Benchmark – Nursing Process: Approach to Care

NRS 410 Benchmark – Nursing Process: Approach to Care

The nursing process is a systematic problem-solving approach for meeting a patient’s health care needs. The components of the nursing process include assessment, diagnosis, planning, implementation, and evaluation. It enables nurses to identify the health care needs of a patient and provide patient-centred care. This paper will discuss cancer and will include diagnosis and staging of cancer, complications, and side effects of treatment, risk factors for cancer, and the role of the American Cancer Society. It will also outline how the nursing process is utilized in cancer patients’ care and explore how the incorporation of liberal arts and science studies contributes to the foundation of nursing knowledge.

Nurses strive to provide the best possible care to diverse clients under consistently changing conditions. From the medications administered to the type of dressing used to heal a wound, nurses apply procedures that have been tested through research and deemed appropriate according to evidence-based standards of practice. Through foundational knowledge related to research methods, translation of research data is used to improve nursing practice and, ultimately, patient outcomes. Therefore, nurses must become familiar with the s

pecific language of scientific research and the research process. As health care professionals, nurses seek to provide their patients with the best possible health care. To determine which approaches to care result in the best possible care, the effectiveness of each approach specific to a chosen population must be investigated. The pursuit of knowledge is the basis for research. Researchers seek to find answers to various scientific questions, but there are the boundaries associated with the pursuit of knowledge (Helbig, 2018).

Diagnosis and Staging of Cancer

Cancer is diagnosed based on an assessment of physiologic and functional changes and diagnostic evaluation. A comprehensive patient history identifies any warning signs for cancer such as changes in bowel or bladder habits, a sore that does not heal, unusual bleeding or discharge, thickening or lump in the breast, indigestion or difficulty swallowing, changes in a wart or mole, and nagging cough or hoarseness (Wardle et al., 2015). In addition to history taking, a complete physical examination is conducted with a specific focus on tumor characteristics.

Diagnosis also entails conducting laboratory tests, imaging tests, and microscopic study of tissues and cells. Frequently used imaging tests include endoscopy, computed tomography, Magnetic resonance imaging, fluoroscopy, and ultrasonography (Wardle et al., 2015). Microscopic tests include cytology, which is the microscopic study of cells, to establish whether they appear malignant or premalignant. A common cytology study is the Pap smear, which entails scraping cells from the female cervix and smearing on a slide for microscopic diagnosis (Wardle et al., 2015). Laboratory tests include Tumor marker identification. Tumor markers are substances produced by normal or neoplastic tissue and may appear in blood at increased levels in the presence of a neoplasm.

Staging of cancer is performed to determine the size of the tumor and the presence of metastasis. Several systems have been developed to enable the classification of the anatomic extent of disease. The TNM system is commonly used; TNM is an acronym in which T refers to the size of the primary tumor, N represents lymph node involvement, and M refers to the degree of metastasis (Rosen & Sapra, 2020). The TNM stages cancer from stage 0 to IV. The higher the number, the larger the tumor size and the greater the spread into other tissues and cells.

Stage 0- Presence of abnormal cells with no metastases; however, there is a chance of cells becoming malignant. This stage is referred to as carcinoma insitu.

Stage I- Localized cancer. Invasion is up to the subserosa with no lymph node involvement or metastasis.

Stage II- Locally advanced cancer in early stages with an invasion of the subserosa. No regional nodal spread or distant metastasis is present (Rosen & Sapra, 2020).

Stage III- Locally advanced cancer, late stages. There is an invasion of the adjacent structures and more than seven regional nodes. No distant metastasis is present (Rosen & Sapra, 2020).

Stage IV- Metastatic cancer. There is an invasion of the adjacent structures, and more than seven regional nodes are involved. There is also evidence of distant metastasis.

Complications of Cancer

Complications of cancer result from the invasion of body tissues by malignant cells and the side effects of treatment.  Complications of cancer include infection, bleeding and hemorrhage, and septic shock. Infection occurs as a result of immunosuppression, such as in leukemia and lymphoma cancers, which are associated with defects in cellular and humoral immunity (Rolston, 2017). Invasive diagnostic procedures and treatments often alter the mucous membranes and skin integrity, which are the body’s first-line defense. Consequently, the body’s defense against infections become compromised in numerous ways (Rolston, 2017). Furthermore, impaired nutrition compromises the body’s ability to fight invading organisms due to anorexia, nausea, vomiting, and diarrhea.

