Case Study of a Cancer Patient: Assessment, Treatment, and Care Management

This case study discusses the assessment, treatment, and care management of a cancer patient. It includes patient assessment, signs and symptoms, screening and early detection strategies, cancer stages, and clinical investigation. It also includes palliative care for the cancer patient.

Case study about a cancer
patient

Table of Contents
INTRODUCTION...........................................................................................................................3
MAIN BODY...................................................................................................................................3
Reflection...............................................................................................................................6
CONCLUSION................................................................................................................................6
REFERENCES................................................................................................................................8

INTRODUCTION
Cancer refers to the abnormal growth of body cells. This is one of the diseases associated
with potential cancer within individuals. This is the uncontrolled growth of body cells that
should be taken in control otherwise can lead to cancer within individuals. In this essay, there is
a discussion about the case study of an individual suffering from cancer, including various
information. There is a discussion about cancer treatment which consists of the current
therapeutic or supportive care management. There is also discussion about the following of the
ethical policy through using the patient information like taking care of patient confidentiality
(Yatabe and et. al., 2019). This case study includes the patient assessment, signs and symptoms,
screening and early detection strategies, cancer stages and clinical investigation. It also includes
palliative care for the cancer patient. There is also discussion about the barriers, psychosocial,
psychological and ethical considerations and needs of individuals and their cultural safety. This
essay also includes the reflective practice framework that reflects the case review about the
nursing interventions and care strategies that can impact cancer treatment or management. It also
includes recommendations associated with future changes to practice with new knowledge.
MAIN BODY
Cathy is 62-years-old lady who is developing lungs cancer disease. Cathy has previously
diagnosed with high blood pressure associated with health issues. Cathy has a history of smoking
from the last 20 years, which creates a high risk of getting lung cancer during diagnosis
(Lantuejoul and et. al., 2020). A patient assessment includes the diagnosis of lung cancer, a type
of cancer that needed the assessment, which includes the diagnosis. In this, a patient has the
diagnosis of lung cancer, which includes a lung biopsy. Lung’s cancer includes the cancer in
which patients may form due to smoking, exposure to certain toxins and second-hand smoke, and
family history. Cathy is having two child son named John and Robert. Her husband was died past
3 years ago due to heart attack. And now, Cathy is living alone and can manage her conditions
alone.
Both are living outside of city and visit every two years. They cannot get here for the care
of their mother Cathy, but they take care of the financial expenses of cancer. Cancer biology
includes the cell which grows out of control. Unlike normal cells, cancer cells ignore the signals
to stop dividing or die and be shed (Jafari and et. al., 2018). This creates an uncontrolled
situation and crosses the natural boundary and spreads in the body where they don't belong.

There are various types of cancer, including skin cancer, lungs cancer, prostate cancer, breast
cancer, colorectal cancer, kidney cancer, bladder cancer, and many more. There is a clinical
characteristic of lung cancer, which includes a cough that doesn't go away and coughing up
blood even in a small amount. It also includes shortness of breath.
There is epidemiology that includes lung cancer, which is generally determined by the
smoking habits during previous decades where Cathy has been smoking from the past 20 years.
There is pathophysiology of lung cancer, which includes the physical changes in the individual
body. This can lead to exposure to tobacco smoke and other possible causes that may include
radiation, asbestos, and air pollution (Cainap et. al., 2020). Immunotherapy includes the immune-
oncology, a type of treatment for non-small cell lung cancer. Which is effective and help to
identify body's immune system that can recognise and destroys cancer cells.
There are various sign and symptoms of lungs cancer, which may include cough which
does not go away or gets worse, chest pain which get deepen with coughing, breathing and
laughing, hoarseness, loss of appetite, unexplained weight loss, feeling tired or weak, shortness
of breath and many more. There is need for the screening of lungs cancer which may include low
dose computed tomography this includes the CT scan or LDCT. Some of the strategies may
include bone scan, positron emission tomography, CT scan, ultrasound, and X-ray (Howlader
and et. al., 2020).
Cancer stage refers to the extent of cancer that provides information about the cancer and
how large the tumor is and its spread (Li et al., 2021). This is the one that includes the stage of
the diseases which may include the order of detect the stage of cancer. This may include the
stage system like TNM staging system, which includes the information about where the tumor is
located in the body, size of the tumor, whether cancer is spread to nearby lymph nodes, and
whether cancer has spread in different parts of the body. TNM, in which T refers to the size and
extent of the main tumor, is usually called primary tumor. Here, N refers to the number of lymph
nodes which are directed towards cancer. M refers to the metastasized cancer that provides
information about the spread from the primary tumor to other body parts. There is a primary
tumor that includes the TX, which is the main tumor that can't be measured. T0 tumor can’t be
found (Dardiotis and et. al., 2019).
TNM system is effective and describes cancer in detail. There are different stages that
healthcare professionals generally discuss, including stage 0 which includes the abnormal cells

