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Colorectal cancer is said to be one of the most common cancers in the U.S. In this text, I largely concern myself with this type of cancer. In so doing, I will amongst other things take into consideration not only its pathophysiology but also its clinical manifestations, treatment options, interventions, and expected outcomes.
Colorectal Cancer: A Brief Overview
The Centers for Disease Control and Prevention -- CDC (2011) observes that "of cancers that affect both men and women, colorectal cancer is the second leading cancer killer in the United States…" In basic terms, this type of cancer as CDC (2011) further points out affects the colon (large intestine) or the rectum.
The exact causes of colorectal cancer remain unknown. However, it is important to note that a number of risk factors do exist. These include but they are not in any way limited to age. Indeed, according to the National Cancer Institute -- NCI (2012), most of those diagnosed with colorectal cancer happen to be of age 50 and above. The other risk factors identified by NCI (2012) include a history of either polyps or ulcerative colitis, family history of either rectum or colon cancer, as well as personal history of other cancers such as breast, ovary or even colon cancer.
As Yarbro, Wujcik and Gobel (2010) point out, "in colorectal cancers, a series of mutations occurs in the epithelial cells of the colonic and rectal mucosa." These mutations as the authors further note end up affecting the body's somatic cells. It should be noted that in this case, the offspring may not inherit these changes from the parent as the reproductive cells are not essentially affected. However, it is important to note that similar mutilations could in some instances occur in some individuals' "germ-line (reproductive) proto-oncogenes and some germ-line tumor suppressor genes" (Yarbro, Wujcik and Gobel, 2010). According to the authors, a child could inherit these mutations from a parent.
Clinical manifestations of this particular kind of cancer according to Davey (2010) largely depend on the site of the tumor. It is however important to note that during its early stages, colorectal cancer may not present any symptoms. As the tumor progresses, the associated symptoms become less subtle and hence more specific. At this point, the cancer could have progressed to a stage that is relatively hard to treat. Some of the most common symptoms of colorectal cancer according to NCI (2012) include but they are not limited to presence of blood in the affected individual's stool, fatigue, vomiting, etc. Other symptoms could include weightless (unexplained), constipation or diarrhea, gas pains that are rather frequent, etc. (NCI, 2012). However, as I have already pointed out above, symptoms of colorectal cancer are likely to vary depending on not only the location but also the size of the cancer. It should also be noted that the above symptoms do not necessarily mean an individual has colorectal cancer. This is more so the case given that several other medical conditions including rectum ulcers could present similar symptoms. In that regard, individuals experiencing symptoms similar to those highlighted above should be advised to go for screening so as to ascertain the actual cause of the said symptoms.
In most cases, colorectal cancer is diagnosed during its advanced stages. This is more so the case given that most symptoms of colorectal cancer appear after the disease has reached an advance stage. It should however be noted that a scan can help in the detection of colorectal cancer way before this particular kind of cancer reaches an advanced stage. Imaging tests in this case include sigmoidoscopy and colonoscopy. According to NCI (2012), by conducting a physical exam, doctors could successfully identify anything that feels unusual, i.e. presence of an unusual lump. A rectal exam could also help in the identification of an unusual lump (mass). When it comes to a digital rectal exam, the doctor looks for the presence of the said lumps by inserting his or her lubricated finger in a patient's rectum (NCI, 2012). This is more so the case when it comes to rectal cancer. Colon cancer according to NCI (2012) could also be suggested after a fecal occult blood test (FOBT). This particular test helps in the detection of blood presence in the stool. It should however be noted that to successfully diagnose colorectal cancer and its extent, several tests may have to be undertaken. The other tests used in the detection of colorectal cancer include biopsy, virtual colonoscopy, barium enema, etc. (NCI, 2012).
Nursing Diagnosis and Interventions
Nursing diagnoses for a patient with this particular kind of cancer could in the opinion of White, Duncan and Baumle (2010) include fear or anxiety related to not only diagnosis but also prognosis (long-term). The patient could also exhibit fear related to either surgery planning or possibility of recurrence. Nursing interventions in this case include permitting the patient to spend time alone and/or with those close to him or her, answering the relevant questions that may arise, etc. (White, Duncan and Baumle, 2010). One key outcome of the said interventions at this point could be diminished fear. Secondly, yet another nursing diagnosis identified by White, Duncan and Baumle (2010) in this case is "deficient knowledge related to disease process, treatment options, and follow-up." Interventions identified by the authors in this particular case include the determination of the learning style of the client so as to ensure information is presented in a manner consistent with that learning style, presentation of more info to the patient regarding the disease process, etc. This could lead to enhanced comfort and familiarity with the disease process. Another nursing diagnosis in this case could be constipation. This is more so the case given that the same could be caused by tumors and/or a diet low in fiber (White, Duncan and Baumle, 2010). Interventions could therefore include recommending a high-fiber diet with the outcome being relieved constipation.
The treatment of colorectal cancer is largely dependent on several factors. These factors include but they are not limited to the cancer's stage (Smeltzer et al., 2010). The other factors affecting treatment options in this case according to NCI (2012) include the general health of the patient as well as the recurrence of the said cancer. As NCI (2012) further points out, basic treatment options in this case include radiation therapy, chemotherapy, targeted therapy, and surgery. While surgery seeks to get rid of cells deemed cancerous, radiation therapy according to NCI (2012) either stops the growth of or kills cells that appear cancerous. It should be noted that just like many other treatment options, the extensiveness of surgery is largely dependent on the stage of the cancer. Chemotherapy on the other hand seeks to kill or prevent the division of cells marked as being cancerous (NCI, 2012). Lastly, in the word of NCI (2012), "targeted therapy is a type of treatment that uses drugs or other treatment to identify and attack specific cancer cells without harming normal cells." In some instances, radiation therapy is used alongside chemotherapy. Various cancer treatment options as Medifocus (2011) points out more often than not have serious side-effects. These side effects (in general) according to Medifocus (2011) "may include nausea/vomiting, fatigue, anxiety, depression, pain, sleep disturbances, loss of appetite, dry mouth, gastrointestinal disturbances, and peripheral neuropathy." The treatment period (e.g. The period of time an individual is supposed to undergo chemotherapy) could be affected by a number of factors such as the specific stage of the cancer.
It should be noted from the onset that colorectal cancer is best treated if detected early. In that regard, the outlook of this particular kind of cancer is largely dependent on the stage at which it is diagnosed (NCI, 2012). During its early stages,…[continue]
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