Cancer occurs from the abnormal proliferation of cells in the body. Cancer or malignant cells are abnormal, have no useful function, and cause harm to normal body tissues. Any new or constant cell growth not required for normal development or replacement of damaged and dead tissues is called neoplasia (Walter et al., 2019). A tumor refers to any abnormal proliferation of cells, which can be benign or malignant. A benign tumor (non-cancerous) is usually confined to its original location and does not invade surrounding tissues or spread to distant body sites. The purpose of this paper is to describe cancer and the approach to cancer care using the nursing process.
Various diagnostic tests are used to diagnose cancer, including laboratory, imaging, and cytology. Lab tests like tumor marker identification use tumor cells to diagnose cancer. Imaging tests include bone scans, positron emission tomography (PET) scans, CT scans, and MRIs (Walter et al., 2019). Cytology is used to examine cells and helps to determine if they are benign, premalignant, or malignant. It is considered a definitive diagnostic test for cancer.
Staging of cancer determines the precise location of cancer and its extent of metastasis during diagnosis. The most commonly used staging method is the Tumor, Node, Metastasis (TNM) system developed by The American Joint Committee on Cancer. The TNM system outlines the general anatomic extent of a tumor and groups it from stages 0-4 (Walter et al., 2019). Stage 0 is cancer in situ, meaning there are abnormal cells located where they started and have not spread to nearby tissues. Stage 1 is characterized by a small tumor that has not spread outside of the organ it developed in. Stage 2 indicates a locally advanced tumor in the early stages, while in stage 3, the tumor is in the late stages and usually has lymph node involvement (Walter et al., 2019). In stage 4, the malignant cells usually have spread to other body parts.
Cancer complications include impaired oxygenation, impaired nutrition, and Infection. Impaired oxygenation occurs when tumors grow in the airways causing airway obstruction, and if lung tissue is affected, the lung capacity reduces. Tumors also compress blood and lymph vessels in the chest, obstructing blood flow through the chest and lungs (Seo et al., 2021). Besides, tumors often thicken the alveolar membrane and injure the pulmonary blood vessels causing a decreased gas exchange. Patients with cancer often have impaired nutrition due to GI structure and function alterations. For instance, abdominal obstruct or compress structures along the GI tract, impairing the absorption of nutrients and elimination of wastes. In addition, tumors invading the liver damage the organ impairing its metabolic functions. Infection is a common complication attributed to the invasion of the skin and mucous membranes (Seo et al., 2021). Furthermore, tumor cells invade the bone marrow and impair the production of white blood cells, which are vital for normal immune function.
Commonly used cancer treatments include surgery, radiotherapy, chemotherapy, and immunotherapy, independently or in combination, to kill cancer cells. The side effects of surgery include disfigurement, scarring, and bleeding/infection at the incision site. Radiotherapy side effects include altered taste sensations, skin changes, alopecia, and fatigue (Leach, 2020). Common chemotherapy side effects include nausea and vomiting, hair loss, mucositis, anemia, neutropenia, thrombocytopenia, altered bowel elimination, cognitive changes, and sleep disturbance. Side effects of immunotherapy include peripheral neuropathy, flu-like general malaise, fever, chills, flu-like general malaise, and skin dryness, itching, and peeling.
Mucositis can be lessened through frequent oral hygiene with teeth cleaning and mouth rinsing, which is vital in managing stomatitis and mucositis. The alopecia skin side effects can be minimized by avoiding direct sunlight, wearing a hat to cover the hairless scalp, and using sunscreen. In addition, stool softeners can be administered to patients with altered bowel function to alleviate constipation and avoid injury to the anal skin (Leach, 2020). Pain can be alleviated using non-opioid analgesics and non-pharmacological measures like heat or cold compressions and massages. Furthermore, appetite stimulants can be used for patients with reduced appetite and at risk of nutritional deficiency.
Cancer is the second leading cause of mortality in Americans after heart disease. The American Cancer Society (ACS) projects that about 1.9 million new cancer cases will be diagnosed in 2023, and 609,820 cancer-related mortalities will occur. Cancer is associated with lifestyle factors like alcohol consumption, tobacco smoking, physical inactivity/sedentary behavior, overweight/obesity, and poor dietary habits. Zhang et al. (2020) found that consuming 50 and 100 g of ethanol per day was linked with 22 and 91% higher cancer risks, and heavy drinkers had a 31% higher risk of cancer mortality than non-drinkers. Tobacco smoking is the most vital risk factor for cancer morbidity and mortality. The risk of cancer in smokers increases by several folds for cancers, like laryngeal, pharyngeal, lung, upper GI tract, and oral cancer. Furthermore, being overweight and obese was linked with 5–50% higher risks of breast, esophageal, colorectal, endometrial, kidney, liver, gallbladder, ovarian, stomach, pancreas, and thyroid cancer (Zhang et al., 2020). Besides, obese males and females, obesity had 6 and 10% higher risks of cancer mortality than their healthy-weight counterparts.
In addition to lifestyle factors, viruses (oncoviruses) have been associated with various cancers. Viral carcinogenesis occurs when viruses infect body cells and destroy DNA strands (Das, 2021). Hepatitis B virus is linked with Primary liver carcinoma, while Hepatitis C is associated with Primary liver carcinoma and B-cell lymphomas. Human papillomavirus (HPV) causes vulvar carcinoma, cervical carcinoma, and other anogenital carcinomas (Das, 2021). Besides, Epstein-Barr virus is linked with B-cell lymphoma, Burkitt’s lymphoma, and nasopharyngeal carcinoma.