that are present and can spread nearby tissue. Stage I, stage II, and stage III are higher in number
and larger in cancer tumour and more spread by nearby tissues. Stage IV includes the spread to
distant parts of the body (Ogino and et. al., 2019).
Stage 0: In this, the cancer is where it started within cells and it has not spread across the whole
human body.
Stage 1: In the very first step of cancer, it is small as well as has not spread anywhere else within
human body.
Stage 2: In the second stage of cancer, the cancerous cells has grown but not spread anywhere
else within human body.
Stage 3: In the third stage, the cancer is larger and the cells may have been dispersed towards the
surrounding cells and tissues or the lymph nodes to cause harm to the normal cells.
Stage 4: In this, the cancerous cells has been spread from where it is started to the other human
body organs and are often called as metastatic cancer.
The TNV system significantly uses the letters and numbers in order to illustrate the
cancer. The TNV system is generally used in a unique pathway depending upon the kind of
cancer a person can involve. And for the TNV system, its first letter T generally illustrates the
size of the tumor cells having numbers 1 to 4, including 1 for little and 4 number for excessive
(Cancer staging, 2015). In addition, the letter N stands for the lymph nodes having a number 0 to
3, including 0 means no lymph nodes contains cancer and 3 number generally means lymph
nodes can involve various cancerous cells. Furthermore, the letter M in TNM generally stands
for metastases or whether the cancerous cells has been dispersed throughout the organs and parts
of human body, containing a number 0 to 1 where 0 means cancerous cells has not been
dispersed and the number 1 means cancerous cells has been explicitly spread.
The grades of cancer generally depend over what the cells specifically look like under a
microscope. And in general, a lower grade can depict the reduced increasing the cancer as well
as the higher grades can depict a faster raising one. In this, the grading system which is mainly
used is as mentioned:
Grade 1: The grade 1 can include the cancerous cells which can resemble the normal cells and
are not increasing speedy.
Grade 2: It can include the cancerous cells which do not look like the normal cells and are
increasing much speedily than the normal cells.

Grade 3: It can involve the cancerous cells which generally look abnormal cells and can increase
more aggressively.
Cathy (Hypothetical name) is having history of smoking from the past 20 years; she is
developing high risk of having lung cancer during diagnosis. She has a family history of smoking
and due to this, she is now suffering from lung cancer. With these such illness, she is also
developing cancer associated illness such as she is recently diagnosed with high pressure levels
of blood and many more that can affect her body. There is need to provide appropriate
therapeutic care treatment to Cathy that can help to overcome her cancer illness more
appropriately. There is various treatment available for treating the cancer illness of Cathy such as
surgery, chemotherapy, bone marrow transplant, immunotherapy, targeted drug therapy and
many more. In context with medication, there are the chemotherapy drugs which are used for
non-small cell lung cancer are generally given to patient through a vein as an intravenous
infusion. In this, some of the more commonly used medications can involve cisplatin,
carboplatin, paclitaxel, gemcitabine and many more. While talking about treating the lung
cancer in case of Cathy, there is need to provide a healthy diet to Cathy which can involve plenty
of vegetables and fruits along with healthy proteins and fats and a whole grain. As some of the
cancer and its treatment can significantly decrease the appetite. It becomes quite essential to
make the many of the diet and calories which are to be eaten. In this, there are the evidence
based clinical managements for Cathy to reduce the impacts of lung cancer that is the care nurses
must promote the patient to quit smoking as it is the best-known method to reduce the lung
cancer. In this, the care nurses can make patient to avoid exposure towards the harmful
substances. They must promote the patient to get regular exercise as it can help the patient to
maintain a healthy weight and make them physically more active (Ngiam et. al., 2019).
There are the complementary interventions for Cathy to treat her lung cancer can involve
such as meditation and Yoga. In context with therapeutic interventions, Cathy having lung
cancer can be effectively treated with chemotherapy, surgery, radiation therapy or any other
association of these such care treatment therapies (Hong et. al., 2019.). As per the case scenario,
there are some of the psychosocial requirements of her and lacking of which can cause severe
illness such as depression, anxiety, fear and many more. Her psychosocial needs can involve
employment, healthy eating and having support to overcome her emotions. These things can
quite make impact over health of Cathy and become a reason of her excessive smoking habits.