Bleeding and hemorrhage are caused by thrombocytopenia, a decrease in the circulating platelet count, below 100,000/mm3.  Platelets play a vital role in normal blood clotting and coagulation, and thus low platelet levels result in abnormal hemorrhage (Rolston, 2017).  Thrombocytopenia usually results from myelosuppression after chemotherapy and radiotherapy. Besides, tumor invasion of the bone marrow can impair the normal production of platelets. Septic shock occurs due to a high infection by gram-negative bacteria such as Escherichia coli and Pseudomonas aeruginosa. It occurs as a complication of untreated infection and as a result of invasive diagnostic tests and treatment modalities that cause systemic infections (Gegechkori, Haines & Lin, 2017). Septic shock can be managed by administering broad-spectrum antibiotics to combat underlying infections. It can be prevented by using aseptic techniques when handling cancer patients.

Side Effects of Treatment

Therapies used in cancer treatment include surgery, radiation therapy, chemotherapy, and immunotherapy. Each treatment approach is associated with side effects that increase the risk of patients developing complications. Surgery is associated with adverse effects such as infection on the surgical site and, in worse cases, systemic, bleeding, wound dehiscence, fluid and electrolyte imbalance, thrombophlebitis, and organ dysfunction (Rolston, 2017). Radiotherapy affects the oral mucosa, GI tract, and bone marrow cells. This results in side effects such as stomatitis, dryness of the mouth, change and loss of taste, decreased salivation, dysphagia, anorexia, nausea, vomiting, and diarrhea (Gegechkori, Haines & Lin, 2017). Effects on the bone marrow result in leukopenia and thrombocytopenia, resulting in increased bleeding, which can cause chronic anemia.

Similarly, chemotherapy has a negative effect on cells that have a rapid growth rate and affects most body systems. Chemotherapeutics result in myelosuppression, which causes leukopenia, anemia, and thrombocytopenia, which increases the susceptibility to infections and bleeding (Nurgali, Jagoe & Abalo, 2018). In the GI, they cause stomatitis, nausea, vomiting, decreased appetite, and diarrhea. In addition, chemotherapeutics cause neurologic damage, which manifests with loss of deep tendon reflexes, peripheral neuropathies, paralytic ileus, and hearing loss due to acoustic nerve damage (Nurgali, Jagoe & Abalo, 2018).  Chemotherapy is also associated with causing kidney damage, pulmonary fibrosis, cardiac toxicities, fatigue, early menopause, and lack of sperm production (Nurgali, Jagoe & Abalo, 2018). Side effects of immunotherapy include fever, nausea, vomiting, muscle pain, and hypotension.

Methods to Lessen Physical and Psychological Effects

Physical effects of cancer and cancer treatments include pain, stomatitis, muscle wasting with weight loss, whereas psychological effects include grief and a disturbed body image (Gegechkori, Haines & Lin, 2017). Stomatitis can be minimized by providing patients with oral saline mouthwashes to avoid trauma from toothbrushes. Besides, substances that may irritate the oral mucosa are avoided, such as alcohol-based mouth wash as well as foods that are difficult to chew and spicy foods to prevent further trauma (Nurgali, Jagoe & Abalo, 2018). The patient’s lips can be lubricated to avoid them from becoming dry and cracked.

Pain can be minimized by using non-pharmacological measures such as cold/hot compressions and administration of analgesics. The three-step approach ladder should be used to treat cancer pain. Non-opioid analgesics are used for mild pain, weak opioid analgesics for moderate pain, and strong opioid analgesics for severe pain (Nurgali, Jagoe & Abalo, 2018). If the pain escalates, the strength of the analgesic is increased until pain relief is achieved. Besides, Adjuvant medications are administered to boost the effectiveness of analgesics and manage other symptoms that may cause the pain experience. Weight loss and muscle wasting can be minimized by providing simple diets to promote absorption (Nurgali, Jagoe & Abalo, 2018). Nutritional supplements are prescribed to meet dietary needs, and patients incapable of parenteral feeding are supported via enteral feeding.

Psychological effects can be minimized by using a positive approach when caring for patients with a disturbed body image. Besides, patients can be encouraged to be independent and participate in self-care and decision making to promote positive self-esteem (Grassi, Spiegel & Riba, 2017). Patients can also be assisted to undertake tasks and activities that are valuable to them. Furthermore, negative feelings and threats to body image should be assessed and discussed.

