Physical And Mental Care For Cancer Patients Sample Paper

Introduction

The American Cancer Society (2017) estimates that over one million people are diagnosed with cancer each year. It is difficult for both patients and their families to understand the diagnosis and know how to deal with it. The approach to the care of cancer should include physical and psychological treatment, appropriate diagnosis procedures, education for patients and their families, as well as personalized tools and strategies that will allow treating patients according to their needs.

Cancer Diagnosis and Staging

While cancer causes many symptoms to manifest themselves, it is not cancer per se that influences the appearance of symptoms; rather, it is the presence of benign tumors and other problems linked to the condition. If the patient has experienced symptoms similar to those that occur in cancer, he or she must immediately inform the doctor who will then order lab tests, scans, and other procedures for the accurate detection and diagnosis of cancer. Body fluids (blood, urine, etc.) lab tests are used for detecting the levels of certain substances in the organism. While either low or high level of specific substances in the human body can be the sign of cancer, lab tests are not the only methods of detection and cannot be used alone for the diagnosis of cancer (NIH, 2015).

Imaging procedures and biopsies are reliable tools that health care providers use for cancer diagnosis. Imaging is used for creating pictures of areas inside the patient’s body to help doctors see whether any signs of tumors are present. Such pictures can be taken with the help of CT scans, nuclear scans, ultrasound, MRI, x-rays, and PET scans (NIH, 2015). Also, in the majority of instances, doctors need a biopsy performed to diagnose cancer. During the procedure, the doctor removes a tissue sample, which is then given to a pathologist for further investigation. The sample of tissue can be removed with a needle, an endoscope, or through surgery (NIH, 2015).

The TNM system (developed and approved by the American Joint Committee on Cancer, AJCC) is used for describing stages of cancer. According to the system, doctors use the test result for answering the following questions:

  • Where is the primary tumor located and how large is it? (T, tumor).
  • Have the lymph nodes been affected by the tumor? If they have, then how many? (N, node).
  • Has the disease spread to other parts of the patient’s organism? If yes, where and to what extent? (M, metastasis).

After getting results from the TNM test, doctors determine the stage of cancer that a patient has. While each type of cancer has accurate staging information, the list below applies to the majority of cancers:

  • Stage 0. This stage of the disease describes cancer in place. Cancers of stage 0 are located in the place they originated and have not spread to any other tissues. Because of this, stage 0 of cancer is highly curable, predominantly through the surgical removal of the tumor (“Stages of cancer,” 2015).
  • Stage I. This stage is characterized by a small tumor that has not grown too deeply into the adjacent tissues. Also, cancers of stage I have not spread to the lymph nodes or other parts of the organism. This stage of cancer is often referred to as early-stage cancer.
  • Stage II and III. These two stages of cancer are indicative of larger tumors that have grown deeply into the adjacent tissues. The tumors may also spread to lymph nodes but not other body parts.
  • Stage IV. This stage of cancer means that the disease has spread to other parts of the body; it is also called metastatic or advanced cancer (“Stages of cancer,” 2015).

While the TNM system mentioned above is predominantly used for describing cancers that form solid tumors (e.g., lung, colon, breast cancers), doctors also use other staging systems for classification. These stages are the following:

  • Cancers of the blood. The TNM system cannot be used to describe the characteristics of leukemia, lymphoma, or multiple myeloma because these types do not form solid tumors (“Stages of cancer,” 2015).
  • Childhood cancers. The staging system approved by the AJCC does not include childhood cancer (“Stages of cancer,” 2015). Most childhood cancers are staged separately to cater to specific situations.
  • Brain tumors (central nervous system tumors). Because cancerous brain tumors only affect the spinal cord and the brain, only the “T” description of the TNM system applies (“Stages of cancer,” 2015). At the moment, there is no one unified staging system used for determining stages of brain tumors.

