Breast Cancer: Diagnosis and Treatment - Essay Example

?Breast Cancer Overview Breast cancer is the more common type cancer among American women and is one of the leading causes of death in the United States (Weaver, 2007). For instance, in 2007, experts estimated placed at 240,000 people, including men, who will be victims of cancer in the United States for that year (Weaver, 2007). The treatment for cancer differs from people to people (Weaver, 2007). It is fairly common that a mastectomy may be performed when breast-conserving therapies do not work or will put the cancer patient at risk (Weaver, 2007). According to Weaver (2007), there are two types of breast cancers. One is the ductal breast cancer that takes place in ducts connecting the lobes and the nipple. Weaver (2007) said that this is about 80% of the breast cancers. In contrast, lobular breast cancer that takes place in the lobes where milk production occurs accounts from 10 to 15% of cancer patients (Weaver, 2007). Diagnosis. Diagnosis is “the process of finding the nature of the disorder” (British Medical Association, 2008, p. 170). In executing diagnosis, a medical professional “listens to a patient’s account of his or her illness and a physical examination is usually involved” and “tests may be ordered after the formation of a provisional diagnosis” (British Medical Association, 2008, p. 170). Breast cancer is suspected when a lump is discovered in breast self-examination or mammography (British Medical Association, 2008). However, doctors usually make the diagnosis of a breast cancer based on the results of a biopsy ordered on the patient (British Medical Association, 2008). Pathophysiology. Pathophysiology is “the study of the disease on body functions” (British Medical Association, 2008, p. 436). The current knowledge on the pathophysiology of breast cancers is that the condition emerges after a series of molecular changes at the cellular level that result in the “outgrowth and spread of breast ephithelial cells with immortal features and uncontrolled growth” (Swart, 2011, second paragraph). Genome studies indicated discrete tumor subtypes with distinct characteristics (Swart, 2011). Based on the genome studies, four subclasses of breast cancer have been identified: lumina A, luminal B, basal, and human epidermal growth factor 2 HER2-positive (Swart, 2011, second paragraph). Etiology. Etiology or aetiology means the “group of conditions which form the cause of any disease” (Marcovitch, 2005, p. 252). It also means “that part of medical science dealing with the causes of the disease” (Marcovitch, 2005, p. 16). Based on the work of Swart (2011), it seems that the most important etiological knowledge on breast cancer at present is that the etiology for breast cancer is not random but separable based on “distinct molecular and cellular origins” (Swart, 2011, 3rd paragraph). Further, according to Swart (2011, 3rd paragraph), based on the current etiology on breast cancer, thinking on the risks factors, prevention, and treatment strategies are now changing. Clinical manifestations. Clinical manifestation or signs refer to “the physical manifestations of an illness elicited by a doctor when examining a patient—for example, a rash, lump, swelling, fever or altered physical functions such as a reflex” (Marcovitch, 2005, p. 143). In the case of breast cancer, one the clinical manifestations can be a “painless lump” (British Medical Association, 2008, p. 94). Other symptoms “may include a dark discharge from the nipple, retraction (indentation) of the nipple, and an area of dimpled, creased skin over the lump” (British Medical Association, 2008, p. 94). Defining the Role of a Breast Cancer Nurse One concept on the role or intervention of the nursing profession among breast cancer patients is the one articulated by St. Vincent Medical Center (2008) pertaining to a “Breast Cancer Nurse Navigator.” According to the Vincent Medical Center (2008, 1st paragraph), a Breast Cancer Nurse Navigator “assist breast cancer patients and their families find their way through the complexities of the healthcare system and allow them to focus on their healing” (St. Vincent Medical Center, 2008, 1st paragraph). As defined by the St. Vincent Medical Center, the Breast Cancer Nurse Navigator is integral to a multidisciplinary breast cancer program that encompasses “the full spectrum of cancer care from education and screening, through diagnosis, treatment, clinical trials, support services, and survivorship” (2008, 5th paragraph). For the St. Vincent Medical Center (2008), the Breast Cancer Nurse Navigator has six duties. First, it is her or his duty to liaison between the patient and with the most important persons and relations in the patient’s life. Second, she or he must keep the patient and her family informed on their eligibility to various services. Third, the duty of the nurse includes facilitating various types of support services for the patient and family like “financial, emotional and therapeutic initiatives” provided on a “one to one basis” (St. Vincent Medical Center, 2008, last paragraph). Fourth, another important role of the nurse in the mold of the Breast Cancer Nurse Navigator, is to “teach patients and families all about the recommended treatments, reinforcing them and allowing them a better understanding of the treatment plan” (St. Vincent Medical Center, 2008, last paragraph). Fifth, the Breast Cancer Nurse Navigator must “expedite the scheduling of appointments and physicians, treatment sessions and support services” (St. Vincent Medical Center, 2008, last paragraph). Finally or sixth, the Breast Cancer Nurse Navigator must “nurture