Cancer Pathophysiology and Management

Diagnosis and Staging

Cancer is a highly complex medical condition whose development happens due to rapid progression on a cellular level. When looking at the available national statistics for cancer incidence, it becomes evident that the incidence rate for cancer gradually decreased from 2015 to 2018 (Centers for Disease Control and Prevention [CDC], 2021a). However, the quantitative characteristics of the disease remain considerably high, constituting more than 1.7 million new registered cases in 2018 (Ibid.). For this reason, there is a need to look closer at the contributing factors for cancer, diagnosis, and patient education in order to define further directions in cancer management and prevention nationwide.

Hence, the notion of cancer encompasses a series of cellular complexities that can emerge in the human body. According to the World Health Organization (WHO, 2021), cancer is “a large group of diseases that can start in almost any organ or tissue of the body when abnormal cells grow uncontrollably, go beyond their usual boundaries to invade adjoining parts of the body and/or spread to other organs” (para. 1). Abnormal cells, in this case, stand for cells that, at some point, failed to be replaced by new and healthy ones. As a result, the abnormal cells undergo genetic modifications, and their mutation and dissemination create tumors or masses of affected tissue (Randall, 2018). In essence, cancer management is a highly complex endeavor that requires additional tests apart from a physical examination of the patient.

According to the American Cancer Society (2020a), the diagnostic tools for cancer include a physical, computer tomography and MRI, endoscopy scans, lab tests, and a biopsy. The latter stands for the process of taking a piece of a tumor in order to run tests and either confirm or reject cancer diagnoses (American Cancer Society, 2020a). After the tests are done, the type and staging of cancer are identified. Generally, there are two major approaches to cancer staging.

The principal approach to cancer staging is the TNM system. According to the American Cancer Society (2020a), T stands for the description of a tumor on a scale from 0 to 4, depending on its size and spreading to nearby structures. N stands for the extent to which cancer spreads to the nearby lymph nodes (Ibid., “What goes into the stage” section). Finally, M concerns metastases to distant body organs (American Cancer Society, 2020a). In order to facilitate the process of cancer staging to the general public, this system was adapted to a less detailed five-staged scheme, with stage 0 being a carcinoma in situ, or abnormal cells not being cancer yet, and stage IV being cancer that metastasized to distant body parts and is rarely treatable.

Complications and Physio-Psychological Effects

One of the most widespread complications associated with cancer is a metastatic bone disease. According to Ahmad et al. (2018), this disease stands for the chronic pain associated with abnormal cells developing in the body and affecting various organs. The researchers claim that such a complication “may be due to substances produced by tumor cells and inflammatory cells, as well as sustained activation of osteoclasts and nerve compression and injury caused by tumor growth and invasion in adjacent tissues” (Ahmad et al., 2018, p. 2). This condition requires significant physical and psychological support from nurses, physicians, and the patient’s close surroundings.

Another cancer complication is hypercalcemia, which stands for the abnormal level of calcium in one’s blood. It leads to bone weakening, cognitive and cardiac disruptions, and kidney stones (Sadiq et al., 2021). The treatment of hypercalcemia induced by cancer includes fluid and serum calcium reduction medication (Ibid.). Finally, cancer contributes to the patient struggling with deep vein thrombosis (DVT). According to Randall (2018), “prolonged bed rest can cause pooling of the blood in the lower extremities that can lead to clots and DVT” (“Nursing management” section). Caused by prolonged rest and inactive behavioral patterns, the condition may be prevented by regular ambulation.

The complex treatment of cancer has a number of side effects to the procedure. Exposure to chemotherapy and radiation frequently lead to such side effects as nausea and vomiting (Randall, 2018). Another common side effect is urinary retention, caused by anesthesia, anxiety, and pain. This side effect can be managed by encouraging the patient to move around as soon as possible in order to encourage bladder function (Randall, 2018). Finally, pain is also a serious and common side effect, and nurses are responsible for checking on patients to make sure they are given pain-alleviating treatment and psychological support throughout the process.

There are three major ways to lessen the physical and psychological effects of cancer treatment that nurses can employ. The first intervention includes pharmacological treatment, which stands for the administration of medications that may help address the disease-related complications and side effects of the treatment, including pain management, serum calcium management, and diuretics. Another method concerns behavior modifications, which stands for the constant interaction and communication with the patient on the matter of their well-being, anxiety, and concerns. Finally, surgical corrections may be employed to lessen the patient’s pain and eliminate possible post-surgical complications.

