Staging Diagnosis and Treatment of Cancer

Cancer and Treatment

The identification and treatment of cancer as well as the care provided the patient are essential aspects of quality care nursing. Cancer is a complicated illness that progresses in stages and takes both a physiological and psychological toll on the patient. This paper will discuss the act of diagnosing cancer, the stages of cancer, complications that can arise, available treatments, and recommendations for addressing physiological and psychological side effects of care.

Diagnosing cancer is the first step in treatment. Diagnosing consists of performing laboratory tests of blood and urine along with imaging procedures, which take pictures of target areas within the body and allow the physician to see any tumors that are growing. Imaging processes such as CT scans, ultrasounds, MRIs, PET scans, nuclear scans, and x-rays are common practices and methods of diagnosing cancer. Performing a biopsy is another important step in the method of diagnosing whether a person has cancer. This is a process by which the physician takes a tissue sample from the patient for a pathologist to examine so as to see whether or not the cells under scrutiny are cancerous. The tissue can be taken using a number of tools, such as a needle, endoscope, or through surgical operation.

The staging of cancer can be determined by assessing the results of the lab tests, x-rays, scans, etc. Important to note is the fact that there is not one method or way of determining the stage of cancer, as there are several staging systems that can be used to describe the status of the cancer. The TNM staging system is a popular system used for various cancer types. Other staging systems are, however, used primarily for one type of cancer over another. Each system will tell where the cancer is located, the type of cells in the cancer, size, if it has spread, and the grade of the tumor (abnormality).

TNM staging system describes the cancer using the letter T-N-M, where T stands for the size/extent of the primary tumor, N stands for the how many (if any) lymph nodes are affected by the cancer, and M stands for metastasized (if the cancer has spread throughout the body, it has metastasized). Numbers are used in conjunction with the letters; thus a stage described by the TNM system might appear in the following manners: T2N1MX, or T1N0M0. X is used when no measurement is possible. 0 is used when no tumor/cancer is detected. 1-3+ to describe the number of nodes affected, the size of the tumor, or whether it has metastasized.

Other ways to describe the staging of cancer are to use Stage 0 through Stage IV labels. Stage 0 describes the existence of cells which appear abnormal but are not currently spreading. Another descriptor for this stage is carcinoma in situ (CIS), which does not describe cancer per se, but does imply that it could develop into cancer at some point in the future, so it is necessary to monitor it overtime. Stages I through III describe a state in which cancer is present in the body with I describing a state of minimal spreading and III describing a state of greater spreading. Stage IV descriptor identifies a state in which the cancer has significantly spread throughout the whole of the body (National Cancer Institute, 2015).

Complications that can arise from cancer and cancer treatment include the effect of pain, loss of energy, loss of breath, nausea, weight loss, brain/nervous system dysfunction, abnormal reactions from the immune system, and the cancer spreading (Mayo Clinic, 2015). These complications do not necessarily occur together or at all, and some individuals experience worse side effects than others. Many complications arise as a result of the stage of the cancer and the treatment employed. If the cancer is identified and treated early, side effects and complications can be minimal. If, on the other hand, the cancer is not identified until it is already in a late stage of progression, the complications are likely to be insurmountable and very problematic for individuals and loved ones seeking quality care for the patient. In cases of Stage IV cancer, for instance, the patient is likely to receive pain relief medication (such as morphine) that eases pain associated with the spreading cancer but which also renders the patient unresponsive to those around.

Likewise, the side effects of treatment depend upon the type of treatment utilized, and these vary as well. Treatments that are available depend upon the goal that is being sought by the treatment provider and the patient. If cure is the goal (assuming the cancer is not in a late stage), surgery, chemotherapy or radiation therapy may be in order. This is an example of primary treatment, which is a method of completely removing the cancer or destroying the cancerous cells. Surgery is most typically the approach utilized in this case. However, chemo- or radiation therapy may be employed if the cells show signs of being reduced by this approach. Other forms of treatment include adjuvant and palliative treatment, with the former occurring post-primary treatment and the latter occurring in cases where the goal is to relieve pain in the patient. Hormone therapy is an effective strategy in these cases, but surgery, chemo- and radiation therapy may all be used as well (Mayo Clinic, 2015).

A patient with cancer can thus experience all manner of physiological symptoms and psychological symptoms as well. Recommendations for addressing both physiological and psychological side effects of cancer and treatment depend again on the goals set forward by the patient and physician and upon the patient's outlook and desire for a specified outcome. Anxiety, fear, depression, sadness, anger, isolation and feelings of helplessness can all occur as a result of being diagnosed with cancer and/or of receiving treatment. These psychological effects stem from the fact that cancer is perceived as something that one must battle and that one can feel powerless against, especially if one's life is threatened.