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Colon Cancer Research
Colon cancer refers to the abnormal multiplication of the large intestine and/or rectum cells that have the ability to grow while invading other tissues of the body making it difficult for the affected cells to continue their normal functioning. Colon cancer presents a lot of challenges during the nursing of the patient. This disease can also create complications that increase the patient's need to have a well-trained and knowledgeable nurse in their care to improve the quality of their life and ability to support their recovery. A nurse needs to understand the peculiarities of the disease to influence his/her ability to provide prime care for patients diagnosed with this condition. Therefore, the purpose of this paper is to discuss colon cancer to increase awareness about it among nurses, other healthcare providers, and the general population to positively influence its prevention and treatment.
Background and Significance
Colon cancer is a disease that commonly affects old people but it can also occur in adolescents and middle-aged adults. In 99 percent of cases, the diagnosed patients are mostly over 50 years old (Miller et al., 2016). Colon cancer generally strikes men more often than women and males are usually diagnosed with the disease at a younger age than females. A majority of males that have colon cancer are of the approximate age of 60 years while a majority of females are usually in their early seventies (Miller et al., 2016). Compared to other types of cancer, colon cancer constitutes about 10 percent of the disease cases. In the United States, approximately 136, 000 instances of colon cancer were registered in 2016 alone (Miller et al., 2016). Studies conducted by the American Cancer Society reveal that in a group of 21 men, it is likely that one of them will be diagnosed with colon or rectal cancer at some point in his life (Arnold et al., 2017). The risk of this disease is lower for women but it is insignificant about the high number of women diagnosed with the disease globally.
The disease has a high mortality rate and a considerable potential to limit opportunities and reduce the quality of life for millions of patients all over the globe. There is a high percentage of lethal outcomes among both males and females. Statistics from the World Health Organization reveal that in the year 2015, the number of people suffering from colon cancer worldwide amounted to about 9.4 million and about 800,000 succumbed to it by the end of that year (Arnold et al., 2017). It has been discovered that after the diagnosis of colon cancer is confirmed, only 65 percent of the patients in the US survive for longer than 5 years (Arnold et al., 2017). However, their quality of life deteriorates with time if treatment is not working effectively. The survival rates of patients are dependent on the stage at which they have been diagnosed and the quality of care they receive after the disease was detected. In most cases, patients who receive early diagnosis survive for long and have a good chance of having a remission. However, less than 40 percent of people diagnosed with colon cancer are at their first stage (Arnold et al., 2017). This is due to the silent nature of the disease as it starts to manifest itself physically after it has progressed past the initial stages.
The fight with the disease requires high costs which include those for disease diagnosis, chemotherapy, and cancer medication. Also, other expenses can be incurred in the hospital or in-home care to provide care services. In the United States, the Department of Health has allocated 29,000 US dollars for the care of each patient with colon cancer in Medicare but this amount has proved insufficient as other out-of-pocket settlements are sometimes made by the patient (Th? lin & Sikka, 2015). The cost of Medicare does not include hospice care. Thus, the high incidence, prevalence, and high death rate caused by colon cancer are a concern for nursing staff, whose aim is to provide care for colon cancer patients to reduce the death rate and improve their quality of life.
Etiology and Risk Factors
Cancer of the colon is caused by a variety of factors that interact with the patient's environment and cause the onset of the disease. The most significant of them are genetic predisposition, the age of the individual, and the lifestyle choices that increase the risk of developing the disease.
The role of genetics in causing the development of rectal and colon cancer has been supported by empirical evidence provided by examination of the occurrence of the disease among close relatives. Certain illnesses of the large intestines that are inheritable and transmitted from one generation to the next to have been identified as major factors that play a key role in the disease occurrence. The hereditary nonpolyposis colorectal cancer and familial adenomatous polyposis are most likely to occur in the offspring (Valle, 2014). Studies involving the comparisons of fraternal and identical twins reveal that an identical twin has an increased risk of developing colon cancer if one of the twins has the disease.
The presence of genetic predisposition is influenced by other factors such as lifestyle choices of the individual that increase the risk that a person will have the disease. The possibility of developing colon cancer raises as the person's age advances above 50 years and the risk is even higher if the person is male (Miller et al., 2016). More than 95 percent of diagnosed cases of colon cancer have individuals aged above 50 years. Bad habits, such as frequent consumption of alcohol and smoking, increase the chances of developing colon cancer (Benson et al., 2014). The consumption of foods that have high-fat content raises a person's likelihood of developing an inflammatory disease of the bowel, a factor that increases the risk of colon cancer (Benson et al., 2014). An example of a food that is commonly consumed and has high-fat content is red meat. Cigarette smoking and the use of marijuana also put an individual at increased risk of developing this disease.