Contributing Factors

Despite the variety of cancer types, the contributing factors to cancer are similar in each case, as no specific triggers to cause cell abnormality can be identified. Some of the most common contributing factors to cancer a patient cannot manage to include older age and a genetic predisposition to cancer (CDC, 2021b). However, as far as preventable risks are concerned, the potential contributing factors to cancer include alcohol and tobacco use, obesity, human papillomavirus, and exposure to the sun (Ibid.). Hence, maintaining healthy habits, along with managing substance intake, can minimize the risk of cancer and a series of other diseases. There exist such metrics as a lifetime risk of cancer, which calculates “the risk of a person being diagnosed with cancer over the course of a lifetime” (American Cancer Society, 2020b, para.1). Thus, according to the organization, every second male and every third female have a risk of being diagnosed with cancer, including in situ cancer forms. Hence, it is of paramount importance to pay attention to the risk factors of cancer and try to minimize them on a daily basis.

American Cancer Society

For more than a century, a national volunteer organization called the American Cancer Society (ACS) has helped thousands of people cope with their cancer diagnosis and find resources for both financial and emotional support throughout the treatment journey. The ACS is a significant source of education and support for both cancer patients and their families, as the organization provides people with resources on prevention, treatment, and rehabilitation after treatment. On the official website of the ACS, people can find fundamental information about what cancer is, types of cancer, and various risk factors (American Cancer Society, n.d.b). Additionally, there are various programs and services presented by the organization to assist the patients and their caregivers, including around-the-clock helpline, patient support and survivor communities, financial aid programs for treatment away from home, and volunteer assistance services (American Cancer Society, n.d.a). These resources are definitely recommended for people going through cancer treatment and post survival process.

Moreover, the ACS also has a tool named Personal Health Manager that provides people with information and resources based on the type of cancer they have. It serves to assist the patients in planning and maintaining their treatment and rehabilitation (American Cancer Society, n.d.c). Hence, it is also a beneficial tool in terms of cancer management that should be embraced by the patients. In essence, every piece of information published on the ACS website has value for the cancer patients, their families, and everyone willing to learn and discover how to eliminate the risks of having cancer.

Nurses’ Intervention in Cancer Treatment

Cancer treatment is a complex endeavor that requires support and patient education from the emergence of cancer risk, its diagnostics, treatment, and post-interventional rehabilitation. Hence, once the patient discovers the risk of having cancer, chances are they will feel overwhelmed and scared, and it is a nurse’s responsibility to make sure that the patient does not feel isolated during the journey of recovery. For this reason, regardless of the cancer stage, the nurse’s primary responsibility is to provide the patient with education on the matter of potential options of treatment and resources to help reach out to the community of survivors, mental health professionals, and oncologists. Regardless of the cancer stage, the nursing intervention requires management of the side effects, pain alleviation, education, professional and psychological support during the process. However, the approaches to care differ regarding the stage of cancer. Thus, in the terminal cancer stage, one of the nurses’ responsibilities is to find resources for palliative care. Essentially, the nurses’ task is to promote long-term support and encourage resilience in patients and their families through presenting an optimistic approach towards care and post-operational checkup and rehabilitation.

Liberal Arts and Science in Nursing

In order to provide efficient nursing care, nurses are to create a holistic approach to the patient, including both psychological and medical support. Liberal arts, including psychology, sociology, and history, can help nurses define the non-clinical factors that can contribute to the quality of medical care provided, including a patient-oriented approach, profiling the patient in the socio-cultural context, and an evidence-based approach to the medical intervention through historical data. Sciences, on the other hand, assist the nurses in providing quality medical care and professional support for the patients. Disciplines like chemistry that are also important in the context of care are considered interdisciplinary research areas that encompass both science and liberal features. Medical care, in this context, is also interdisciplinary, as it essentially encompasses several aspects of education for the sake of holistic care. For this reason, it may be concluded that such aspects as statistical analysis, mathematics, psychology, sociology, and history are crucial in nursing education in terms of developing critical thinking skills and having insights into the personalized care of every patient, especially in such sensitive topics as cancer.


American Cancer Society. (2020a). Cancer staging. Web.

American Cancer Society. (2020b). Lifetime risk of developing or dying from cancer. Web.

American Cancer Society. (n.d.a). ACS patient programs and services. Web.

American Cancer Society. (n.d.b). Cancer A-Z. Web.

American Cancer Society. (n.d.c). Personal health manager. Web.

Centers for Disease Control and Prevention. (2021a). Cancer data and statistics. Web.

Centers for Disease Control and Prevention. (2021b). Risk factors and cancer. Web.

World Health Organization. (2021). Cancer. Web.

Randall, J. (2018). Cellular and immunological complexities. In Pathophysiology clinical applications for client health [E-book]. Grand Canyon University. Web.

Ahmad, I., Ahmed, M. M., Ahsraf, M. F., Naeem, A., Tasleem, A., Ahmed, M., & Farooqi, M. S. (2018). Pain management in metastatic bone disease: A literature review. Cureus, 10(9), e3286. Web.

Sadiq, N.M., Naganathan, S., & Badireddy, M. (2021). Hypercalcemia. In StatPearls (StatPearls Publishing) [E-book]. Web.

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