While providing care treatment to Cathy, the care nurse must respect the autonomy of her such
as informed consent, involvement of Cathy while making decisions and so on. The care nurse
must respect the confidentiality of Cathy such that making her information private can build trust
Cathy's trust on care nurses. These such things can make patient much more comfortable and can
able to improve from illness efficiently (Sunur, 2019).
Reflection
The Gibbs reflective cycle is generally a self-reflection as well as a management tool which
can help an individual to think more systematically and clearly about the various unique
experiences which have gone through during the significant activities and can draw a conclusion.
It is a most famous reflective cyclical model that can involve six stages to explore the whole
experience and can involve stages such as description, feelings, evaluation, analysis, conclusion
and an action plan.
Description: It is the very first stage in the reflective model and can involve a precise
description about the discussion which is placed above. In this, there is a discussion about case
study of Cathy who is 62-years-old lady and developing a lung cancer. Previously she was
diagnosed with increased blood pressure levels and many other illnesses. She has a past history
of excessive smoking which caused her condition more adverse and causes lung cancer. It is
determined from the case study that she has two sons John and Robert who live away from her.
She is living alone from past 3 years after death of her husband. In this, in order to treat her lung
cancer, there is an evidence based clinical management for Cathy so that she can able to reduce
her lung cancer efficiently. There are the medications which can help to treat the condition of
Cathy more appropriately. Furthermore, to reduce the lung cancer condition in Cathy, there are
some nursing interventions such as promoting a healthy diet and lifestyle can effectively help
Cathy to efficiently reduce her lung conditions.
Feelings: While analysing Cathy’s condition, as a care nurse it is known that she is generally
a second-hand smoker and her excessive smoking habits can significantly make impact over her
lungs and causes cancer. The reason of her excessive smoking can be a death of her husband or
can be living alone in her home. At the age of 62, there is a need of support of a person so that an
individual can share their emotions and feelings with other people. and this is the reason why
Cathy is a heavy smoker as she is feeling alone and does not have anyone with her from which
she can share her emotions or feelings.

Evaluation: It is evaluated that Cathy is suffering from lung cancer, she is an excessive
smoker. To treat her condition, there are the care treatment plan available such as medications,
healthy lifestyle, healthy eating and many more. It is evaluated that she needs an evidence based
clinical management to treat her lung cancer so she can also live her life more independently.
Analysis: It is analysed from the case scenario that Cathy needs some kind of attention and
care to overcome her condition, along with this, she also need a proper medication or care
treatment plan which can effectively reduce her cancer condition. To treat her, there is needed an
effective communication so that Cathy can effectively able to share her emotions and feelings
with care nurse. Having trust and effective relationships among care nurses and patients can help
care providers to deliver an effective care service to patients as per their needs.
Conclusion: From the case scenario, it is concluded that her condition is not so good. She
needs a proper care plan and support to overcome her cancer conditions. There is proper care
given to Cathy and also maintained her confidentiality. It is because, the communication of the
personal data or any particular records can create the personal or the professional issues while
the Patient can depend upon healthcare professionals to keep their medical evidences private.
Action Plan: It is the last step within the Gibbs reflective cycle. From the case study is it
identified that if such case will happen again in future then as a care nurse, I will calmly handle
it. As a care nurse, I will effectively manage the patient's situation and provide them an
appropriate care treatment so that patient can able to improve their health and well-being. I will
develop my skills so that in future I can efficiently able to use the skills to treat patients like
improve my communication skills which can help me to develop healthy relationships with
patients. Furthermore, I will make sure in future that the things which I'm lacking in will not
happen again as I'm working on my lacks more significantly.
CONCLUSION
From the above discussion, it is analysed that excessive smoking can severely impact on the
health of an individual. It can affect various parts of human body and can cause lung cancer. A
cancer can slowly affect the normal cells and change the normal cells into cancerous cells which
can slowly and ultimately leads to death of an individual. In the above discussion, it is analysed
from the case scenario, Cathy is having lung cancer due to her excessive smoking habits. To treat
her lung cancer, there are various treatments available to reduce its prevalence such as healthy
lifestyle, medications, healthy eating and many more.

