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Question: Discuss about the Case Study of Colorectal Cancer. Answer: Introduction Health care sector needs to assist the health care users through both medical and emotional support. In this context, nurses play significant role in assessing the patient and identifying the key concerns, the patient suffering from, based on which appropriate care plan is being developed. Cancer is a life-threatening disorder that involves critical health conditions of the patient along with complex treatment procedure, for improving patients quality of life and enhancing the survival period (Siegel, DeSantis Jemal, 2014). In this essay, the key focus is a 65 years old male, named John, who has recently diagnosed with bowel cancer. John is a joyful, charming and active adult, in respect to his age. He is an electrician by profession and not ready to retire from his job yet. However, he has undergone some period of tiredness and occasional pain in abdomen; however, John was not aware about his symptoms and assumed that the symptoms are due to minor bowel inconsistency or due to cons umption of unhealthy food last night. Thus, initially he refused to attempt the tests for bowel cancer. Upon assessing his test report, his GP addressed to John and his wife, Carol that he has bowel cancer, which was shocking to both of them, as John said that no one ever had a history of cancer in his family. However, his GP and practice nurse supported them emotionally and assured that there are plenty therapy, which can help John to deal with his cancer. The key purpose of this essay is to prepare John, after his adjuvant chemotherapy for discharge and discussing the follow up practices he would need and how he needs to manage his own life to live in his current status. Discharge plan After assessing Johns current status by the surgeon and other health care staffs of the multidisciplinary team, they decided to treat John with adjuvant chemotherapy for removing the malignant cells from his colon. However, the assessment did not find metastasis of his cancer, thus, the risk of recurrence of his cancer has been lessened. After his last chemotherapy, Johns care team is planning to discharge him from the hospital upon developing a discharge plan for him. In this context, the discharge planning would concentrate on educating John regarding the follow up care and schedule that is being made for reducing the change of recurrence of his cancer. Upon chemotherapy, the risk of secondary diseases increase, as chemotherapy may kill healthy and growing immune cells sometimes with the malignant cells, making the immune system sensitive to the diseases (Bretthauer, 2011). John may experience several symptoms like tiredness, loss of appetite, mouth sores, skin problems, infections , bleeding, stomach upset or diarrhoea. Thus, John has to maintain his diet and nutrition properly. Therefore, the discharge plan would include a health promotional session for educating John and his wife carol regarding the healthy life activities that John must adhere to sustain the treatments of his colorectal cancer and eliminate the risk of his cancer recurrence. Johns risk of colorectal cancer recurrence should be eliminated through planning appropriate follow up care and assisting him to adopt the after care management. Initially, the treatment plan from the specialist should be sent to the patients other providers, especially the patients general physician, who would guide the patient, i.e. John regarding the requirement of follow up care. A yearly colonoscopy would be done for checking the colorectal cancer recurrence. Moreover, the follow up sessions would be required for routine check up and screening. Screening is needed for people more than 50 years, thus, it is applica ble for John. John and Carol would be advised to ensure his medicine administration on time; where Carol can motivate John to take his medicines on time. The regular medicines would include antinausea medicine for dealing with the stomach upset and prevent fluid loss through vomiting. Pain may be a side effect of the chemotherapy of Johns colorectal cancer. Thus, John should also adhere to his pain medication, as prescribed his specialist or GP, instead of waiting until the pain becomes severe to control. Moreover, John and Carol should continuously monitor any kinds of side effects, John is experiencing or not and should immediately contact with his GP or specialist. As the immune system is weakened, John may become sensitive to several allergens and develop allergic reactions to food or medications (Burt et al., 2013). Thus, John and Carol should immediately concern to his GP as soon as any kinds of allergic reaction like cough, sneeze, rashes or breathing problem is identified. The next recomme ndation for John in his discharge planning would be regarding his nutritional status maintenance. A dietician would make a diet chart for John, which he must adhere to properly. The diet would include vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, fish and avoid food or drinks that produce gas. Johns diet would also include some supplements. In his assessment, John depicted that he hangs out with his mate, who cook up cow meat and he loves to eat steak sandwich with cheese. However, cow meat contains adequate amount of fat, which is not suitable for John, on the other hand John should also not consume cheese as it also contain significant amount of fat; instead, he should focus upon green vegetable (Centers for Disease Control and Prevention, 2011). On the other hand, the physical therapist in the multidisciplinary team would make an exercise plan for John, which would promote his metabolism and increase appetite and reduce pain. He should also cease smok ing and drinking to reduce recurrence rate. John should also associate with Cancer Council information services, from where he could gain more knowledge regarding his cancer, which would promote his healthy lifestyle. After providing all the important information and referrals, John would be finally assessed for his vital signs, consents would be taken and discharge form will be filled and finally discharged upon completion of all the procedures. Self management Colorectal cancer is the third most common cancer type in US, with an overall lifetime risk of approximately one in 20.Although the death due to colorectal cancer have been decreased dramatically throughout the world, as a result of advanced cancer treatment. In this context, after being discharged from the hospital, John would have to adopt the self management skills, for maintaining his independence, while keeping his healthy lifestyle to avoid further complications relate to colon cancer. In previous literatures, several cases have been shown, where the cancer survivors experienced several complications as the secondary complications including physical, psychological, social and spiritual issues, leading to the reduced life expectancy (Inadomi et al., 2012). Thus, John needs to