Cancer: Staging, Complications, and Side Effects of Treatment
Cancer is a complicated and difficult condition to treat, as well as to live with. Due to the many different forms of cancer and the uncertainties involved in its treatment, patients living with the condition often experience a high degree of anxiety and depression. In addition to this, the treatments themselves, such as chemotherapy and radiation therapy, can have painful and disruptive side effects that add to patient suffering during the course of the disease. Finally, even once in remission, cancer can rarely be said to be truly gone, and the possibility of it returning is an ever-present threat in the lives of cancer survivors. These factors all add up to make cancer one of the most frightening illnesses in health care, and yet, by following proper evidence-based treatment methods, the condition can be diagnosed and handled in a systematic fashion.
Diagnosis: The First Step
Cancer is a blanket term that describes a variety of mutations that can occur in any tissue within the body. Diagnosis of the condition usually involves tissue sampling via biopsy to confirm, though the presence of chemical markers in the blood can also indicate the illness is present. Early warning signs for the disease can include symptoms of paraneoplastic syndrome, which is caused by hormones being secreted by the cancerous growth which lead to changes throughout the body and even psychological effects. Also, a condition known as mass effect can occur, which describes the symptoms caused by the cancerous growth physically pushing on surrounding tissue. Depending on where the tumor is located and the type of tissue affected, both paraneoplastic syndrome and mass effect can have a variety of symptoms (Dalmau & Graus, 2012).
There is a wide range of prognoses for patients diagnosed with different forms of cancer. These can range from conditions such as melanoma, which have a relatively high survival rate, to pancreatic cancer which has a relatively low survival rate. In all forms of cancer, early detection improves a patient’s prognosis, though it does not guarantee survival. With cancers that are particularly resistant to treatment, even early detection may not be enough to allow for the effective treatment of the condition, and thus the patient may still die (Kenfield, Stampfer, Giovannucci, & Chan).
Staging: How Advanced is It?
Staging refers to the progress of cancer and its severity. A number of factors go into determining at what stage a particular instance of cancer is. According to the National Cancer institute (NCI) (2015), a cancer’s stage is determined by the following factors: location in the body, type of cell mutation, size of the cancerous growth, whether or not the cancer has spread to the lymph nodes, whether or not the cancer has spread to another part of the body, the abnormality of the cancer cells and how likely they are to grow and spread. The acronym “TNM” is commonly used in assessing the staging of a cancer. T stands for tumor and refers to the size of the primary tumor involved. N stands for nodes in reference to the lymph nodes and describes how many of them the cancer has reached. M stands for metastasized and refers to whether or not the cancer has reached another part of the body other than where the main tumor is located.
The staging of an instance of cancer in a patient is important for prognosis and for the oncology team developing a plan of care for the disease. Some cancers spread much more rapidly than others and are more resistant to treatment. As such, more radical treatment options are justified with these sorts of cancers so long as they are accurately documented using the staging system. This system allows patients to get the treatment they need and protects physicians by providing a standardized method for determining a cancer’s severity and treatment needs NC (NCI, 2015).
Complications: What to Expect
Since the blanket condition known as cancer has many variables and unknowable components, a variety of complications can arise in the treatment of the illness. This section with discuss these complications along with any precautions taken to avoid them or treatments should they arise.
In cancers that indicate treatment with radiation therapy, patients may experience unpleasant skin reactions. One of the most dangerous forms of such reactions is moist desquamation in which patients’ skin’s permeability to fluid is increased leading to sores that seep. These sores are prone to infection, which is particularly dangerous for the immunocompromised cancer patient. Mepital film applied to the sight of skin irritation has shown significant improvements in treating moist desquamation in patients receiving treatment for breast cancer (Morgan, 2014).
Many patients living with cancer become depressed due to the uncertainty of their prognosis and the negative effects of the treatments they must undergo. Many patients chose to give up or stop trying to fight the illness which has a psychogenic and negative effect on their recovery. Exercise programs of low impact activities such as walking or yoga are a popular way to help combat this depression (Sawyer, 2014).