To conclude, the staging of cancer is an essential process that allows healthcare providers to plan treatment (surgery, chemotherapy, radiation therapy, etc.), predict the chance of possible recovery or the return of cancer, determine the effectiveness of treatment, and talk about cancer.

Complications, Side Effects, Physical and Psychological Effects

Complications from cancer and its treatment are not only related to side effects that will be discussed later; they can take many forms depending on the characteristics of the human organism. For example, a patient can have unusual reactions of the immune system. In some cases of cancer, the immune system can react to cancer attacking healthy cells, which is called paraneoplastic syndrome. While it is a rare reaction, it can lead to such adverse health effects as difficulties walking and recurring seizures (Mayo Clinic Staff, 2015). Furthermore, cancerous tumors can affect the brain and nervous systems through pressing on nearby nerves, thus causing pain and the loss of function of one part of the body. Apart from experiencing physical problems when dealing with cancer, patients are also under immense psychological pressure to cope with the problem.

When it comes to the treatment of cancer that predominantly includes chemotherapy, the side effects can take over the daily life of a patient. Such side effects include nausea and vomiting, fatigue, hair loss, pain, difficulty breathing, weight loss, digestion problems, and chemical imbalance. Nausea and vomiting are the two most frequent side effects of chemotherapy (Janelsins et al., 2014) that subsequently interfere with the compliance of cancer therapies and the quality of patients’ lives. Fatigue is an issue that affects cancer patients daily: at least 32% reported fatigue upon their admission to the hospital, 40% on discharge, and 36% six months later (Horneber, Fischer, Dimeo, Rüffer, & Weis, 2012). Hair loss among cancer patients is linked to the chemotherapy damaging hair follicles (American Cancer Society, 2015).

It is crucial to mention that mental problems go hand-in-hand with cancer treatment. Distress, depression, and anxiety are the three most common mental conditions that cancer patients experience. Distress is a short-term condition that may occur when a cancer diagnosis is not expected; it is also common for patients to experience distress during treatment (Stein, Syrjala, & Andrykowski, 2008). Depression and anxiety are long-term and can affect patients that struggle with emotionally recognizing their condition. The prevalence of depression in cancer patients has been estimated to range between 10% and 50%; the prevalence of anxiety can range between 6% and 23% (Stein et al., 2008). PTSD is another important contributor to long-term depression and anxiety and can range between 0% and 32% among cancer survivors (Stein et al., 2008).

Dealing with the mentioned psychological and physical effects of cancer is possible through designing and implementing an integrative and multidisciplinary approach to improve the health outcomes of patients diagnosed with this complex condition. Apart from treating patients physically (through treatment and the management of side effects), psychological support should be provided to cancer patients who tend to experience severe emotional distress when dealing with the side effects of their treatment. Also, lifestyle changes can benefit in alleviating the physical and psychological burden of cancer.

Conclusion

Therefore, health professionals from different fields (nutritionists, psychologists, radiologists, physicians, surgeons, etc.) should work cooperatively to establish an effective approach to care for patients diagnosed with cancer. Beginning from correct diagnosis and ending in recovery, patients must be sure to rely on the multidisciplinary team of professionals that will combine their efforts to create a multi-faceted approach towards care for cancer patients. Such work can have a great impact on the recovery of patients and contribute to offsetting the sadness, which still prevails when the topic of cancer arises.

References

American Cancer Society. (2015). Hair loss. 

American Cancer Society. (2017). Cancer facts and figures 2017. 

Horneber, M., Fischer, I., Dimeo, F., Rüffer, J., & Weis, J. (2012). Cancer-related fatigue: Epidemiology, pathogenesis, diagnosis, and treatment. Deutsches Ärzteblatt International, 109(9), 161-172.

Janelsins, M., Tejani, M., Kamen, C., Peoples, A., Mustian, K., & Morrow, G. (2014). Current pharmacotherapy for chemotherapy-induced nausea and vomiting in cancer patients. Expert Opinion on Pharmacotherapy, 14(6), 757-766.

