Online Healthcare Modules for Breast Cancer Patients: Challenges and Coping Strategies

School of Nursing
ASSESSMENT COVER SHEET
Student Name(s): Student No.(s):
Note: If this is a group assessment submission, please list the student name and numbers of
all group members in the above box.
Unit Name: Integrated Nursing Practice 4
Unit Code: NSB334 Due Date: Friday 12th April 2019
11:59pm
Lecturer’s/Tutor’s Name: Christina Parker
Tutorial Day/Time:
Assessment No. 1 Assessment Title: Online Healthcare Modules

Question 1
a. Two years ago, Michele was diagnosed with breast cancer, this news overwhelmed her
and she felt her world had turned upside down. After treatment, cancer responded to
chemotherapy and she was relieved and glad that her life was balanced again. She was happy
with Pette her husband and her two kids. Two months later she started having coughs and
feeling breathless. After a visit to the hospital, the oncologist told her that the cough was not a
virus. The CT scans showed cancer had spread to the lungs and the liver. The physician stated
further that cancer was not curable.
The greatest challenge Michele faced was uncertainty about the future. In the first
place, she was full of hope for the future, family and her job. After the physician told her that
she might not survive cancer, she lost hope for the future. Causes for uncertainty include the
following.
i. Having to put plans into a hold.
Michele felt like she was unable to look into the future. Making plans was not easy. For
instance, it was hard devoting to a lunch date not knowing how she will be feeling. She had
difficulty planning for a family vacation since she couldn’t predict when she will be having
therapy (Cheang, Vudok, Badjik, & Leung, 2013).
ii. Fear about cancer treatment and its side effects.
Mitchel was scared of the side effects of treatment such as nausea and vomiting, pain and
fatigue. She felt like she was too dependent on Pette for cancer therapy. She was also not sure
if the treatment will work since cancer had spread.
b. Admitting the existence of the unknowns of cancer may make one feel afraid and
anxious. For instance, it may interrupt sleep and make it harder to concentrate at work.
Strategies that may help Michele cope with this particular challenge include the
following.

i. Joining support groups
Support groups help many individuals deal with the emotional issues of cancer by
providing a peaceful environment to share and manage their feelings and challenges.
Talking to the patient can reduce stress and it also creates a sense of belonging that
helps an individual feel more understood and less alone (Delaney, Colvin, &
Fleetwood, 2013).
ii. Individual counseling
Counseling helps the individual discover ways to cope with cancer. She is also able
to manage anxiety and depression, cancer symptoms and treatment side effects.
Counseling helps the individual talk about financial concerns and establish helpful
resources and lastly one gets to learn how to assist the family to understand and adapt
to changes in routine (Cheang, Vudok, Badjik, & Leung, 2013).
Question two
a. Triple-negative breast cancer is a kind of breast cancer that tests negative for
estrogen and progesterone receptors and excess HER2 protein. These results suggest
that cancer is not caused by HER2 protein, estrogen, and progesterone. So, triple
negative cancer does not show a response to hormonal therapy medicines that target
HER2 protein receptors. This implied that Michele couldn't recover from cancer since
there was no cure for it. The only thing that had remained for her was the management
of symptoms which included neoadjuvant chemotherapy and adjuvant chemotherapy
(Colvin & Fallon, 2017).
Question three
a. signs and symptoms
i. Lump or thickening of the breast tissue. The lump may be firmly attached to the skin
on top, chest wall or structures beneath it (Gotzsche & Jorgensen, 2014).
ii. Breast pain, warmth, and irritation which is not related to periods

iii. A nipple that turns inwards
iv. Formation of dimples on the skin of the breast particularly when the hands are raised.
This is caused by attachment of the tumor to the skin overlying it. The dimples convey
a pitted appearance and a skin color change called peae d’orange (Gotzsche &
Jorgensen, 2014).
b. Pain experienced by cancer patient maybe disease or treatment related. The
pathophysiology of cancer pain is as follows. A tumor may cause pain in the breast or
spread of cancer to other parts of the body. Cancer cells in the breast secrets
interleukins, growth factors, and prostaglandins which facilitate pain transmission.
Tumor expansion can also inflict pressure on surrounding organs damaging the nerve
tissues which may lead to neuropathic pain.
Spread of cancer to other parts of the body may be the second cause of pain. For
example, if cancer has spread to the lung the patient will start experiencing chest pain.
If it spreads to the liver, an individual will experience pain in the upper right part of the
abdomen (Gotzsche & Jorgensen, 2014).
Question four
a. Computerized tomography scan
A CT scan is an X-ray technique that shows a 2-dimensional of body’s internal organs. It’s
often used to check if the breast cancer has spread to other internal organs. It helps decide if
the breast cancer can be removed through a mastectomy. Before the test, a die is injected into
the arm. A scan is conducted to check other parts of the body since cancer can spread to organs
such as liver, lungs, lymph nodes and spine (Nelson, Cantor, & Griffin, 2012).
b. The test showed that cancer had spread to the lungs and the liver. Breast cancer can
spread when the cell detaches from the tumor and travel to distant regions such as lungs
and liver through the bloodstream or lymphatics. This process is called metastasis.
c. From the results, the cancer has advanced to stage four. It means that cancer has
metastasized to other parts of the body. At this stage, the cancer is not curable and the