Pathophysiology of Colon Cancer
The development of colon cancer usually starts due to the presence of high content of fat in the large intestines. The presence of these fat molecules could be a result of a high-fat diet or the compaction of contents in the gut due to infrequent defecation (Benson et al., 2014). This state causes an evolution of flora and fauna of the gut. The change in their composition in the colon causes the polymorphic leukocytes to attack this new invasion to produce a reaction that will lead to the inflammation of the affected section of the gut that causes the formation of abscesses (Benson et al., 2014). The abscesses then worsen the inflammation and cause necrosis of the colon leading to the formation of ulcers. The consistent state of ulceration results in the production of poorly developed cells that is the onset of the appearance of cancerous cells and the development of a tumor in the colon. This leads to the manifestations of cancer.
The ulceration of the colon or the rectum as a result of inflammation causes the presence of blood in the stool at the onset of the disease (Th? lin & Sikka, 2015). It also changes the bowel movements of the individual causing significant discomfort. As the disease progresses, constipation worsens and the patient develops a poor appetite that provokes nausea and vomiting (Th? lin & Sikka, 2015). The patient loses weight and the properties and the contents of stool change as the person produces less stool with little density.
Complications of the disease include intestinal obstruction which is a result of the inflammation of the growth of the colon polyps that mechanically obstruct the flow of contents towards the rectum or anus. Surgery done to manage the disease can also cause mechanical obstruction (Benson et al., 2014). Another complication is metastases. Cancer can spread to other areas such as the lungs, stomach, kidneys, and liver, which increases the patient's potential to succumb to the disease due to multiple organ failures (Benson et al., 2014).
Treatment of Colon Cancer
Surgery is an effective method of managing this type of cancer. It involves the resection of a section of the large intestine that has been affected (Benson et al., 2014). Surgery is usually effective before the disease spreads to other tissues and when the tumor is localized commonly during the first stage of cancer. The main aim of surgery is to prevent the growth of the cancerous cells past the affected area by removing the cancerous part of the colon.
Another treatment solution for colon cancer is chemotherapy. These are the drugs that are used to prevent the progression of the size of a tumor or metastasis to other organs. They contain chemical agents that counteract the progression of the disease (Benson et al., 2014). This method of treatment can be combined with radiation therapy to improve the quality of treatment for the patient. Examples of chemotherapy drugs for colon cancer are Capecitabine and Oxaliplatin (Benson et al., 2014).
Nursing Evidenced-Based Practice
The first recommendation in the management of colon cancer is educating the patient. The role of a nurse is to make the patient aware of the pathophysiology of the disease, its process, and prognosis (El Shami et al., 2015). This information will be important in helping the patient to prepare for the course of chemotherapy and radiotherapy and also to avoid factors that worsen their condition and negatively influence the good outcome. The second recommendation is the monitoring of the patient's bowel state and ensuring his/her relaxation and comfort (El Shami et al., 2015). The nurse should check the bowel state of the patient to intervene in cases of constipation. This helps ensure proper usage of laxatives and stool softeners prescribed to the patient as well as prevent an overdose in a bid to relieve the feeling of constipation.
Monitoring the patient's diet and encouraging them to consume foods high in fiber is another recommendation for the management of colon cancer. The nurse needs to ensure that the patient avoids foods that are high in fat because they have the potential to worsen their condition (El Shami et al., 2015). Consuming food that has high fiber content will increase the patient's ability to pass soft stool and reduce the severity of the feeling of constipation. Providing the patient with emotional support and psychotherapy is a critical intervention in the management of cancer. The nurse should ensure emotional support because the pain and discomfort from the disease can cause depression (El Shami et al., 2015). Most importantly, the nurse should assess the patient for pain and administer morphine to relieve the patient's suffering.
Colon cancer affects the rectum and the large intestine commonly in individuals aged above 50 years. The disease develops due to the inflammation that occurs in the colon leading to ulceration and the cancerous growth of cells. The symptoms can include blood in the stool, discomfort, constipation, lack of appetite, and loss of weight. There is a genetic predisposition to the disease which is influenced by such lifestyle factors as smoking, frequent consumption of alcohol, and red meat. The key approaches to the treatment of the disease are the surgery of the affected section and chemotherapy combined with radiotherapy. The nursing interventions include educating the patient about the disease, monitoring the patient's bowel and diet, and managing the pain that is caused by colon cancer.