the patient and family” at a most difficult point in their lives so “they may proceed into survivorship with trust, safety, compassion and knowledge” (St. Vincent Medical Center, 2008, last paragraph). In line with the sixth tasks, the St. Vincent Medical Center ensures an “individualized survivorship plan” (2008, last paragraph). For the said roles of the nurse among breast cancer patients, the St. Vincent Medical Center has an acronym called LISTEN: L is for liaison, I is for informed, S is for support services, T is for teach, E is for expedite, and N is for nurture. In other words, other than simply defining a set of tasks, duties, or roles for a nurse among breast cancer patients, the medical center emphasizes the value of empathy among nurses for breast cancer patients and their loved ones. The role of nurses for breast cancer patients defined by the Breast Cancer Nurse Navigator mold of the St. Vincent Medical Center indicates innovations on the role the nursing profession can take among breast cancer patients that goes beyond hand-washing, wound care, dressing of wounds, assisting patients to take their medicines, and assisting doctors and specialists with regard to their duties. Other hospitals have also adopted the concept of a nurse breast cancer navigator similar with the concepts adopted by the St. Vincent Medical Center. One such hospital is the Hotel Dieu Hospital in Canada (Melinyshyn and Windtonic, 2006). Other than the concept of a Breast Cancer Nurse Navigator articulated by the St. Vincent Medical Center, Robinson-White reported (2010) that the role of a breast cancer nurse and breast cancer nurse navigator has been articulated in various fashions. Robinson-White (2010) based her findings based on a review of literature. According to Robinson-White (2010), nurses among breast cancer patients have taken multiple roles in caring for patients. The work of Clark et al. (2009) highlights the importance of the ability of nurses to take care of breast cancer patients beyond the traditional roles and duties of nursing. Clark et al. (2009) revealed that the work of Maguire et al. (1980) was the first to show the importance of nurse specialists among cancer patients. Breast Cancer Nurse Specialists “can identify patients at risk of distress and provide effective emotional support” (Clark et al., 2009, p. 43). According to Clark et al. (2010, p. 43), the role of breast cancer nurses “has evolved and now includes many technical clinical roles such as seroma draining, patient follow-up, and management of lymphoedema.” Unfortunately, however, according to Clark et al. (2009, p. 43), potentially these roles “can compromise the traditional role in support and information giving.” The importance of emotional support that can be extended by nurses to breast cancer patients is highlighted by this fact: Clark et al. (2009, p. 44) discovered that in a sample of 474 breast cancer patients they have covered, at least 9% have “reached the criterion for depression.” Another concept of the role of nurses among breast cancer emphasizes the role of the nurse in educating the cancer patient on how to deal with a postmastectomy. This was the emphasis of Bonaldi-Moore (2009). Weaver (2007), for instance, confirmed that nurses have an important role to teach cancer patients, including those who have undergone mastectomy, acquire emotional support and comfort. Further, nurses have also a role in assisting patients cope up with loss, including the loss of their breast or breasts (Weaver, 2007). In the literature, what appears to be dominant is the expanded role of nurses among breast cancer patients: roles covering direct support for the patient and support for his or her loved ones, a support that covers the patient’s physical and other well-being. Conclusion In this work, we have not yet exhausted the literature on the role of nurses among breast cancer patients. However, it is clear that especially among breast cancer patients, nurses have to adopt an expanded role for themselves among cancer patients in order to ensure that patients are comfortable and have a good quality of life. References Bonaldi-Moore, L. (2009). Educational program: The nurse role in educating postmastectomy breast cancer patients. Plastic Surgical Nursing, 29 (4), 212-219. British Medical Association. (2008). Illustrated medical dictionary. Dorling Kindersley. Clark, L., Holcombre, C., Hill, J., Downey, H., Fischer, J., Krespi, M. and Salmon, P. (2009). The Perception of support received from breast care nurses by depressed patients following a diagnosis of breast cancer. Oncology, 91, 43-45. Marcovitch, H. (2005). Black’s medical dictionary. 41st ed. London: A& C Black Publishers Limited. Melinyshyn, S. and Wintoc, A. (2006). The role of the nurse navigator in the breast assessment program at Hotel Dieu Hospital. Unformatted, written for the Nursing Journal. Retrieved 18 October 2011, from http://www.krcc.on.ca/pdf/The%20Role%20of%20the%20Nurse%20Navigator%20in%20the%20Breast%20Assessment%20Program.pdf Robinson-White, S. (2010). Patient navigation in breast cancer: A systematic review. Cancer Nursing, 33 (2), 127-140. Swart, R. (2011). Breast cancer pathophysiology. Retrieved 18 October 2011, from http://emedicine.medscape.com/article/1947145-overview#a0104 St. Vincent Medical Center. (2008). What is a breast cancer nurse navigator. St. Vincent’s Medical Center. Connecticut: St. Vincent Medical Center. Retrieved 18 October 2011, from http://www.stvincents.org/Asset/iu_files/BreastCancerNurseNavigatorsBrochure.pdf Weaver, C. (2007). Compassionate care mastectomy for patients. Nursing Made Easy November/December, 26-37. Read More