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An Approach to Care of Cancer Overview Essay

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Updated: May 15th, 2022

Introduction

There is considerable evidence that palliative care is an important approach in managing cancer. According to Byock (2005), teams are more important and effective than isolated individuals are, especially because caring for cancer patients requires multiple skills, judgments as well as experiences. According to Krouse, Rosenfeld and Grant (2004), survival rates significantly increase when multidisciplinary teams are involved. From diagnosis to treatment and provision of comfort and psychological support, there is need for palliative care. This form of care involves interdisciplinary and multidisciplinary teams as well as inclusion of family members. The purpose of this discussion is to describe palliative approach to care for cancer patients. This analysis will provide a description of diagnosis and staging of cancer in normal patients. It will further provide a description of physiological and mental complications associated with cancer, some side effects and methods applicable to lessen these effects. In particular, this review will take into consideration ovarian cancer to describe diagnosis and staging processes in palliative care. Arguably, palliative care not only provides comfort to the patients, but also prolongs the patient’s life through provision of psychological attention and care.

Diagnosis and Staging of Ovarian Cancer

Diagnosis

Suspecting the presence of ovarian cancer is primarily based on a number of symptoms, especially abnormal physical examination, CT and NRI scans of the abdomen as well as the pelvis region (Siegel, Naishadham & Jemal, 2012). According to Byock (2005), the use of exploratory operation remains the best way to diagnose ovarian cancer with high degree of certainty in humans. In normal circumstances, the presence of a malignant growth on the patient’s ovary requires a complete removal of the ovary. Biopsy test of the removed ovary is usually not considered at this stage primarily because it may lead to spreading of cancer cells to other tissues, which may cause advancement of cancer.

Secondly, it is important to carry out a laparoscopy tests in an effort to evaluate the cell mass on the pelvis. In case of high suspicion of malignancy on the pelvic region, open surgery may be recommended for diagnosis. However, diagnostic laparoscopy is recommended incase where the patient’s health is compromised or when the disease has advanced. In other cases, it is important to consider paracentesis (thoracentesis) as a diagnostic confirmation prior to starting chemotherapy.

Most modern diagnostic procedures require the diagnostic team to apply Tumor markers (CA 125), prior to performing diagnostic surgery. This is normally done in patients who are suspected to have cancerous cells or after they have been diagnosed with these cells. The aim is to measure the levels of protein marker CA 125. In normal cases, the marker must be below 35U/mL. According to Krouse, Rosenfeld and Grant (2004), more than 80% of patients of ovarian cancer have their levels of this protein exceeding over 65U/Ml.

Staging process for ovarian cancer

Staging occurs after the findings of the exploratory surgery. In fact, it is based on these findings. According to Schmeler, Lynch and Chen (2006), staging must be done according to the size, location and extent of the ovarian cancer. Moreover, Byock (2005) asserts that accuracy in staging during surgery is one of the most critical aspects because it determines the long-term outcomes of the procedure as well as choice of the most appropriate treatment intervention after the diagnostic surgery.

According to Schmeler, Lynch and Chen (2006), staging must be defined with roman numerals, with each stage assigned a unique Roman numeral. Specifically, there are for stages designated II, III, IV, and I. Letters A, B and C are also used to subdivide each of these stages, which determine the extent of the tumor. A higher the stage of the disease means that there is a high rate of tumor involvement.

The early stage cancer is designated by stage I and II. In this case, Stage IA and IB disease designate the stage at which the cancer is limited to either one or both ovaries. However, the ovarian membrane is still intact. In Stage IC disease the patient’s ovary has actually ruptured, with evident signs of metastasizing cells. In this case, fluid taken from the peritoneal cavity in the process of diagnostic surgery provides evidence of cancerous cells. In stage II disease, the involvement of the tumor has gone beyond the original sites to include other organs of the pelvic.

Advanced stage disease includes stages III and IV. In stage III, the cancer is only found in the abdomen, especially in the abdominal nymph glands. Finally, stage IV disease indicates that the process of metastasizing of cells has actually taken place, with cancer cells spreading beyond the abdomen.

Complications of cancer

A number of complications that are not expected may affect interventions for managing and treating cancer. However, the obvious complications in any intervention procedure in cancer therapy include pain, fatigue, breathing complications, loss of weight, diarrheas, constipation and nausea. In addition, immune reaction to cancer is a notable complication in some interventions. For instance, studies have shown that human immune cells may recognize cancer cells as foreign bodies and therefore initiate immune mechanism to attack and kill them, which in most cases results in paraneoplastic syndromes. These syndromes, in turn, may cause seizures and difficulty in movement. Moreover, cancer metastasizing is a normal complication in most cancer patients, but it is worth noting that ovarian cancer has a lower probability of spreading as compared to other forms of cancer.

Radiation and chemotherapy, though considered as some of the most effective interventions, are prone to produce a number of complications. For instance, they produce several side effects that can have a significant impact on the patient’s quality of life. Radiation therapy is normally used for treating internal malignancies as well as those on the skim. However, it causes some short-term effects such as hoarseness, skin irritations and throat pain. In some cases, long-term side effects of radiations are dangerous. For example, if radiation is directed to some cavities such as oral or peritoneal, there is a probability of damage to glands on these regions such as salivary glands.

On the other hand, chemotherapy causes a number of side effects such as hair loss, weakened immune system and nausea. However, most of these side effects will disappear within a short time.

Physiological and mental complications of cancer are common in most patients. According to Dhaliwal, Sloan and Arkinstall (2009), cancer patients are at a high risk of developing mental disorders such as anxiety and depressions. They may experience sadness and grief in response to both the diagnosis and treatment procedures. Mood disorder is a dangerous mental complication in cancer treatment and patient care. It requires professional treatment alongside the treatment interventions for cancer.

Lessening complications

To lessen these complications, there is need for advanced psychological interventions. In fact, there is need for inclusion of professional psychotherapists within the multidisciplinary teams in order to ensure that besides the treatment of cancer, there is a simultaneous intervention to manage mental complications.

In addition, support group therapy as well as antidepressant medication is two important interventions that should be included in the treatment and management process.

Conclusion

Palliative approach to cancer proves to be the most effective ways of treating and managing cancer. It allows for inclusion of multidisciplinary and interdisciplinary teams in managing the condition. Within these teams, there are both clinical and psychotherapist professionals to ensure that apart from the clinical interventions, the patients obtain support and psychiatric services in order to manage mental complications. Taking ovarian cancer as an example, this review has described an effective process for diagnosis and staging in palliative care. In fact, it confirms that palliative care not only provides comfort to the patients, but also prolongs the patient’s life through provision of psychological attention and care.

References

Byock, I. (2005). Completing the continuum of cancer care: Integrating life-prolongation and palliation. CA Cancer J Clin, 50(2), 123- 32.

Dhaliwal, H. S., Sloan, P., & Arkinstall, W. W. (2009). Randomized evaluation of controlled-release codeine and placebo in chronic cancer pain. J Pain Sympt Manage, 10(2), 612-23.

Krouse, R. S., Rosenfeld, K., & Grant, M. (2004). Palliative care research: Issues and opportunities. Cancer Epidemiol Biomarkers Prev, 13(1), 337-9.

Schmeler, K. M., Lynch, H. T., & Chen, L. M. (2006). Prophylactic surgery to reduce the risk of gynecologic cancers in the Lynch syndrome. N Engl J Med, 3(5), 354-261.

Siegel, R., Naishadham, D., & Jemal, A. (2012). Cancer statistics, 2012. CA Cancer J Clin, 62(10), 456-461

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