Cancer denotes an abnormal growth of cells, as a result of, changes in gene expressions following deregulated cell division and death (Ruddon, 2007). Consequently, this produces a population of cells that invade tissues and metastasizes to other sites, and if untreated, it causes significant morbidity and/or death of the affected person (Ruddon, 2007). In essence, cancer stems from alterations in the expression of certain genes; this phenomenon deregulates the cellular program for cell division and differentiation. In the long run, cell division, as well as cell death, become unregulated leading to the growth of tumor cells.
The events that trigger abnormal cell growth are multifaceted. This abnormality could be caused by genetical or environmental factors (Ruddon, 2007). Cancer can either be benign or malignant. Benign tumors are not pathological in nature; they only lead to the accumulation of a mass cells at selected sites in the body (Ruddon, 2007). Malignant tumors have notable characteristics that differentiate them from benign tumors. First, malignant tumors have the ability to invade and destroy neighboring tissues. Secondly, malignant tumors have the ability to migrate to various parts of the body (metastasize) through the lymphatic and circulatory systems, thus, have the ability to invade distant tissues (Ruddon, 2007). Thirdly, malignant tumors are less well differentiated than normal cells from which they were derived from, and finally, malignant tumors grow more rapidly than benign or normal cells (Ruddon, 2007).
During the diagnosis of cancer, exfoliative cytology, surgical excision procedures, and obtaining a sample tissue by biopsy are used to collect samples from targeted sites in order to ascertain absence or presence of a malignant tumor (Ruddon, 2007). During such examinations, the degree of malignancy of the samples is ascertained. Malignant cells have an abnormal morphology; in other words, they are variable in size and shape. The nucleus of malignant cells is often larger than the nucleus of normal cells and have a large chromatin material. Besides, malignant cells have a high mitotic rate, and they are boldly evident in the invaded tissue (Ruddon, 2007).
The histological classification of malignant cells depends on the extent of differentiation, as well as the growth rate as indicated by the mitotic index. Based on these factors, cancers have been graded on a scale of I-IV. Grade I has a differentiation range of 75-100%; grade II has a range of 50-75% (Ruddon, 2007). Grade III has and grade IV has ranges of 25-50% and below 25% respectively (Ruddon, 2007). In addition, more advanced approaches to the malignancy grading account for the mitotic activity, amount of stromal tissue in or around the tumor and amount of infiltration into the surrounding tissue. This advancement in tumor grading a general guide to prognosis, as well as, the effectiveness of various therapeutic approaches (Ruddon, 2007).
Apart from tumor grading, tumor staging is paramount. Tumor staging highlights the degree of cancer growth, as well as progression, and has four stages. The first one is clinical staging. This stage examines the progression of the disease using physical examination, x-ray films, laboratory tests, and endoscopic examination (Ruddon, 2007). The second stage involves tumor imaging. This stage evaluates the progression of the tumor following sophisticated radiography. Techniques employed at this stage include CT scans, radioisotope scanning, MRI, PET, arteriography and lymphangiography (Ruddon, 2007). In the third stage, there is surgical staging. Surgical procedures are used to evaluate the extent of the tumor. In the final stage, there is pathologic staging. Biopsies are used to assess the degree of spread, involvement of lymph nodes and depth of invasion (Ruddon, 2007).
Essentially, in stage one, the tumor is located in the initial organ with no evidence of nodal or vascular spread, and it can be removed by surgical resection with up to 90 percent survival rate (Ruddon, 2007). In stage two, the tumor spreads to the surrounding tissues and lymph nodes, and has a 45 percent of being resected (Ruddon, 2007). Survival rate at this stage is up to 55 percent. At stage three, the tumor is a bit larger than in stage two. In addition, at this stage, the tumor is normally deeper, and the survival rate is up to 25 percent (Ruddon, 2007). Finally, at stage four, the tumor is more than 10 cm in diameter, and has severely invaded the underlying tissue. The survival rate at this level is under 5 percent (Ruddon, 2007).
There are various approaches to the management and treatment of cancer. The first two major ones are surgery and radiotherapy. Surgery remains one of the most efficient forms of cancer treatment. Surgery has been found to play a crucial role in the conservation of organs and structures, as well as maintain the functionality of many parts of the body (Kearney & Richardson, 2006). Secondly, radiotherapy involves the use of electromagnetic radiation to kill malignant cells. This therapy aims at delivering a high dose to the tumor volume in three dimensions, killing malignant cells, but avoiding the destruction of surrounding tissues although this is not always the case (Kearney & Richardson, 2006). Chemotherapy is the third approach; chemotherapy involves the use of pharmaceutical drugs to either slow the progression of cancer cells. In addition, gene therapy is under evolution. Cancer biologist are working hard to develop gene therapies that aim at correcting the genetic abnormalities that cause malignant tumors.
Furthermore, pain management is an important procedure in the care of patients and nurses play a significant role on this endeavor. Cancer patients often encounter pain, and in fact, it is the main symptom in the course of the disease (Davies & Epstein, 2010). Pain is an indication of severe tissue damage. Cancer can lead to various complications. These complications can be, as a result of, the disease itself or the cancer management regimes. With respect to radiation therapy, this approach is likely to cause a second cancer although such cases are minimal if it is administered accordingly (Davies & Epstein, 2010). Secondly, radiation therapy causes patients to have excess tiredness, skin reactions and hair loss. On the other hand, chemotherapy can cause various side effects, and this varies depending on the type of drug in question. Chemotherapy is likely to cause pain, fatigue, diarrhea, and sores in the mouth and throat, vomiting, constipation, and blood disorders (Davies & Epstein, 2010). Others include changes in thinking and memory, sexual disorders, hair and appetite loss. In line with this, cancer can have three significant complications.
First, the use of chemotherapy could lead to the damage of various organs such as kidneys. Kidneys play an essential role in not only drug metabolism, but also excretion, and chemotherapies have long term effects which lead to the destruction of the kidney (Davies & Epstein, 2010). Other organs that likely to be affected include lungs, the heart, liver and the reproductive system. The other major complication that may arise, as a result of, cancer or cancer treatment is memory loss. Chemotherapy is the main form of therapy that cause this complication (Davies & Epstein, 2010). In addition, chemotherapy may affect the nervous system. Most of these symptoms subsidize after the end of chemotherapy.
In summary, this paper has discussed the underpinnings of cancer especially, the staging and grading of cancer, diagnosis, treatment and management, and side effects of cancer. Cancer denotes an abnormal growth of cells, as a result of, changes in gene expressions following deregulated cell division and death. Cancer could occur either be in benign or malignant form. Based histological factors, cancers have been graded on a scale of I-IV. Grade I has a differentiation range of 75-100%; grade II has a range of 50-75%. Grade III has and grade IV has ranges of 25-50% and below 25% respectively. On the other hand, tumor staging highlights the degree of cancer growth, as well as progression, and has four stages. Gene therapy, chemotherapy, radiotherapy and surgery are the main forms of treatment used to manage cancer. Depending on the approach used, patients can develop various complications, and the most severe ones lead to organ damage.
References
Davies, A., and Epstein, J. (2010). Oral Complications of Cancer and Its Management. Oxford: Oxford University Press.
Kearney, R., and Richardson, A. (2006). Nursing Patients with Cancer: Principles and Practice. New York: Elsevier Health Services.
Ruddon, R.W. (2007). Cancer Biology. Oxford: Oxford University Press.
