Medical & Health // Approach to Care
The approach to cancer care has revolutionized just like most disciplines. It now provides for state-of-the art or more sophisticated biomedical therapies than in the past (Adler & Page, eds, 2008: 1). Health is promoted and maintained by the dynamic and balanced interplay among the biological, psychological, behavioral and social factors (Institute of Medicine, 2001: 16 as qtd in Adler & Page, eds, 2008). When this interplay is disturbed, disease or disorder ensues. But the current already-high level of sophistication in cancer care misses out on the psychosocial angle of disease. The inadequacy reduces the efficacy of revolutionized disease management and patient health itself. Psychological and social or psychosocial issues that cancer can create or worsen include all emotional troubles and pains, lack of knowledge or skills in dealing with cancer, lack of resources, and negative impacts on the patient’s work, school and family life. These increase or intensify bodily suffering, weaken natural resistance to contagion, reduce cooperation with treatment, and discourage the patient’s own will to recover or survive. (Adler & Page, eds, 2008: 1).
In order to meet this lack and make the current approach truly responsive to the needs of cancer care, 10 recommendations were made by this report for incorporation into the current approach. These were an active provision for appropriate psychosocial services, healthcare providers’ meeting the improved standard in their practice, patients’ and their families expecting or securing this standardized psychosocial service, a large-scale demonstration and evaluation of psychosocial approaches by all major healthcare institutions, support of these services by buyers of healthcare providers, oversight mechanisms that include psychosocial healthcare services by these institutions, the development of competencies in delivering the said services by healthcare workers, the establishment of standardized taxonomy and nomenclature on psychosocial health services, priority research on providing such cancer care that meets the recommended standard, and the monitoring of programs aimed at improving the delivery of psycho social services (Adler & Page, 2008:1).
Diagnosing and Staging of Cancer
Cancer is diagnosed by physical examination, laboratory tests, imaging tests, and biopsy (Adler & Page, eds, 2008 :1). Though a physical examination, the doctor can locate lumps that may develop into tumors as well as other abnormalities. Laboratory tests of urine or blood can reveal the nature of the abnormalities. A complete blood count can reveal can detect the number of cells and come to a diagnosis of leukemia. Imaging tests can check out the bones and internal organs without need for surgery. Computerized tomograhy scan, bone scan, magnetic resonance, positron emission, ultrasound and x-ray are examples. And biopsy takes a small sample of an organ, which may be suspected of cancer. It is a sure way of diagnosing cancer in most cases. Doctors can examine a tissue, blood or bone under a miscroscope. They can differentiate normal from abnormal cells by means of their sizes and orderliness (Adler & Page, eds, 2008 : 1).
A determination of the cancer stage is necessary for the choice of therapy and the estimated choice of cure or survival (Adler & Page, eds, 2008: 1). Imaging tests, like bone scans and x-rays, can detect if a malignancy or cancer is in an early and controllable place or has spread to other organs. This is called metastasis. Staging is expressed in Roman numerals of I to IV. The higher, the numerals, the more advanced the cancer is. Letter or words are also used to set the stage of cancer, such as Ib, IIa and IIIb (Adler & Pager, eds, 2008: 1).
Complications
Cancer treatment produces many complications (Mayo Clinic Staff, 2017). These include pain, fatigue, difficulty in breathing, nausea, constipation or diarrhea, loss of weight, chemical changes, adverse effects on the brain the nervous system, unusual reaction by the immune stem, and spread of the condition (Mayo Clinic Staff, 2017:1).
Not all cancers cause pain (Mayo Clinic Staff, 2017:1). When they do, it is caused by the cancer itself or its treatment. There are medications and other methods that can eliminate pain that proceeds from the condition or its treatment. Cancer also often causes fatigue, often as a consequence of chemotherapy or radiation treatment. This fatigue, however, is manageable and passing. Those ill of cancer may also experience shortness of breath, but like pain and fatigue, there are approaches that can relieve it (Mayo Clinic Staff, 2017: 1).
Nausea is still another complication of some cancers and their treatment (Mayo Clinic Staff, 2017:1). A doctor can tell if treatment may lead to this complication but he will also prescribe medications or other approaches of preventing or reducing the complication. Some patients report developing constipation or diarrhea as a complication of cancer or its treatment, but like other complications, there are medications that can manage both (Mayo Clinic Staff, 2071:1).
