding, anemia, and difficulties in passing urine in men among others. Comprehensive history taking is therefore essential to come up with an accurate diagnosis of the specific cancer that the patient might be suffering from during a clinical visit. Objective assessments are utilized in the diagnosis of cancer. The objective assessments include observation, percussion, auscultation, and palpation. There is also the utilization of clinical investigations such as lab works, imaging tests and biopsy. Laboratory investigations show whether there is an elevation or reduction in biomarkers for cancers. Imaging tests that are utilized in the process include CT scans, X-rays, bone scan, nuclear scan, and MRI scan (Hinds & Linder, 2020). Tissue biopsy is also done to provide an accurate assessment and diagnosis of cancer.

Staging of cancer occurs once one is diagnosed with the disease. Staging is important to enable the determination of the most effective aggressive treatment that can be adopted to slow the spread of cancerous cells. Staging of cancer can be done using a number of approaches. One of the approaches is the TNM staging system. The TNM staging system focuses on the tumor size, number of lymph nodes affected by cancer, and if the cancerous cells have metastasized or not. The classification based on tumor is measured as TX (tumor cannot be measured), T0 (tumor cannot be found), and T1, T2, T3, and T4 to represent the size of the main tumor, with the high the T number implying more growth of tumor cells to the surrounding tissues. The classification based on regional lymph nodes is measured as NX(cancer in surrounding lymph nodes not measurable), NO (there is no cancer in surrounding lymph nodes), N1, N2, and N3 to demonstrate spread of cancerous cells to the surrounding lymph nodes. The diagnoses based on metastasis is denoted as follows; MX (metastasis not measurable), M0 (cancer has not metastasized) and M1 (cancer has metastasized) (Charnay-Sonnek & Murphy, 2019).

The other way of staging cancer adopts the stage 0 to IV approach. In this approach, stage 0 cancer implies the presence of abnormal cells but not metastasized, stage I,II, and III implying presence of cancer, with the higher the number the larger the size of tumors and metastasize. Stage IV implies that cancer has metastasized to distant body parts (Hinds & Linder, 2020).

Complications of Cancer

Cancer is associated with a number of complications. One of them is cardiac tamponade. Cardiac tamponade occurs due to the compression of the cardiac muscle secondary to fluid accumulation in the pericardiac sac. The compression of the myocardium by the accumulated fluids lead to inadequate cardiac filling in the diastole phase of cardiac cycle, hence, reduced stroke volume. Breast cancer, leukemia, lymphoma, and lung cancer are associated with this complication (Russo et al., 2018). The other complication of cancer is increased intracranial pressure. Increased intracranial pressure is attributable to the rise in the volume of meninges and skull. The cause of increased intracranial pressure is metastasis of cancer cells to the brain. Often, patients with breast and lung cancer experience this type of complication. The last complication of cancer is spinal cord compression. Spinal cord compression may arise due to the encroachment of neoplasm in the epidural space of the spinal cord. The risk of this complication is high in patients with cancers associated bone metastasis (Warnakulasuriya & Greenspan, 2020).

Side Effects of Treatment and Methods of Lessing Side Effects

Cancer treatment is also associated with side effects. Cancer treatments such as chemotherapy are associated with side effects that include fatigue, alopecia, infection, anemia, constipation, diarrhea, nausea and vomiting, and weight changes. Patients may also experience additional side effects such as bladder and urine changes, peripheral neuropathy, fertility problems, and changes in sexual function and libido. The use of treatment approaches such as radiotherapy is associated with side effects that include dry mouth, gum sores, hair loss, tooth decay, lymphedema, and difficulty in swallowing (Wright, 2019).

The above physical and psychological effects of cancer treatment can be lessened with the adoption of a number of interventions. For instance, the gastrointestinal side effects of the treatment can be lessened by increasing fluid intake, drinking fluids between meals, and taking anti-diarrheal medications. Interventions such as taking tart fruits, chilled foods, cleaning mouth before eating, and using seasonings may be adopted to address the issue of changes in sense of taste. Interventions such as use of relaxation techniques, eating small but frequent meals, avoiding foods that are hard to digest, and resting after meals may be used to manage nausea and vomiting. The psychological effects of hair loss can be managed by using wigs or wearing hats, linking patients to social support programs, and avoiding excessive combing of the hair (Wright, 2019).

Factors Contributing to the Yearly Incidence and Mortality Rates of Cancer in Americans

A number of factors contribute to the yearly incidence and mortality rates of cancer in Americans. One of the factors is the increased predisposition of the population to the modifiable risk factors for cancer. Accordingly, the majority of the American population engages in lifestyle and behavioral factors that increase their risk of developing cancers. An example is the high rate of smoking among the population that increases the risk of lung and throat cancer in the population. Lung cancer has been named the leading type of cancer diagnosed among the Americans due to the effect of modifiable factors such as smoking (Nipp et al., 2018). The second factor contributing to the yearly incidence of cancer in Americans is poor uptake of cancer screening services among the population. The effective management of cancer is achieved if the disease is diagnosed in its early stages. Early diagnosis of cancer depends largely on the health seeking habits of the population. Poor uptake of the cancer screening services translates into delayed diagnosis and poor prognosis in cancer treatment. Factors such as stereotypes and cultural influences on the utilization of cancer screening services contribute to yearly incidence as well as mortality rate of cancers in America (Hong et al., 2018; Rees et al., 2018). The last factor that contributes to the yearly mortality rate of cancer in America is the cost of treatment. Cancer treatment is expensive for patients and their significant others. According to Yabroff et al., (2019), the yearly incidence of mortality due to cancer in America is attributable to challenges in access to and affordability of cancer care. As seen from the study by Allcott et al., (2019), financial burden of cancer treatment leads to poor adherence to treatment regimen, hence, the high rate of mortality in cancer patients. Therefore, embracing responsive strategies could prevent early mortalities among cancer patients due to the effect of cost burden to them.

