Cancer Care and Treatment
Diagnosis and staging of cancer
In almost all cases, the disease, cancer, is diagnosed by a specialist following a microscopic examination of tissue or cell samples of a particular individual. In a few instances, physicians may know of the presence of a cancer with the aid of tests performed on DNA (deoxyribo-nucleic acid), RNA (ribo-nucleic acid) and cell proteins. Such tests’ outcomes prove highly critical when it comes to selecting the optimal therapeutic alternative. Tissue and cell examinations may also aid in the diagnoses of a number of other forms of ailments. For example, if a physician is unsure of whether a particular lump or growth in a patient’s body is cancer, he/she might extract a little bit of it for testing to diagnose any one of many problems, including cancer, infections and other issues which may lead to the development of cancer-like lumps. This process of obtaining a bit of an unnatural bodily growth (sample) for the purpose of carrying out tests is termed biopsy, while the tissue/cell sample is labeled as a biopsy specimen. The process has been termed as pathology by some. Potentially cancerous growths may be detected by means of imaging tests or even sensed as lumps in physical patient examinations. However, the confirmation of their true nature (carcinogenic or not) necessitates sampling and microscopic scrutiny. Every abnormal growth isn’t cancerous; as a matter of fact, a majority of tumors are non-carcinogenic in nature (The American Cancer Society medical and editorial content team, 2015).
Low or high levels of particular substances within the body may indicate the development of cancer. Hence, physicians may make appropriate diagnoses with the assistance of laboratory examinations of body fluids (urine, blood, etc.). But a key point to note is that unusual laboratory test results do not assuredly mean the individual has developed a cancer. While laboratory examinations do mark a significant tool, physicians mustn’t depend solely on them for making cancer diagnoses. In a majority of instances, there is a need to perform biopsies before categorically making a cancer diagnosis. Biopsies, in simple words, denote processes wherein physicians extract a tissue sample and send it to a pathologist who undertakes a microscopic examination of it to ascertain whether or not the growth is a cancer. The following techniques may be utilized to obtain tissue/cell samples:
â€¢ Using needles: A needle is employed for withdrawing body fluids or tissues.
â€¢ Using endoscopes: Endoscopes are slender lighted tubes utilized by physicians to view areas within a patient’s body. The mouth and other natural body openings are the entryways of these scopes. Subsequently, the physician withdraws body cells/tissue with the help of a special instrument.
â€¢ Via surgery: Incisional or excisional can help obtain the required sample.
â€¢ Excisional biopsies entail the removal of the whole tumor. Quite frequently, parts of normal body tissue surrounding the lump are removed as well.
â€¢ Incisional biopsies entail the removal of only some part of an abnormal growth.
Staging of Cancer
Cancer staging may be defined as a process whereby healthcare providers ascertain the quantity of cancer in a patient’s body and its precise location. This procedure helps ascertain how grave the patient’s disease is, depending on both the primary/initial growth size and how far it has extended within the patient’s body. Determining disease stage facilitates the development of patient prognoses and treatment plans (AJCC, 2017).
The most extensively utilized system for cancer staging is the TNM staging system, with a majority of healthcare organizations and facilities employing it as their chief cancer diagnosis technique. Most cancers can be defined using this system, with the exception of a few such as blood cancers, spinal cord and brain tumors, which require different systems for staging.
Within the TNM staging system:
â€¢ T. implies the main/primary tumor’s magnitude and range.
â€¢ N. denotes the amount of surrounding cancer-afflicted lymph nodes and â€¢ M. implies a determination of whether or not the given cancer has metastasized (i.e., spread into the patient’s body from the main tumor site).
Cancers described using this system are accompanied by numbers following individual letters for providing further details regarding the patient’s cancer (e.g., T3N1M0 or T1N0MX). The meaning of the numbers and alphabets has been described in the following section:
Primary Tumor (T)
T0: Primary tumor can’t be detected.
TX: Primary tumor can’t be measured.
T1, T2, T3, and T4: Denotes the primary tumor’s magnitude and range; the bigger the number, the greater its size, or extent of growth into surrounding tissues. This can be subdivided further in order to offer additional details (e.g., T3a, T3b, etc.)
Regional Lymph Nodes (N)
N0: Surrounding lymph nodes are free of cancer.
NX: It is not possible to measure the cancer within the surrounding lymph nodes.
N1, N2, and N3: Denotes the location and number of cancer-afflicted lymph nodes; the bigger the number, the larger number of cancer-afflicted lymph nodes.
Distant Metastasis (M)
M0: Other body areas haven’t been affected by the cancer.
M1: Other body areas have been affected by the cancer.
MX: It is not possible to measure metastasis.
Complications of Cancer
There are a number of complications linked to the disease of cancer and therapies utilized to cure patients. They include:
â€¢ Pain. Pain may be as a result of the disease as well as its treatment techniques; however, every cancer does not bring about pain. Drugs and other means may successfully alleviate such pain.
