Clinical Case Study of a Cancer Patient

This clinical case study focuses on a cancer patient with colon cancer. It discusses the diagnosis, treatment forms such as surgery and chemotherapy, and the importance of palliative care. The study also highlights the patient's experience and the need for holistic care.

Clinical case study of a cancer patient 1
CLINICAL CASE STUDY OF A CANCER PATIENT
By,
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Tutor
University
City and State
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Clinical case study of a cancer patient 2
Introduction
Cancer is a chronic condition that results from abnormal rapid overproduction of cells in the
human body. There are various types of cancers that affects people of all walks of life and race.
The nature of this abnormal growth of cells can either be benign or malignant. Benign type of
cancer mainly involves cells of epithelial origin (Liu et al, 2016). This is in contrast to malignant
types of cancers that affect cells and tissues of mesodermal and endothelial origin and have the
ability to spread within the body affecting many parts. These abnormal cells in malignant cancers
infiltrate normal tissues leading to spread of a tumor. The spread of cancerous cells and tumors
can either be via the bloodstream or the lymphatic system (Miller et al, 2016). Depending on the
body part affected, cancers are of various types and their severity ranges depending on the stage
of development. The common types of cancers that have colonized a big part of the human
population include lung cancers, brain cancers, colon cancers, esophageal cancers and ovarian
cancers. The etiology and causes of cancer still remains to be idiopathic as scientists have argued
that it is caused by multiple factors that influence the pathophysiology of the disease. With
adequate scientific research efforts to understand the disease manifestation, there has been a high
link between cancer development and genetics. Some genes control and regulate cell growth
within the body. As stated by Basch et al, (2016) a defect in the regulatory genes can lead to
abnormal cell production hence cancer development. There are various forms of treatment and
care approaches that have proven to be effective against the various types of cancer over the
years. The aim of this discussion is to critically analyze a cancer patient that has undergone
various forms of treatment and how this has affected the patient. It will focus on a case study of a
cancer patient and the strategies put in place to ensure the patient’s recovery and the holistic
treatment and palliative care provided.

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Case study.
Mr. X is a 52 year old man who has a diagnosis of colon cancer. He was admitted two months
ago following exacerbation of his condition and is undergoing treatment and palliative care
within the hospital. On admission he had experienced an increased frequency of rectal bleeding
and bloody stools. He had cramping abdominal pains that were continuous in nature and had no
relieving factors. The chief complains included also an increased weight loss without an attempt
to cut off the weight. He is a known diabetic for the past 5 years and has been on insulin therapy.
He has a medical history of ulcerative colitis that was managed 2 years ago. He has a family
history colorectal cancer that affected his grandfather. He is an occasional social drinker and
takes at least 5 beers when he meets up with his friends on weekends. He is currently recovering
in the wards from a surgery that was performed to remove a tumor from the descending part of
his colon. He is also under adjuvant chemotherapy. Other forms of treatment that the patient has
undergone through since his admission include radiation therapy and targeted therapy.
Diagnostic techniques and Treatment forms.
There are various forms of treatment that have proven to be effective in cancer patients over the
years. Although it is quite hard to treat any form of cancer, there are measures that can be taken
to minimize the spread of tumors and encourage the well-being of the patient. The treatment
forms target the tumor formation and help reduce the rate at which the cancerous cells multiply
(Khalil et al, 2016). These treatment forms can be divided into four major categories. These
include surgery whereby the tumor is removed, chemotherapy that involves use of chemical
agents such as drugs to combat and suppress the disease development, radiation therapy that
entails the use of ionizing radiation to kill cancer cells and biological therapy that involves use of
medicines made from living sources. The biological therapy can be further divided into targeted

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therapy that involves the use of biological agents that target certain genetic pathways,
immunotherapy and hormonal therapy. All these forms of treatment have significant effects on
the patient. There is need for the care giver to ensure adequate monitoring and provision of a
holistic care that focusses on patient safety and well-being at all times (Basch et al, 2017).
Mr. X underwent surgery to remove the tumor that was detected on his colon. The detection
techniques before a colonic surgery include a colonoscopy. This is a technique that a
gastroentologist uses to evaluate the inside of the colon and assists in identification of any defect
there within (Schnipperet al, 2015). It involves insertion of a colonoscope. It is a device that is
about four foot long with a light and camera attached to its end that helps the examiner to
identify abnormal structures including areas of tumor in the colon. Other diagnostic techniques
that are of importance in identifying areas of tumor include imaging using an MRI scan. This
form of technique requires use of magnetic fields in detection of tumors. It entails linking a
powerful magnet to a computer so as to make detailed pictures of areas within the body. An MRI
was therefore conducted on Mr. X so as to identify the extent of the tumor before performing the
surgery. In addition to this form of medical imaging in the diagnosis of tumors, a CT is of
importance in identification of a spread in a malignancy. For colon cancer clinical cases for
example, the tumor can easily spread to the liver, lungs and other organs as its stage advances.
According to Mayer and Arteaga (2016), there is therefore need to perform CT scans to check
for spread of the cancer and also help in grading the stage of the disease. For the case of Mr. X,
there was minimal spread of the tumor as the cancer was on its early stages. After the
identification of the tumor using these techniques, surgery is then done to remove the tumor.
Surgery is an important part of cancer treatment as it prohibits spread of cancerous cells to other
parts of the body thereby aiding in patient recovery.