Mayo Clinic Staff. (2015). Complications. Web.

NIH. (2015). Diagnosis. Web.

Stages of cancer. (2015). Web.

Stein, K., Syrjala, K., & Andrykowski. M. (2008). Physical and psychological long-term and late effects of cancer. Cancer Supplement, 112(11), 2577-2592.

Patient With Headache: History And Physical Tests

Comprehensive History

Identifying Data

A.L.

Chief Complaint

“I have recently fallen from my bike and hit my head. I was wearing a helmet, but I still have headaches and cannot fall asleep for a long time when going to bed.”

History of Present Illness

The patient has a complaint of persistent headaches, which started to occur after he fell from his bicycle. He fell and hit his head two weeks ago, and the pains began appearing a day after the accident. Thus, he has been having headaches for approximately two weeks. Moreover, the patient states that he cannot fall asleep due to headaches and struggles to get enough sleep to function properly. The headaches can occur during the day and get worse in the evening, as the patient works with computers and often strains his eyes, which is an aggravating factor. He does not mention any other possible symptoms. Relieving factors: A.L. has limited his time working with the computer and stopped biking for some time. He drinks green and chamomile tea as a natural remedy. He takes over-the-counter pain relievers when the headaches are disturbing his sleep.

Medications

The patient uses pain-relieving medications to deal with headaches and falls asleep. Otherwise, he does not mention any other prescribed or over-the-counter medications.

Allergies

The patient has a mild form of allergy to seafood. He does not report having any medicine-related allergic reactions.

Past Medical History

Two years ago, the patient fell off his bicycle during a biking trip and strained his arm muscles as a result. He also had some accident-related neck injuries and was hospitalized to eliminate the possibility of a concussion. A.L. was treated for the injuries and underwent physiotherapy for his arm. Physiotherapy lasted for three months, during which he seemed to recover all of his strength and agility.

Past Surgical History

The patient has no history of major or minor surgeries.

Family History

The patient’s great-grandparents’ health history is not recorded anywhere. As can be seen in Figure 1, A.L.’s grandparents from the father’s side passed several years ago. His grandmother passed away due to complications from a heart attack at the age of 84, and the grandfather died in a car crash. Both grandparents did not have any hereditary conditions. A.L.’s grandparents from the mother’s side are still alive, both having hypertension and mobility problems due to old age. The patient’s parents are alive. The mother is a medical worker with no apparent medical issues apart from fatigue due to a busy work schedule. The father is a former construction worker with occupation-related allergies – he recently developed an allergic reaction to dust and had to leave his workplace. Currently, he is working with his son in the business of selling sporting goods.

Genogram for A.L.’s family.
Figure 1. Genogram for A.L.’s family.

Social History

The patient likes biking and often goes on biking and hiking trips with his friends. He leads a healthy lifestyle, abstaining from drinking alcohol. A.L. does not smoke or use any illicit substances. He works as a small online retailer, selling bicycles and hiking equipment. Apart from his active hobbies, he also likes to travel. A.L. lives alone in an apartment in the city.

Sexual and Reproductive History

The patient is heterosexual. He is currently single, his last long relationship ended two months ago, and he did not meet anyone else during this period. He has no children.

Health Care Maintenance (HCM) Strategies

The patient is interested in maintaining his health. He often visits doctors for regular check-ups, including dental care. Moreover, he frequently visits physiotherapists and massage therapists to check the condition of his muscles.

Review of Systems

The patient’s systems seem to be in great condition. There are no obvious reasons for the patient to have headaches. The physical assessment reveals no problems with the patient’s functioning.