â€¢ Fatigue. Tiredness occurs due to many reasons among cancer patients; however, it is usually manageable. Fatigue linked to radiation therapy or chemotherapy is commonly reported, but generally temporary.
â€¢ Breathing difficulties. Cancer or its treatment approaches may make patients feel out of breath. There are treatments which can provide adequate relief from this issue.
â€¢ Nausea. Particular cancer treatment approaches and types of cancer lead to nauseous feelings among patients. Physicians are, at times, able to predict which treatments have a tendency of bringing about nausea and can prescribe or administer appropriate treatments and medicines for alleviating or preventing it.
â€¢ Constipation or diarrhea. Cancer and its treatment approaches may impact the patient’s bowels, giving rise to either constipation or diarrhea.
â€¢ Loss of weight. Cancer and its treatment approaches can cause the patient to lose weight as the abnormal growth eats upnormal cells’ nutrients, thus depriving them of necessary nutrition. Typically, the type of food or number of calories consumed fail to impact this and it’s, thus, hard to treat. Usually, artificial nutrition is fed via tubes into veins or the patient’s stomach, but this fails to curb the loss of weight.
â€¢ Chemical changes within the body. Cancer disrupts patients’ usual bodily chemical balance, making them more vulnerable to contracting acute complications. Indications of chemical imbalance include bewilderment, constipation extreme thirst and frequent urination.
â€¢ Nervous system and brain related issues. Cancers may pressure surrounding nerves, thus paralyzing parts of the patient’s body or causing them pain in specific sites. Brain-related cancers may give rise to symptoms similar to strokes (e.g., weakness in one region of the body) and headaches.
â€¢ Abnormal immune system responses to the cancer. For some patients, the immune system can respond to cancers by waging war on healthy body cells. Termed asparaneoplastic syndrome, such an uncommon reaction may result in walking difficulties, seizures and various other symptoms and signs.
â€¢ Cancer which spreads. With the disease progressing to more acute stages, it can metastasize or spread within the body. The kind of cancer decides where it may spread to.
â€¢ Recurrent cancer. All survivors of cancer are vulnerable to the disease’s recurrence and a few kinds of cancer exhibit greater likelihood to recur as compared to others. Physicians ought to educate patients on measures to decrease cancer recurrence risks by formulating a follow-up cancer patient care following treatment, which includes routine tests and scans for recurrence several months and even years following successful treatment (MFMER, 2017).
Side Effects of Cancer Treatment
Cancer cells are destroyed by radiation therapy and chemotherapy. However, such treatment techniques may impact normal body cells as well and lead to the following side effects:
â€¢ Appetite loss
â€¢ Vomiting and nausea
â€¢ Fatigue and weakness
â€¢ Weight gain
â€¢ Mouth sores
â€¢ Premature menopause
â€¢ Hair loss
â€¢ Increased risk of contracting infections
There are drugs and treatments for alleviating a number of the above adverse effects.
Methods to Lessen Physical and Psychological Effects of Cancer
Emotional and psychological patient care is common, and imperative to cancer patients’ complete recovery. Tackling patients’ psychological health issues following cancer diagnosis may ensure better patient control over their lives, decreased stress, depression and anxiety, improved disease/treatment coping and a better quality of life. The above goals may be achieved through;
â€¢ Seeking a novel outlook: Physicians ought to emphasize on the things patients can change with regard to their health and life, rather than dwelling on things that can’t be changed.
â€¢ Refraining from generalizing. Cancer has different meanings for different patients. They all have different, distinctive experience, which is a fact physicians would do well to remember.
â€¢ Encouraging patients to discuss their feelings: Patients may be persuaded to discuss their feelings with kith and kin, spiritual leaders, fellow cancer survivors or physicians themselves.
â€¢ Encouraging patients to adopt healthy lifestyles: Physicians must emphasize the importance of rest, exercise, private time and proper nutrition.
â€¢ Referring for professional counseling: This includes referrals for group, individual, couple, and family therapy.
â€¢ Recommending mind-body therapies: These include relaxation therapies, energy therapies, laughter therapy, and stress management therapies.
AJCC. (2017). What is Cancer Staging? Retrieved from American Joint Commitee on Cancer: https://cancerstaging.org/references-tools/Pages/What-is-Cancer-Staging.aspx
MFMER. (2017). Cancer Complications. Retrieved from Mayo Foundation for Medical Education and Research: http://www.mayoclinic.org/diseases-conditions/cancer/basics/complications/con-20032378
The American Cancer Society medical and editorial content team. (2015, July 30). How is cancer diagnosed? Retrieved from The American Cancer Society medical and editorial content team: https://www.cancer.org/treatment/understanding-your-diagnosis/tests/testing-biopsy-and-cytology-specimens-for-cancer/how-is-cancer-diagnosed.html
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