REFERENCES
Books and Journals
Abbosh, C., Birkbak, N.J. and Swanton, C., 2018. Early stage NSCLC—challenges to
implementing ctDNA-based screening and MRD detection. Nature Reviews Clinical
Oncology, 15(9), pp.577-586.
Cainap, C., Pop, L.A., Balacescu, O. and Cainap, S.S., 2020. Early diagnosis and screening in
lung cancer. American Journal of Cancer Research, 10(7), p.1993.
Dardiotis, E., Aloizou, A.M., Markoula, S., Siokas, V., Tsarouhas, K., Tzanakakis, G., Libra, M.,
Kyritsis, A.P., Brotis, A.G., Aschner, M. and Gozes, I., 2019. Cancer-associated stroke:
pathophysiology, detection and management. International journal of oncology, 54(3),
pp.779-796.
Hong, C.S., Deng, D., Vera, A. and Chiang, V.L., 2019. Laser-interstitial thermal therapy
compared to craniotomy for treatment of radiation necrosis or recurrent tumor in brain
metastases failing radiosurgery. Journal of Neuro-Oncology, 142(2), pp.309-317.
Howlader, N., Forjaz, G., Mooradian, M.J., Meza, R., Kong, C.Y., Cronin, K.A., Mariotto, A.B.,
Lowy, D.R. and Feuer, E.J., 2020. The effect of advances in lung-cancer treatment on
population mortality. New England Journal of Medicine, 383(7), pp.640-649.
Jafari, S.H., Saadatpour, Z., Salmaninejad, A., Momeni, F., Mokhtari, M., Nahand, J.S.,
Rahmati, M., Mirzaei, H. and Kianmehr, M., 2018. Breast cancer diagnosis: Imaging
techniques and biochemical markers. Journal of cellular physiology, 233(7), pp.5200-
5213.
Lantuejoul, S., Sound-Tsao, M., Cooper, W.A., Girard, N., Hirsch, F.R., Roden, A.C., Lopez-
Rios, F., Jain, D., Chou, T.Y., Motoi, N. and Kerr, K.M., 2020. PD-L1 testing for lung
cancer in 2019: perspective from the IASLC Pathology Committee. Journal of Thoracic
Oncology, 15(4), pp.499-519.
Li, S., Yi, M., Dong, B., Tan, X., Luo, S. and Wu, K., 2021. The role of exosomes in liquid
biopsy for cancer diagnosis and prognosis prediction. International Journal of Cancer,
148(11), pp.2640-2651.
Ngiam, K.Y. and Khor, W., 2019. Big data and machine learning algorithms for health-care
delivery. The Lancet Oncology, 20(5), pp.e262-e273.
Ogino, S., Nowak, J.A., Hamada, T., Milner Jr, D.A. and Nishihara, R., 2019. Insights into
pathogenic interactions among environment, host, and tumor at the crossroads of
molecular pathology and epidemiology. Annual Review of Pathology: Mechanisms of
Disease, 14, pp.83-103.
Sunur, E.K., 2019. Information and the Human Soul: A dialogue between Thomistic
Metaphysics, Information Theory and Contemporary Philosophies (Doctoral
dissertation, Graduate Theological Union).
Yatabe, Y., Dacic, S., Borczuk, A.C., Warth, A., Russell, P.A., Lantuejoul, S., Beasley, M.B.,
Thunnissen, E., Pelosi, G., Rekhtman, N. and Bubendorf, L., 2019. Best practices
recommendations for diagnostic immunohistochemistry in lung cancer. Journal of
Thoracic Oncology, 14(3), pp.377-407.

Online:
Cancer staging, 2015 [Online] Available through:
<https://www.cancer.gov/about-cancer/diagnosis-staging/staging>