Cancer patients may also lose weight as malignant cells steal food and nutrients from normal cells (Mayo Clinic Staff, 2017). The condition is difficult to treat and the kind or amount of food ingested to compensate will not perform the task. Not even tubal feeding will. The normal chemical balance in the body is also bound to be disrupted by cancer and render the person more vulnerable to other serious complications. These are extreme thirst, constipation, frequent urination, and confusion (Mayo Clinic Staff, 2017:1).
Brain and nervous system disturbances can also be complications (Mayo Clinic Staff, 2017:1). These can occur when malignant tumors press against proximate nerves, causing pain and paralyze that side of the body. The person is likely to experience headaches, signs and symptoms similar to strokes and one-sided paralysis. A rare condition may also occur in cancer cases, called parancoplastic syndrome. The body’s immune system may target normal cells instead of malignant cells. Its many signs and symptoms include seizure and difficulty in walking. Metastasis is one very serious complication. It means spreading to other organs, near or distant, as cancer advances. The type of cancer determines which organs it tends to spread to. And cancer recurrence is a risk that survivors may confront. No one knows for sure why some types are more likely to recur than other types. Cancer experts can, however, monitor by setting up an after-treatment care plan, which includes periodic tests and scans for a number of months or years, to watch for recurrence (Mayo Clinic Staff,2017:1).
Side Effects
Cancer patients and their families and friends know that cancer therapies produce side effects (Angelis, 2008: 199). The familiar ones include diarrhea, mucosal membrane toxicity, plame-plantar crythrodysesthesia, and infusion reactions. The unique and unfamiliar ones include proteinuria, hypertension, and skin conditions. These skin conditions include acneiform rash, dryness of the skin, changes in the nails, and hair discoloration (Angelis, 2008: 199).
There is inadequate information about the side effects and the clinical effectiveness of molecularly targeted treatments (Angelis, 2017: 199). Their side effects are as unique as they are disruptive of quality of life on a daily basis. When these targeted therapies are used along with those for traditional adverse reactions to cancer therapies, the level of both toxicities and sufferings of all kinds increases (Angelis, 2017: 199).
Methods to Lessen Physical and Psychological Effects (Mustian, et al 2010) Physical activity may play an important role in the rehabilitation of cancer survivors during and following treatment. Current research suggests numerous beneficial outcomes are experienced in cancer survivors undergoing exercise interventions during or following cancer treatment. Exercise not only plays a role in managing side effects but also improves functional capacity and quality of life. The purpose of this article is to provide an overview of the oncology literature supporting the use of exercise as an effective intervention for improving cancer-related fatigue, other side effects, functional capacity, and quality of life among cancer survivors.
The American Cancer Society recently reported that prompt detection and better therapies have increased the number of cancer survivors (Mustian et al, 2010:1). These survivors, however, still suffer from both short and long-term side effects of cancer and their therapies. Experience unfailingly testifies to the far-reaching and adverse effects of the condition on these survivors during and after treatment. These are times when exercise appears to be a valuable remedy to the condition and a tool in raising the level of the quality of their lives during and after treatment (Mustian et al, 2010:1).
Most recent studies on the value of exercise in the control of cancer side effects and complications suggest its effectiveness as a form of intervention in managing these consequences and in raising their quality of life (Mustian et al, 2010:7). But these studies are new and limited. They use only small population sizes and they amount and type of exercise used in their experiments lack consistency. Furthermore, the lack of appropriate methods used prevents a generalization for its application for a significant number of sample populations. And the lack of appropriate statistical and follow-up analyses also prevents the needed comparison between the mode of exercise and treatment dose (Mustian et al, 2010: 7).
All in all and despite these challenges and limitations, initial findings consistently point to both the safety and advantage of exercise in the management of adverse side effects and complications of cancer and cancer therapies (Mustian et al, 2010: 7). When individualized and suited to the precise cancer site and stage, treatments and the patient’s own fitness level, the effectiveness of exercise in minimizing both physical and psychosocial side effects and complications of cancer and cancer treatment may be most effective. Aerobic activities, resistance training, both aerobic and resistance regimens and other forms of enjoyable exercise, like yoga and Tai Chi, can be or have been shown to be efficacious in reducing the physical and psychosocial sufferings of cancer patients from treatment while succeeding in lifting the level of their quality of life during treatment and after (Mustian et al, 2010: &). These observations should encourage further research and experiments on exercise as part of cancer therapy.
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