Nursing Process and Cancer Care: Diagnosis to Treatment

Introduction

Today, despite significant progress in recent years, cancer continues to be a major global health concern, affecting individuals across various age groups and demographics. Given its multiple causes, diverse manifestations, and potential for devastating, life-altering consequences, cancer diagnosis and management require an evidence-based, multidimensional approach to care. This paper examines several essential aspects of cancer care, ranging from diagnostic methods and staging techniques to complications, treatment side effects, factors influencing incidence rates, patient education, and interdisciplinary research. A summary of findings concerning the nursing process approach to care as applied to cancer diagnosis and treatment is provided in the conclusion.

Diagnostic Methods and Cancer Staging

The initial method of diagnosing cancer is the physical examination, in which a medical professional examines the body for unusual lumps or changes in skin color that may be indicative of cancer. Various laboratory tests — such as blood and urine analyses — also assist in identifying irregularities potentially caused by cancer. For example, leukemia can be detected through an abnormal count or type of white blood cells in a complete blood count diagnostic test (Cancer Screening, 2023).

Imaging examinations provide clinicians with valuable noninvasive insights into internal organs and bones that can facilitate cancer diagnoses. Techniques such as computerized tomography scans, bone scans, magnetic resonance imaging, positron emission tomography scans, ultrasound, and X-rays are all used to produce detailed visualizations. Notwithstanding the availability of these diagnostic tests, the gold standard for cancer diagnosis remains the biopsy, in which physicians harvest a cell sample for detailed laboratory analysis (Nielsen & Narayan, 2023). Different biopsy methods are used depending on the cancer type and its location. In sum, biopsies are typically an indispensable tool for confirming cancer diagnoses (Cancer Screening, 2023). Among women, breast cancer remains the second leading cause of cancer death in the United States.

Staging involves assessing the extent and location of cancer within an individual's body and guides the medical professional in determining the specific stage of a patient's cancer. Although several staging approaches exist, the most commonly used system for most cancer types is the TNM system — where T refers to the original primary tumor, N indicates whether the cancer has spread to nearby lymph nodes, and M indicates whether the cancer has metastasized to other parts of the body (Cancer Staging, 2023). The TNM system is recommended by both the Union for International Cancer Control and the American Joint Committee on Cancer for staging numerous cancer types according to common standards. According to the National Cancer Institute, "In the TNM system, the overall stage is determined after the cancer is assigned a letter or number to describe the tumor (T), node (N), and metastasis (M) categories" (Cancer Staging, 2023, para. 5).

While the TNM system provides a detailed description of a specific cancer, TNM designations are in many cases grouped into broader stages, as described in Table 1 below.

Table 1: Descriptions of Cancer Stages

Stage 0: Abnormal cells are present but have not yet spread to nearby tissue — termed carcinoma in situ (CIS). CIS is not cancer, but it may become cancer.

Stages I–III: Cancer is present. The higher the number, the larger the tumor and the more it has spread into nearby tissues.

Stage IV: The cancer has metastasized to distant parts of the body.

Source: Adapted from Cancer Staging, 2023, para. 7

Complications, Treatment Side Effects, and Managing Their Effects

While every individual's condition is unique, cancer can cause a wide array of complications that adversely affect health and general emotional and physical well-being. One common complication is cachexia, an especially complex condition typically prevalent during advanced stages of cancer (Jaschke & Rachner, 2023). The adverse effects of cachexia are multifaceted and include muscle atrophy, weight loss, and increasing physical weakness (Jaschke & Rachner, 2023).

Another significant complication is cancer-related fatigue (CRF), described as a "distressing problem" by researchers in the field (Pearson et al., 2023, p. 1). CRF induces overall physical weakness that can impact virtually every aspect of daily living. According to clinicians at Yale Medicine (2023), "People experiencing CRF describe it as feeling tired, weak, slow, and having no energy. With no means to relieve their symptoms, people with CRF report feeling depressed and helpless" (para. 4). CRF can even interfere with basic physical activities such as walking and eating (Cancer-related Fatigue Overview, 2023).

Pain is another well-known and challenging complication of cancer and its treatments. Severe pain can disrupt both physical and mental functioning to the point where relief becomes the patient's sole focus. Additional side effects of cancer treatment may include loss of taste and smell, neuropathy, and other alterations in sensory perception (Vromans et al., 2020).

Because every case of cancer is unique, interventions designed to lessen physical and psychological effects should be patient-specific. Common strategies include rehabilitation, ensuring sufficient rest, and maintaining adequate nutrition, since a balanced diet can counteract treatment-related side effects and help protect the body from the harmful effects of treatment. Appropriate physical exercise, proper hydration, and medications can also help alleviate the physical and psychological effects caused by cancer treatments (Lee et al., 2018).

Conclusion

The nursing process employs a systematic approach to formulate accurate diagnoses and tailor patient-centered care plans, making it particularly suitable for use with cancer patients. The research consistently demonstrated that various types of cancer still represent a major public health threat despite decades of progress in diagnosis and treatment. Complications caused by cancer and its treatments — including cachexia, cancer-related fatigue, and severe pain — were identified, along with strategies to alleviate these effects, such as personalized interventions, nutrition management, exercise, and medications. The factors contributing to annual cancer incidence and mortality in the United States include unhealthy lifestyles, aging demographics, and environmental carcinogen exposure. Finally, the American Cancer Society's resources for education and support were described, and ACS services that align with the five phases of holistic care — assessment, diagnosis, planning, implementation, and evaluation — were highlighted.

References

Age and Cancer Risks. (2023). National Cancer Institute. Retrieved from https://www.cancer.gov/about-cancer/causes-prevention/risk/age

Cancer-related Fatigue Overview. (2023). Yale Medicine. Retrieved from https://www.yalemedicine.org/conditions/cancer-related-fatigue

Cancer Screening. (2023). Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/cancer/diagnosis-treatment/drc-20370594

Cancer Staging. (2023). American Cancer Society. Retrieved from https://www.cancer.org/cancer/diagnosis-staging/staging.html

Current Cigarette Smoking Among Adults in the United States. (2023). Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/index.htm

How We're Providing Support. (2023). American Cancer Society. Retrieved from https://www.cancer.org/about-us/what-we-do/providing-support.html

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Nielsen, S., & Narayan, A. K. (2023). Breast cancer screening modalities, recommendations, and novel imaging techniques. The Surgical Clinics of North America, 103(1), 63–82.

Pearson, E. J., Denehy, L., & Edbrooke, L. (2023). Identifying strategies for implementing a clinical guideline for cancer-related fatigue: A qualitative study. BMC Health Services Research, 23(1), 1–9.

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Vromans, R. D., Pauws, S. C., Bol, N., van de Poll-Franse, L. V., & Krahmer, E. J. (2020). Communicating tailored risk information of cancer treatment side effects: Only words or also numbers? BMC Medical Informatics & Decision Making, 20(1), 1–12.