Approach to Care: Cancer
Grand Canyon University: NRS 410v Pathophysiology and Nursing Management of Clients Health November 9, 2014
Approach to Care: Cancer
Devastation and fear of the known are common feelings for those who receive news of having Cancer. Every year, over a million people will be diagnosed with cancer annually according to the American Cancer Association. When first receiving a cancer diagnosis, it is difficult for clients and loved ones to really understand any information provided immediately after the diagnosis is given. Every cancer is also staged from a biopsy of the site, and as a nurse, it is important to really understand the type of cancer along with the current stage. There is a multitude of cancer information available, but really the nurse needs to be prepared to provide accurate information to patients and families. This paper will provide a brief description of the stages of cancer, some of the side effects from treatments available, and care of the patient with cancer. Staging of Cancer
A physician will stage a cancer from 0 to IV to determine just how large the tumor is and how systemic it has become. “By moving through the bloodstream or lymphatic system, cancer cells can spread from the primary site to lymph nodes or to other organs, where they may form new tumors” (National Cancer Institute). The TNM system is often used to determine the current stage of cancer. From the TNM system the size of the tumor, at which length the nodes are involved, and what extent the lymph nodes are exposed are used to determine the stage. Metastasis is the final part of staging cancer, which is spreading of the cancer to other areas of the body that are from the original site of the cancer. This leads to a grading system that helps determine the appropriate treatment plan or prognosis for the patient.
Carcinoma in Situ
Stage 0, also known as in Situ, is the earliest phase of cancer. A cell mutates into a cancer cell along with other cells in the same area, which forms a tumor in that tissue. This is not a diagnosis of cancer in Breast Cancer, but rather indicates an increased risk of cancer. Further treatment varies for those in Stage 0. Some patients may be observed while others may be started on tamoxifen, but there are of course risks associated with this medication such as increased risk of pulmonary embolism, venous thrombosis, stroke and Uterine Cancer. “The NSABP-P-1 trial of 13,388 high-risk women comparing tamoxifen to placebo demonstrated an overall 49% decrease in invasive breast cancer, with a mean follow-up of 47.7 months” (National Institute of Cancer). Some patients may participate in clinical trials to reduce chances of further spread of the cancer while others may opt for more extreme prophylaxis such as a bilateral mastectomy. Cancer Stage I, II, III
Stages I, II, and III all stand for disease being actually present. The higher level of staging could indicate a larger tumor. It could also indicate a more systemic disease process involving the lymph system. Once it has spread into the lymph system, the cancer can then spread to nearby organ systems. Along with tumor excision and removal of any effected lymph nodes, concurrent use of medications like tamoxifen in treatment of breast cancer, and the use of radiation and/or chemo therapy are all used in treatment plans at these stages of disease manifestation.
At Stage I, the tumor is small measuring less than 2cm and has not spread into nearby lymph nodes. As the cancer progresses, Stage II has a larger tumor measuring two to five centimeters, but has not inundated the surrounding tissues and has not spread from the current infected tissues, but it can sometimes be found in the associated lymph nodes. Stage III contains not only a larger tumor and is usually found in the nearby lymph nodes. Stage IV
The final stage is Stage IV, where it is found that the cancer has spread from...
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