Complete Physical Examination

Vital Signs

  • Weight: 142 lbs.
  • Height: 5’8”
  • BMI: 21.6
  • Temp.: 97.9 F
  • Pulse: 62
  • BP: 117/73
  • Respiration: 12

Mental Status Exam (MSE)

The patient appears well-nourished and groomed. A.L. is dressed in clean clothes; his hair is well-kept. However, he seems to be somewhat tired. His behavior is not erratic, and he seems to be fully aware of his surroundings. He answers questions with limited articulation but in a logical and coherent way. His language is consistent, and he communicates without any complications.

The patient is concerned about his headaches and wants to receive treatment. Although he appears tired, he does not have any serious behavioral issues. His mood is stable, and he does not express any dissatisfaction in an aggressive or distraught way.

The patient has no problem explaining his situation and states that he is not experiencing any acute pains during the examination. Perhaps, his stable condition allows him to formulate his thoughts clearly. The patient’s thought process seems to be logical, as he answers questions and provides only necessary and relevant information.

A.L.’s responses are rather quick, but he takes time to think over his answers and recall past events. He is aware of his actions and words and also knows about the dangers connected to his active hobbies. His interaction with the environment does not reveal any cognitive issues.

The MSE does not reveal any problems with the patient’s mental state (Matuszak, McVige, McPherson, Willer, & Leddy, 2016). He does not appear to have any issues with his thought process, communication, reaction time, and actions. While he does not have a headache at this present moment, his mental state may be stable at other times a well.

Skin

The patient’s skin is pink, warm, and soft to touch. The patient has tanned zones on his face, neck, legs, and lower arms as a result of frequent outdoor activities. There are no sunburns in these areas. The rest of the skin is paler in tone. The surface of the skin is smooth and dry, especially in the elbow area. The patient’s nails are pink and have no deformations or colored spots. A.L.’s hair is thick, dark, short, and curly. It appears to be healthy and well-nourished, with no visible issues or infestations. All of the signs indicate that the patient’s skin, hair, and nails are healthy (Jarvis, 2015).

Head

The head is symmetrical without any apparent injuries. The trauma that the patient had two weeks ago is not present; there are no spots or deformations. The posterior auricular and occipital lymph nodes seem normal to palpation (Jarvis, 2015).

Eyes

The patient’s vision is acute. The eyes have white sclera. The pupillary light reflex of the patient is fast. The patient blinks to light and responds to motion. The cranial nerves (CN) II are normal. The pupils constrict to light and dilate appropriately. Eye movements are proportional to any activities, The CN III-IV and VI are checked. Eye closure is standard; the CN VII is intact.

Ears

The ears are symmetrical, their canals are clear. The hearing function is normal, the CN VIII is intact, and the patient has passed the Whispered Voice Test (Jarvis, 2015).

Nose and Sinuses

The nose has a normal color and asymmetrical shape. The sinuses are clear, and the palpation does not reveal any obstruction or aching sensation.

Mouth and Throat

The patient’s mouth is symmetrical. The lips are somewhat dry; the tongue is pink, does not have any injuries, and has a rough texture. The smell is normal. The CN IX and X are intact because the patient has passed the Motor Function Test (Jarvis, 2015).

Neck

The patient is able to move his head with no problems; there are no muscle pains during movement. The posterior cervical and superficial cervical lymph nodes are normal to palpation (Jarvis, 2015).

Respiratory

The patient’s breathing is regular and effortless. There are no obstructions in the respiration. The supraclavicular lymph nodes are normal.

Cardiovascular and Peripheral Vascular

The pulse rate is near the lower limit of the normal range, which can be explained by the fact that the patient is a physically active man and a semi-professional athlete. The patient’s BP seems normal, although he has a family history of hypertension. The pressure measurement reveals no problems with BP.

Abdomen

The abdomen is soft, non-tender. Normal bowel sounds are present in all four quadrants to auscultation. Lumbar lymph nodes are normal (Jarvis, 2015).