Factors That Contribute to The Incidence and Mortality Rates of Various Cancers in Americans

According to the CDC, the major risk factors for cancer in the US include exposure to the sun, tobacco use, alcohol use, overweight and obesity, unhealthy diet, and physical inactivity. Besides, infections with Hepatitis B and C virus and some strains of HPV increase the incidence of liver and cervical cancer (CDC, 2020). Skin cancer is the most prevalent cancer in the US. Most melanoma cases are a result of exposure to ultraviolet light from the sun or tanning beds (CDC, 2020). Besides, about one-third of American adults get sunburned each year.

Smoking and passive smoke contribute to approximately 90% of lung cancer deaths in the US. Smoking is associated with cancer of the larynx, mouth, throat, esophagus, stomach, pancreas, liver, urinary bladder, kidney, cervix, colon, rectum, and blood cancers. Approximately 34 million US adults smoke cigarettes, and about 58 million nonsmokers are exposed to secondhand smoke annually (CDC, 2020). Excessive alcohol use, either in the form of binge drinking or heavy drinking, increases the risk of cancer of the mouth, larynx, esophagus, pharynx, breast, liver, colon, and rectum (CDC, 2020).  Approximately 17% of US adults engage in binge drinking, and 6% in heavy drinking.

Physical inactivity contributes to obesity and is associated with lung, esophageal, prostate, breast, endometrial, kidney, and colon cancers. Unhealthy diet practices characterized by inadequate consumption of whole grains, fruits and vegetables and high consumption of red meat is associated with cancers of the breast, liver, endometrial, ovarian, cervical, stomach, liver, pancreatic, bladder, colon, prostate, and kidney (CDC, 2020). Overweight and obesity are associated with at least 13 types of cancer. In the US, an estimated 40% of adults have obesity, whereas 72% are overweight (CDC, 2020). The most common cancers, endometrial, breast, and colorectal cancer. These types of cancer make up 40% of all cancers diagnosed in the US.

How the American Cancer Society (ACS) Provide Education and Support

The ACS offers current information on cancer to patients, families, and health providers. It provides resources on all cancers, including information on treatment options available, side effects of treatment, clinical trials, and pain management (ACS, 2019). In addition, the ACS offers resources on coping strategies, cancer screening, and prevention, and tobacco cessation. The ACS provides daily assistance and support to persons with cancer such as rides to health facilities, lodging, breast cancer support, hair loss, and mastectomy products, and online community support (ACS, 2019).  Furthermore, it connects patients to financial programs, social services, and support groups.

I would recommend patients to ACS services such as hair loss and mastectomy products for those who have alopecia and undergone mastectomy. This would significantly improve their body image, which is often affected by the side effects of treatment. I would also recommend online community support services for psychological support, which will promote mental and social wellbeing.

Utilization of the Nursing Process in Providing Safe and Effective Care

The nursing process is used in providing safe and effective care to cancer patients by identifying problems and complications, developing goals of care, implementing interventions to attain the goals, and evaluating the outcome.

Assessment

It involves identifying problems and complications through history taking, physical exams, and diagnostic results. The nurse assesses for signs of infection, bleeding, skin problems, pain, fatigue, nutritional status, body image concerns, and psychological and mental status (Jomar et al., 2017). This ensures that not only the physical symptoms are focused on but also psychological wellbeing.

Diagnosis

Nursing diagnoses are formulated based on the identified assessment cues. Nursing diagnoses for a cancer patient may include Chronic pain; Fatigue; Imbalanced nutrition, less than body requirements; Impaired tissue integrity; Risk for infection; Disturbed body image (Jomar et al., 2017).

Planning

It aims at preventing complications, alleviating physical symptoms, and improving the quality of life. The goals developed are time-bound to guide evaluation. The goals for a cancer patient can include achieving adequate pain control, relieving fatigue, maintaining optimal nutrition, maintaining tissue integrity, and promoting an improved body image and self-esteem (Jomar et al., 2017).

Implementation

The nurse identifies evidence-based interventions that will promote the attainment of the set goals. For instance, to achieve adequate pain control, the nurse provides pharmacological and non-pharmacological pain-relief measures. To maintain optimal nutrition, the nurse identifies approaches to increase caloric intake, such as giving small frequent meals and administering appetite boosters (Jomar et al., 2017). To maintain tissue integrity, the nurse promotes oral hygiene and teaches the patient about oral mucosa irritants to prevent stomatitis. Besides, the nurse offers skincare interventions to prevent skin lesions.