Role of American Cancer Society

The American Cancer Society (ACS) may provide the support that cancer patients and their significant others require in managing the disease. Firstly, ACS provides cancer patients and their significant others support that include free transportation and lodging to patients seeking specialized treatment in distant locations. The aim of these services is to reduce the cost burden and psychological effects of cancer treatment. ACS also provides patients and their significant others resourceful information that can guide the in making informed decisions about the treatment options. The organization provides educational resources that have accurate information about the different approaches to cancer treatment that patients may explore for the effective management of the disease. The organization also links patients to national resources that they can utilize for the effective management of cancer. For example, patients benefit from social services, support groups, and wigs and prostheses to manage the psychological impacts of the disease. ACS also has an online community where cancer patients share their experiences with the disease and practical tips of lessening the impacts of the disease (ACS, n.d.). The online community empowers patients with interventions to improve their health and wellbeing.

I would recommend a number of services offered by ACS to cancer patients and significant others. One of the services is the online community. Cancer patients should join the online community to get the psychological support that they need by learning from the experiences of other patients. The other service is support with products for lessening the physical impacts of cancer. This includes encouraging the patients to seek support in supply of mastectomy and hair loss products to minimize the psychological impacts of the disease. The other service is breast cancer support where patients can talk with trained professionals and breast cancer survivors to gain the needed social and emotional support in managing the disease (ACS, n.d.).

Utilization of the Nursing Process

The nursing process can be utilized to provide safe and effective care for cancer patients across the life span. The nursing process can be used to develop, implement, monitor, and evaluate the effectiveness of treatments to cancer patients. In the assessment phase, the nurse should aim at obtaining both subjective and objective data concerning the health status and needs of the patients. Nurses perform comprehensive history taking and patient assessment to identify the actual and potential health needs of cancer patients. Nurses use the information from patient assessment to plan the care that cancer patients need. Nurses use the information to develop actual and potential nursing care plans that will guide the administration of treatment, monitoring and evaluation (Charnay-Sonnek & Murphy, 2019). The implementation of the nursing care plans follows where nurses the prioritized nursing diagnoses are addressed to meet the critical needs of the patients. The nurses monitor the patients following the implementation process to determine the response of patients to treatment alongside the need for additional treatments and adjustments. The last phase in the nursing process, evaluation, is done to determine whether the adopted interventions were effective in meeting the care needs of the patients or not (Hinds & Linder, 2020). Through this approach, patients receive high quality, safe and patient-centered care.

Undergraduate Education in Liberal Arts and Science

Undergraduate education in liberal arts and science contributes to foundation of nursing knowledge and prepares nurses to work with patients utilizing nursing process. Education in the above areas develops the desired creative and critical thinking among nursing students, which is important in nursing care. Nurses learn the skills of using carefully thought processes of addressing the needs of their patients. The education in the above areas also increases the level of awareness on the complex needs of patients and the need for the utilization of structured approaches in nursing care. For instance, the education in liberal arts and science opens their understanding about the importance of other aspects of care such as culture and religion, hence, their consideration in the nursing care and process. Lastly, the education in the above areas makes the nursing students to have knowledge and skills to address all issues in nursing and health (Kooken & Kerr, 2018). The students become all-rounded in addressing health-related issues affecting their diverse populations.

Conclusion

In summary, the diagnosis of cancer utilizes both subjective and objective assessment methods. Staging of cancer is important in determining the effective treatments for patients. Cancer and its treatment are associated with significant complications. Interventions to lessen the complications and side effects of the treatment should be explored. The American Cancer Society provides critical resources that benefit cancer patients. Therefore, education in liberal arts and sciences is important to enable students understand the ways in which the needs of cancer patients can be meet efficiently.

 

 

References

ACS. (n.d.). How We’re Providing Support. https://www.cancer.org/about-us/what-we-do/providing-support.html

Allcott, N., Dunham, L., Levy, D., Carr, J., & Stitzenberg, K. (2019). Financial burden amongst cancer patients treated with curative intent surgery alone. The American Journal of Surgery, 218(3), 452–456. https://doi.org/10.1016/j.amjsurg.2019.01.033

Charnay-Sonnek, F., & Murphy, A. E. (2019). Principle of Nursing in Oncology: New Challenges. Springer.

Hinds, P. S., & Linder, L. (2020). Pediatric Oncology Nursing: Defining Care Through Science. Springer Nature.

Hong, Y.-R., Tauscher, J., & Cardel, M. (2018). Distrust in health care and cultural factors are associated with uptake of colorectal cancer screening in Hispanic and Asian Americans. Cancer, 124(2), 335–345. https://doi.org/10.1002/cncr.31052

Kooken, W. C., & Kerr, N. (2018). Blending the liberal arts and nursing: Creating a portrait for the 21st century. Journal of Professional Nursing: Official Journal of the American Association of Colleges of Nursing, 34(1), 60–64. https://doi.org/10.1016/j.profnurs.2017.07.002

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Rees, I., Jones, D., Chen, H., & Macleod, U. (2018). Interventions to improve the uptake of cervical cancer screening among lower socioeconomic groups: A systematic review. Preventive Medicine, 111, 323–335. https://doi.org/10.1016/j.ypmed.2017.11.019

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Yabroff, K. R., Gansler, T., Wender, R. C., Cullen, K. J., & Brawley, O. W. (2019). Minimizing the burden of cancer in the United States: Goals for a high-performing health care system. CA: A Cancer Journal for Clinicians, 69(3), 166–183. https://doi.org/10.3322/caac.21556