The National Tobacco Campaign (National Tobacco Campaign) aims to reduce tobacco exposure for all Australians

Q1.
The Australian government has implemented several cancer prevention
measures to deal with risk factors. National Tobacco Campaign is one such
program which aims to reduce tobacco exposure for all Australians to improve
their health and change perception of smoking (Department of Health, 2016,
para. 2). Tobacco consumption is the most significant risk factor of cancer (Wu
et al., 2018, p. 5). Tobacco use via smoking is preventable, yet it accounts for
13% of cancer each year (Wilson et al., 2018, p. 697). This campaign targets
audiences through TV and social media (Department of Health, 2019, para. 4).
Q2.
There are two primary cancer screening, which helps in early diagnosis. One of
the cancer detection methods is bowel screening, by which about 90% of bowel
cancer can be cured early (Australian Institute of Health and Welfare (AIHW),
2019a, p.3). It is recommended for Australians over fifty-years-old to complete
an immunochemical faecal occult blood test, which can detect bowel
abnormalities, every two years (Cancer Council, 2019a, para. 2-4).
Another one is cervical cancer screening, which protects up to 30% of female
cervical cancer by detecting abnormal cell growth in the lining of the cervix
(AIHW, 2019b, pp. 2-3). It is designed to detect human papillomavirus, where
most Australian women (27-74 years) should be tested every five years (AIHW,
2019b, p. 5).
Q3.
Harold’s lung cancer is primarily indicated by symptoms such as dyspnoea and
persistent coughing. Dyspnoea can be related to the pleural effusion caused by
lung cancer cells invading the pleural space (Metin & Donmez, 2016, p. 62).
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Excess fluid accumulation in the pleural space causes difficulty in lung
expansion and contraction (Brown et al. 2020, p. 615).
Persistent coughing is caused by tumour tissue that stimulates the receptors.
This is because when lung cancer grows in the respiratory tube, substances
entering the air, trigger cough reflexes and cough-causing receptors (Crisp et
al., 2017, p. 1266). More than half of lung cancer patients have reported
persistent cough (Harle et al., 2020, p. 4).
Q4.
a.
Non-small cell lung cancer (NSCLC) is a type of epithelial lung cancer (Zappa &
Mousa, 2016, p. 288), mainly categorised into three types. Firstly, lung
adenocarcinoma moderately grows from the small airway epithelial, which
secrete mucus (Zappa & Mousa, 2016, p. 288). Secondly, squamous cell lung
carcinoma is a slow-growing type that arises from squamous cells (Brown et al.,
2020, p. 602). Lastly, large cell carcinoma is undifferentiated NSCLC with no
signs of squamous or glandular differentiation with rapid growth (Zappa &
Mousa, 2016, p. 288).
b.
Harold's life will be impacted by disease progression, the severity of symptoms
and side effects. Survival of locally advanced NSCLC patients is found to be
around twenty months, and five-year overall survival rate was about twenty-
five percentage (Urvay et al., 2016, p. 4695). Treatments for NSCLC are
diverse, such as surgery, radiation therapy, and chemotherapy, but these can
occur side effects including oesophagitis, skin rash, nausea and vomiting
(Brown et al., 2020, pp. 603-604). Therefore, side effects from tumour
progression and treatment can reduce the quality of life at the psychological,
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cognitive, and physical levels of life (Polanski et al., 2016, pp. 1024-1025). For
example, Harold can have difficulty carrying objects, difficulty in memory and
attention, or difficulty breathing.
c.
Poor access to cancer treatment is a significant challenge in rural areas.
Oncology and chemotherapy services in rural areas are far less than in cities
(Fox & Boyce, 2014, p. 445). This low access is associated with reduced
treatment rate and poor cancer outcomes (Ugalde et al., 2019, p. 2). The lack
of reliable transportation is another barrier to care. Many people in the rural
area rely on public transport, but even public transport is only used by 60% of
rural places (Charlton et al., 2015, p. 2), which leads to limited use of health
services (Dent, 2018, p. 10).
Q5.
a)
Patients receiving chemotherapy are more likely to have neutropenia, with a
small number of white blood cells (WBCs) and a higher risk of infection (Dunbar
et al., 2014, p. 1). This is because chemotherapy kills cancer cells as well as
healthy cells like bone marrow that produces WBCs and plays a vital role in the
body's immune system (Brown et al., 2020, pp. 288-289). Chemotherapy
reduces the immune system making the patient susceptible to infection.
b)
Harold might experience chemotherapy-related fatigue (CRF) and
chemotherapy-induced nausea and vomiting (CINV) as a chemotherapy side
effect. CRF is the most common side effect at each grade of lung cancer
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(Pearce et al., 2017, pp. 5-6). After chemotherapy kills cells, additional energy
is needed to treat the damaged body tissue and the accumulation of toxic
substances (Brown et al., 2020, p. 294). Around 80% of patients experienced
CINV (Chan & Ismail, 2014, p. 5307). Chemotherapy agents directly damage
gastrointestinal epithelial cells, causing CINV (Brown et al., 2020, p. 295).
c)
Interventions for managing CRF include energy conservation and exercise.
Energy dialogue strategies reduce energy consumption. Nurses can teach daily
activities to the patient for reducing cognitive fatigue (Sadeghi et al., 2016, p.
4789). Exercising for CRF is a collaborative intervention with physiotherapy.
Initially, walking every ten to thirty minutes should be encouraged to improve
functional capacity (Patterson et al., 2013, p. 2674). The nurse needs to
educate patients about the benefits of exercise and guide them about exercise
programs (Scott & Posmontier, 2017, p. 78).
For managing CINV, antiemetics can be administered before chemotherapy,
which can ultimately prevent vomiting in about 75% of patients (Crisp et al.,
2017, p. 23). Vomiting agents in the antiemetic drugs antagonise the
neurotransmitter receptor responsible for CINV (Brown et al., 2020, p. 295).
Nurses need to be aware of the mechanism of action and side effects of the
medication (NSQHS, p. 32). Another intervention for CINV is dietary education.
The nurse can recommend foods that are soft, easy to digest and less in odour
(Najafi et al., 2019, p. 577).
d)
Cancer Fatigue Scale can be used to recognise and evaluate the physical,
emotional, and cognitive aspects of fatigue (Sadeghi et al., 2016, p. 4784). In
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