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Chemotherapy is very important when it comes to management of cancer patients. It involves
administration of drugs that targets cancer cells and destroys them (Guy et al, 2015). Mr. X
agreed to receive adjuvant chemotherapy that included drugs like fluorouracil. The
chemotherapy administered is essential as it helps prevent further replication of cancerous cells
thereby minimizing spread of malignancy. Fluorouracil is a common type of medication for
treatment of various types of cancer. It forms part of a category of drugs called anti-metabolites.
It is commonly administered intravenously when treating cancer. The drug works by stopping the
cells from making and repairing DNA. The cancerous cells can therefore no longer grow or
multiply as the growth cycle is interfered with. Chemotherapy mainly targets replication of cells
by interfering with the process of replication. Cytotoxic drugs used in cancer treatment act
against cancer cells by destroying replicative enzymes and impairing cell division (Fukuhara, Ino
and Todo, 2016). Others act by inhibiting the various stages of cell growth within the body and
tissues. Combination chemotherapy is a common form of cancer treatment that involves the
administration of two or more drugs simultaneously that work together to stop the growth of
cancerous cells (Catton et al, 2017). It is effective for treatment of cancer patients in advanced
stages. Other medications given to Mr. X include dexamethasone whose prescription was based
on the fact that the patient experienced symptoms of nausea and vomiting associated with his
state. Dexamethasone is an effective antiemetic despite being an anti-inflammatory drug.
Patient experience and palliative care
The patient’s experience during treatment and management process of cancer is an important
consideration that cannot be avoided. In order for the nurse or the relevant care provider to
ensure holistic patient-centered care, there is need to closely monitor the patient’s progress (Chae
et al, 2016). Most of the drugs used for treatment of cancer are linked to various clinical side

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effects that negatively influence the patient. Mr. X for example was under fluorouracil treatment.
This drug is associated with a series of side effects whose manifestation might be confused to
disease progression. The patient was experiencing a lot of fatigue and malaise. In addition to
this, he felt lethargic characterized by pain all over his body. These are significant side effects of
the chemotherapy that the patient was undergoing and therefore require attention by the care
provider. The patient was also feeling nauseated with some episodes of vomiting. This prompted
the administration of dexamethasone as a complimentary treatment. According to Lawler et al,
(2017), palliative care entails provision of care that addresses individuals as a whole and not only
their disease aspects. In cancer patients such as Mr. X, there is need for all health care team
providers involved in his care to consider not only the management of his condition but also his
emotional and psychosocial well-being. Mr. X was experiencing fatigue and other side effects of
his medication. This can negatively impact the patient’s emotional and psychosocial wellbeing
in that the patient might not be able to engage in certain physical activities that they used to do
before (Goodall et al, 2017). Since the patient is always feeling weak and fatigued, they might
not be able to properly carry out tasks that they had previously been able to do. Walking from
one place to another might become challenging hence the presence of the nurse is important to
ensure that the patient’s needs are met. There is a considerable development of depression linked
to cancer patients and their treatment process. This can be attributable to the fact that they might
feel hopeless as cancers form part of terminal illnesses. The patient might therefore lose hope in
life on the thought of not living for long. The side effects associated with cancer treatment might
also further depress the patient (Sarfati, Koczwara and Jackson, 2016). It is therefore necessary
for the nurse to offer emotional support to the patient and provide hope for them. Loss of
employment by the patient might negatively affect the patient and his family. In this case for

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example. Mr. X was the bread winner of the family. Dismissal from his workplace due to health
concerns may therefore affect his income and his family can get depressed as well.
Reflective practice framework.
In the clinical case of Mr. X, I once engaged the patient in a discussion about his well-being and
how his condition was fairing. In the discussion the following points were brought to my
attention. The patient complained of fatigue and increased abdominal pain. He claimed to take
painkillers such as Panadol whose effect was short lived. The patient described to feel better after
taking the Panadol medication but with time, the symptoms would recur. On thorough scrutiny of
the situation and consultation with the healthcare team leader, it was identified that the current
medication of the patient was producing the characteristic side effects. The solution was to
identify other alternative treatment options and this included radiation therapy since a CT scan
conducted after surgery indicated presence of some malignant cells left (Hamanishi et al, 2016).
To counter the effect of feeling fatigued brought about by the fluorouracil, there was need to
administer methylphenidate. This drug is effective in chemotherapy induced fatigue and
administration of it led to significant improvement in the patient. The lessons learnt from the
experience included ensuring close monitoring of the patient always to identify preventable
errors and ensure patient safety.
Conclusion
In conclusion, cancer is a chronic disease that develops overtime. There is need to encourage
screening among people in order to capture the disease at its early stages. There is a high
probability of cure for the disease if detected early enough. Health education forms an important
part of disease prevention and cure (Ost et al, 2016). In the case of cancer for example, there are

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certain risk factors that enhance the occurrence of the disease. This involves about health
lifestyles and diet. Good health seeking habits help in prevention of the incidence of some cancer
types. A healthy diet that involves high vegetable and fruit content helps minimize the chances of
occurrence of the disease.

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