The combined effects of the cancer itself, the stress of the situation, and the toxic treatment options involved can often cause a decrease in cognitive functioning in patients. This decrease may be linked to depression and anxiety or may have origins in a chemical change in the brain during the course of treatment. Whatever the cause may be, physical activity is also indicated here as a beneficial method of reversing the negative effects according to Gokul et al. (2015).
Side Effects of Treatment
Several of the negative effects of cancer treatment have already been discussed, but these are combined effects resulting from the overall situation. In this section, side effects resulting purely from the treatments involved will be mentioned with an emphasis on chemotherapy. Chemotherapy is essentially a type of treatment that involves poisoning the patient with the belief that the cancerous tissue will die before the patient does. Naturally, it has a large number of unpleasant side effects such as joint pain, fatigue, disorientation, nausea, vomiting, and diarrhea. Very little can be done to manage the side effects of chemotherapy other than to prescribe pain medications and antiemetics. (Iwamoto, 2013).
One such side effect that occurs with chemotherapy and radiation therapy is a diminished immune system. White blood cell numbers drop during chemotherapy and radiation treatments, which leaves the body susceptible to infections. While nothing can be done to improve white cell counts directly, patients are often isolated in clean environments during their treatment. Due to the other side effects involved, patients who are allowed to go home following treatment are not likely to go out of their homes much, which actually keeps them safe from infection (Iwamoto, 2013).
Patients undergoing treatment for cancer are in an unfortunate position of experiencing a high degree of uncertainty. In addition to the effects of the cancer itself such as mass effect and paraneoplastic syndrome, this uncertainty can cause negative psychological effects such as increased anxiety, depression, and hopelessness in the patient. Non-surgical treatment options such as chemotherapy and radiation therapy have a large number of unpleasant side effects associated with them such as skin lesions, general feelings of unwellness, and a compromised immune system. All of these factors work together to make cancer a particularly difficult illness to cope with and to treat. However, due to the work of cancer researchers, a systematic approach to diagnosis and treatment has been developed, which maximizes patient recovery rates as well as their quality of care.
Dalmau, J., Graus, F. (2012). Paraneoplastic syndromes: From remote to clear and present knowledge. Brain: A Journal of Neurology. Retrieved November 19, 2016 from http://brain.oxfordjournals.org/content/early/2012/03/25/brain.aws064.full
Gokal, K., Munir, F., Wallis, D., Ahmed, S., Boiangiu, I., & Kancherla, K. (2015). Can physical activity help to maintain cognitive functioning and psychosocial well-being among breast cancer patients treated with chemotherapy? A randomized controlled trial: Study protocol. BMC Public Health, 15(1), 1-8. Retrieved November 18, 2016, from http://0-web.b.ebscohost.com.liucat.lib.liu.edu/ehost/pdfviewer/pdfviewer.
Iwamoto, T. (2013). Clinical application of drug delivery systems in cancer chemotherapy: Review of the efficacy and side effects of approved drugs. Biological and Pharmaceutical Bulletin, 36(5), 715-718.
Kenfield, S. A., Stampfer, M. J., Giovannucci, E., & Chan, J. M. (2011). Physical activity and survival after prostate cancer diagnosis in the health professionals follow-up study. Journal of Clinical Oncology. Retrieved November 19, 2016 from http://jco.ascopubs.org/content/29/6/726.short
Morgan, K. (2014). Radiotherapy-induced skin reactions: Prevention and cure. British Journal of Nursing, 23(16). Retrieved on November 18, 2016 from http://0 www.ncbi.nlm.nih.gov.liucat.lib.liu.edu/pubmed/25203851
National Cancer Institute (2015). Staging. Retrieved November 19, 2016 from https://www.cancer.gov/about-cancer/diagnosis-staging/staging
Sawyer, A. (2014). Complementary exercise and quality of life in patients with breast cancer. British Journal of Nursing, 23(16), 18-23. Retrieved November 18, 2016, from http://0-www.ncbi.nlm.nih.gov.liucat.lib.liu.edu/pubmed/25203850.