Evaluation: This entails assessing for the attainment of the developed goals according to the set time frame. The nurse evaluates how much the desired outcomes have been accomplished and develops new goals or identifies intervention to achieve outcomes not attained.

Incorporation of Liberal Arts and Science Studies into Nursing Knowledge

Liberal arts and science studies are a foundation of nursing knowledge and practice.  They play an essential role in promoting creativity and critical thinking among nursing students and support the provision of holistic care (Kooken & Kerr, 2018). Mathematics equips students with skills necessary in nursing practice, such as calculating drug dosages during the administration of treatment. The skills are also essential in the interpretation of lab results, such as ABG analysis and vital signs. Social sciences equip students with knowledge of the world’s history and culture and practices of different communities globally (Kooken & Kerr, 2018). This enables nurses to interact with patients from various cultures and provide culturally sensitive care. Besides, social sciences can facilitate the research of cultural practices that positively or negatively impact health and why some conditions are prevalent in people from particular communities.

Liberal arts and science studies enable nursing students to enhance decision-making and communication skills and think from a global perspective. They enable students to provide holistic care to patients with physical, social, economic, and psychological concerns using the nursing process (Kooken & Kerr, 2018). Besides, social sciences, equip students with leadership skills that are essential in nursing practice.

Conclusion

A diagnosis of cancer is made through history taking, physical examination, and diagnostic tests. Cancer staging is conducted to establish the size of the malignant tumor, lymph node involvement, and degree of metastasis.  Complications of cancer include infection, septic shock, and bleeding and hemorrhage, which occur as a result of treatment side effects and invasive procedures. The physical effects of cancer can be minimized by effective pain control, nutritional support, and appropriate skin care. Psychological effects can be reduced, encouraging patients to be independent and participate in self-care and discussing psychological concerns. The causes of increased incidence and mortality rates of various concerns include tobacco smoking, sun exposure, physical inactivity, poor diet, excessive alcohol intake, infectious agents, and obesity and overweight. The nursing process is used to identify problems and complications in cancer patients and developing goals that are evaluated after implementing evidence-based interventions. Lastly, liberal arts and science studies equip nursing students with creativity and critical thinking skills, enhance research skills, and promote culturally appropriate nursing care.

References

American Cancer Society. (2019). How we’re providing support. American Cancer Society | Information and Resources about Cancer: Breast, Colon, Lung, Prostate, Skin. https://www.cancer.org/about-us/what-we-do/providing-support.html

Centers for Disease Control and Prevention. (2020). Cancer. https://www.cdc.gov/chronicdisease/resources/publications/factsheets/cancer.htm

Gegechkori, N., Haines, L., & Lin, J. J. (2017). Long-Term and Latent Side Effects of Specific Cancer Types. The Medical clinics of North America, 101(6), 1053–1073. https://doi.org/10.1016/j.mcna.2017.06.003

Grassi, L., Spiegel, D., & Riba, M. (2017). Advancing psychosocial care in cancer patients. F1000Research, 6, 2083. https://doi.org/10.12688/f1000research.11902.1

Jomar, R. T., Gomes, R., Leite, D. C., Gomes, H. F., Peres, E. M., & Junior, E. (2017). Nursing diagnoses in adult/elderly patients undergoing outpatient antineoplastic chemotherapy: a review. Ecancermedicalscience, 11, 736. https://doi.org/10.3332/ecancer.2017.736

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

Nurgali, K., Jagoe, R. T., & Abalo, R. (2018). Editorial: Adverse Effects of Cancer Chemotherapy: Anything New to Improve Tolerance and Reduce Sequelae? Frontiers in pharmacology, 9, 245. https://doi.org/10.3389/fphar.2018.00245

Rolston K. V. (2017). Infections in Cancer Patients with Solid Tumors: A Review. Infectious diseases and therapy, 6(1), 69–83. https://doi.org/10.1007/s40121-017-0146-1

Rosen, R. D., & Sapra, A. (2020). TNM Classification. In StatPearls [Internet]. StatPearls Publishing.

Wardle, J., Robb, K., Vernon, S., & Waller, J. (2015). Screening for prevention and early diagnosis of cancer. American psychologist, 70(2), 119.

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 Reports, 10(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 Oncology, 5(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 Oncology, 21(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 Pharmacology, 9, 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 Medicine, 7(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. Medicine, 99(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 Clinicians, 71(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 Nursing, 28(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 Canadien, 67(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 Applications, 11(2), 140–152. https://doi.org/10.1111/eva.12523