Diagnosis and staging of cancer
Staging of cancer is the classification of severity of cancer. It is an important step towards evaluating the progress of cancer treatment and helping in devising a treatment plan for the patient (National Cancer Institute, 2015). The concept of cancer staging is founded on the understanding of how cancer progresses. The uncontrollable growth of cancer cells leads to the formation of a tumor, which is a tissue mass made of cells that fail to die. The tumor continues to grow and affects the surrounding tissues and organs. If the cells break away and reach other organs through the lymphatic or bloodstream, then the cancer is said to have metastasized. The stage of the cancer is determined after conducting medical and physical examinations to get information about the progress of the disease. Examining the tumor physically is one of the tests performed. Various imaging techniques like computerized tomography and PET are also employed to indicate the location of the tumor, as well as its reach, how big it is, and the extent of metastasis. Laboratory tests involve testing body fluids. Further investigations into cancer may involve providing reports on the pathology and cytology of the tumor. Finally, surgical reports give more information about the physical appearance of the tumor and the reach of the tumor (National Cancer Institute, 2015).
Staging of cancer is done when the cancer is diagnosed, regardless of the type of cancer. Therefore, the clinical stage is the initial stage of cancer and it happens before treatment is commenced. Shedding more information about the reach of cancer helps in further staging. This usually happens after conducting biopsy tests or surgery. This second level of staging is called the pathologic stage. The stage at which the cancer was diagnosed determines the designation of cancer. It means that changes in cancer, such as further spread, do not change how the cancer is referred to; instead, the new information is added to the initial stage reference (National Cancer Institute, 2015).
There are common factors that are considered when staging cancer, regardless of the system used to stage cancer. For instance, the type of cells and the location of the primary tumor are considered. In addition, the number of tumors is also considered to determine whether cancer has metastasized. The reach and size of the time are also considered. Finally, the grade of the tumor is considered (National Cancer Institute, 2015).
The most popular staging system is abbreviated as TNM cancer staging. The first initial, T, is representative of the primary tumor. Here, the patient is examined for the size of the tumor. The size of the tumor is classified as T1, T2, T3, and T4 to indicate how large the tumor is during diagnosis. The N stands for the lymph nodes spread of the tumor, whereby it is determined whether the cancerous cells have moved into the surrounding lymph nodes. The extent of involvement of the regional lymph nodes is designated as N1, N2, or N3. Finally, the M stands for the occurrence of metastases, whereby it is determined whether cancer has moved to other body parts. Determination of metastases is classified depending on whether it has happened far from the primary tumor (M1) or near the primary tumor (M0) (National Cancer Institute, 2015).
There is also another principle of staging that can be used together with the TNM criterion. The initial stage is known as stage 0, whereby cancer-like cells are present but in a single location. The first, second, and third stages, designated as I, II, and III respectively, show the extensiveness of the disease, with higher numbers indicating more extensiveness. Finally, stage IV is an indication of high and distant metastases (National Cancer Institute, 2015).
Although most cancers are staged using the TNM system, there are other types of cancers, such as brain cancer and blood cancer, that are stage depending on the grade of cancer and the type of cells involved. There is also the “summary staging” that is used in all cancers. It involves classifying cancers into five categories, which are in situ, localized, regional, distant, or unknown (National Cancer Institute, 2015).
Complications and Side Effects of Treatment
The symptoms that are associated with cancer have various adverse effects to the body of the patient. The treatment also has equally devastating complications. The major complications include skin problems, including hair loss, dryness and itchiness, nausea/vomiting, pain, fatigue, and weight loss or weight gain, among others. Advanced cancer causes more severe complications, which include organ and system failure (Nelson et al., 2000).
Most cancer patients undergoing treatment report with skin irritation and dryness as side effects. Rashes also develop on the skin. Dryness of the skin is the leading side effect of cancer treatments that affect the skin, with fingernail problems coming second, and finally the problem of redness and itching of the skin. Reversible hair loss also occurs. The complications of the skin are usually due to radiotherapy (Reily, 2009).
Pain is another common complication that is caused by cancer and the various therapies administered during treatment. Cancer patients also experience fatigue, which is usually temporary and occurs after going through therapy sessions. Praneoplastic syndromes are other common cancer complications (Nelson et al., 2000). Nausea and vomiting mainly occur due to the direct stimulation of the vomiting center when administering radiotherapy, especially to the head. They may also occur due to anxiety. The more the cancer advances, the more the complications and their severity increase. Advanced cancer is characterized by endocrine abnormalities like adrenal insufficiency and hypercalcemia (Nelson et al., 2000). Hypercalcemia occurs due to the stimulation of the chemoreceptor trigger zone or the administration of drugs like morphine. Other severe complications include hematologic disorders (McLeod, Vella-Brincat, & Macleod, 2009).
Breathlessness, also known as dyspnoea, is a cancer complication that may happen due to radiation stricture or tumors in the airways. Effusions or infections in the lungs may also decrease the lung volume. Drug therapy, such as administration of opioids, NSAIDs, and bronchodilators can manage the complication. Psychosocial support can also assist by providing relaxation and breathing techniques (McLeod et al., 2009).
Methods to Lessen Physical and Psychological Effects of Cancer
Lessening the side effects of cancer treatments is very important in the management of cancer. For instance, the dryness of the mouth and the skin can be soothed by the use of sprays like Evomucy and Evoskin respectively. The treatments are available in the form of spray to avoid touching the painful skin when applying (Reily, 2009). Nausea and vomiting can be managed using anti-emetics or antipsychotics. Other complications and side effects can also be managed using drugs.
Psychological stress is very common among cancer patients (McLeod et al., 2009). The stress can be handled better by obtaining social and emotional support. The patient should be trained on how to manage stress through methods like meditation and relaxation. Counseling therapy and attending cancer education classes can also reduce levels of anxiety associated with treatment complications. Engaging in physical exercise and taking drugs for depression are also ways of lessening the psychological effects of cancer (National Cancer Institute, 2015).
References
McLeod, R., Vella-Brincat, J., & Macleod, S. (2009). The palliative care handbook. Christchurch, New Zealand: Nurse Maude Association.
National Cancer Institute (2015). Cancer staging. Web.
Nelson, K. A., Walsh, D., Abdullah, O., McDonnell, F., Homsi, J., & Komurcu, S… (2000). Common complications of advanced cancer. Seminars in Oncolology, 27(1), 34-44.
Reily, C. V. (2009). Managing cancer treatment side-effects. Practice Nurse, 38(3), 42.