Musculoskeletal

The patient’s muscle movement is normal, although one arm is not as flexible due to the previous injury. Neck movements are normal, indicating no injuries from former accidents. There is no discomfort in moving arms and legs. Crossed-arm adduction and resisted arm extension reveal no significant differences and cause no pain (Malanga & Mautner, 2016).

Neurological

The patient’s reactions are of normal speed. The mental functioning is stable, and the patient is fully aware of the situation and his surroundings. The CN I-XII are intact (Jarvis, 2015). The patient’s neurological system has no problems.

References

Jarvis, C. (2015). Physical examination and health assessment (7th ed.). Philadelphia, PA: Elsevier Health Sciences.

Malanga, G. A., & Mautner, K. (2016). Musculoskeletal physical examination: An evidence-based approach (2nd ed.). Philadelphia, PA: Elsevier Health Sciences.

Matuszak, J. M., McVige, J., McPherson, J., Willer, B., & Leddy, J. (2016). A practical concussion physical examination toolbox: Evidence-based physical examination for concussion. Sports Health, 8(3), 260-269.

Hadrian, The Roman Emperor In Eyes Of Spartianus

Roman Empire was one of the greatest and mightiest states the world had ever known. Its achievements and influence on the development of our history could not be overestimated. Being an empire, a state where one person has absolute power, it was dependent on decisions of that man. That is why, it is not surprising that a lot of historians devoted a great number of their works to description and analysis of lives of emperors. Hadrian is not an exception.

He started his life as a common roman citizen that is why his becoming a leader of the great state seems even more miraculous. He inherited power from Trajan, however, he did not continue his policy. That is why, it is possible to suggest that this shift became one of the most important reasons of his popularity. Describing his person, Spartianus outlines only positive qualities and actions. This description serves as a good evidence of Hadrians reputation.

First of all, the author underlines the fact that Hadrian was a very wise ruler, which cared about all aspects of his giant empire. He outlines Hadrians desire to save borders of the state “In many places where he visited the frontiers, which were not separated from the Barbarians by rivers, Hadrian raised a kind of wall, by driving into the ground great piles” (Spartianus 1). Results of these actions can be seen even nowadays in Hadrians Wall. Moreover, Hadrian travelled across his country, trying to take part in different processes in order to understand and rule his state better.

The author of the work also appreciates this fact, showing directly his great admiration “Never did a Prince traverse over the Empire with such celerity!” (Spartianus 1). Besides, the author also underlines diplomatic abilities of Hadrian. Travelling across his country, Hadrian managed to conclude an alliance with a great number of Romes opponents. His predecessor, Trajan, was famous for his military expeditions against these rulers, while Hadrian managed to solve this problem with the help of diplomacy.

Admiring Hadrians diplomacy and wisdom, the author also stresses his fairness. Hadrian punished governors and procurators, sorting out the mess in provinces. Moreover, very often Hadrian was present at trials as a judge and he was severe but fair. He prohibited killing of slaves by their masters, underlining necessity of trials and judges. Describing these facts, the author could not but admire Hadrians activity as a ruler of the state.

Another fact which admires Spartianus is Hadrians interest for art and science. “This ruler loved poetry, and cultivated carefully all branches of literature. He understood likewise arithmetic, geometry, and painting” (Spartianus 4) He erected different monuments and loved literary discussions. Moreover, he enjoyed philosophy. Showing comprehensiveness of Hadrians character, the author also manifests his own positive attitude to Hadrian, saying “this Emperor seemed never the same” (Spartianus 4).

Roman Empire was a military state, that is why it was very important for its ruler to be informed in this field. Spartianus says that the emperor “handled weapons with much skill, and was a master of the military art” (Spartianus 4). Moreover, Hadrian remembered almost all his veterans who fought with him.

Having analyzed this work, it is possible to say that the author admired the rule of Hadrian, underlining his comprehensive character. “He wrote, dictated, heard others, and conversed with his friends; and all at the same time!” (Spartianus 8).

error: Content is protected !!