understand the risk of survivorship issues, which he may experience and should develop coping skills to deal with these issues and promote his survival. Several physical issues may be experienced by a cance r survivor, which should be prevented for the sake of reducing long term effect of treatment and persistence of the symptoms. John may also experience some of the long term physical effects of colorectal cancer. Johns treatment has undergone surgery and adjuvant chemotherapy and his care team has also described the need for radiation therapy in future. All of these treatment procedures include short and long term side effects (Baxter et al., 2011). For instance, he most common issue is change in bowel function, including stool urgency, frequent stooling, difficulty distinguishing gas from stool, incontinence, diarrhoea, liquid stool, erratic stooling patterns or inability to defer defection. Moreover, his future radiation therapy may also include rectal bleeding or pain. Once John experience these kinds of physical issues, should immediately consult with the physician, which would be followed by the administration of anti-diarrhoeal medication, protective undergarments and dietary changes. Although there would be no complications related to colostomy in Johns case, as he would not need a colostomy. Another physical issue that John can experience is urinary incontinence and sexual problems. Urinary incontinence is although common in old age. For this John would be recommended for erectile dysfunction related medication, referrals to urologist or gynaecologist and pelvic floor muscle exercise (Lithner et al., 2012). Several previous literatures have provided evidences for the effectiveness of pelvic floor muscle exercise on increasing bowel and urinary control, thereby decreasing the signs of incontinence. On the other, based on Johns age, he might not significant problems related to his sexual life, however, if so, he would be referred to a gynaecolog ist. Regular physical activity is important for people like John, experiencing bowel cancer. It is recommended by multiple national guidelines for cancer survivorship carethat survivors, i.e. John should get at least 150 minutes of moderate intensity or 75 minutes vigorous intensity physical activity per week, which includes pelvic floor muscle exercise. Some other studies recommend at least 180 minutes of physical activity per week for the survivors, who have undergone chemotherapy for lowering the risk of colorectal cancer recurrence. In addition to physical exercise, maintaining healthy weight and diet is also required for John, as obese patient have shown to increase the risk of cancer recurrence and the risk of obesity enhances after chemotherapy or other treatments, due to slow down of metabolic processes. Therefore, healthy diet including low fat foods and ample amount of vegetables, would promote Johns healthy living. To prevent recurrence John should reduce his alcohol intake and cease smoking, as both of these habit influence the cancer recurrence. Some supplements are also recommended as potential additive therapy in the treatment of their cancer, for John to improve his health status. The chance of secondary infection may also increase in case of John, as the weakened immune system makes it easy for the opportunistic pathogens to invade body (Foster Fenlon, 2011). Thus, John needs to ensure that he is properly nourished to make his immune system stronger. Thus, he would be recommended to administer with supplements, probiotics and antibiotics for preventing infections. In addition to the physical issues, John may also have psychological issues like anxiety, depression. The chance is high in case of John, as in the case study, it has been seen that John and his wife were signific antly upset, upon being the aware of his cancer. This is a sign that he would be worried regarding his life expectancy and would be anxious regarding his treatment and associated pain. All of which may lead to development of depressive symptoms. To prevent this psychological issue, he needs adequate emotional support and empowerment from his family as well as health care staffs. In addition, fear of recurrence is already there in Johns case (Qian Yuan, 2012). He is an active individual, but the cancer treatment would restrict his activity, independence and would develop a sense of loss for what might have been, like socialization, meeting friends and others. John is a free and independent person, but upon his treatment, his family and friends would sympathize him for his condition, all of these would lead to psychosocial reorientation, developing depressive or other psychological disorders. Behavioural therapies, counselling, music therapies, acupuncture, relaxation techniques and continuous support from his wife and care providers may empower his independence. John may be referred to rehabilitation centre for improving his living standard, independence and socialization, which would improve his self esteem (O'Connor et al., 2011). His social and emotional well being is also threatened, as his wife is distressed upon hearing the news of his condition. As John would not be able to continue his job as an electrician efficiently, his financial status would also be affected. Moreover, as his physical status would be compromised, John may not be able to meet his friends like before, which may make him isolated and lonely, reducing the quality of his life. Thus, he could contact some social support or community service centre, where he would be able to meet other cancer survivors who are living healthy and active life, which would motivate his independence and survival (Poston et al., 2011). Finally, the spiritual well being of John may also be affected by his cancer treatment. For instance, uncertainty of survival and wrong or perception of illness may lead to reduction of John and his wifes inner strength. It has been argued by Fong et al., (2012) that the spiritual strength is crucial to live longer with chronic and life threatening disorders like cancer. Thus, to fight against his colorectal cancer, he needs to build his inner strength and will for getting an improved life, for which he needs continuous support and motivation from his wife and other dear ones. In the context of Johns self management, effective communication is required from the members of his care team. As John is an active older adult, undergoing living standard crisis, he needs supportive and respectful communication. The medical staffs and nurses should have potential verbal and non-verbal communication skills including potential listening skills, which would promote a trustworthy relationship building within the care provider and John. A supportive communication with the health care provider would create such an environment that would promote his inner strength, will for getting health improvement and emotional strength (Silver Baima, 2013). In addition to John, it is the responsibility to the nurse, to provide adequate support to Johns wife Carol, so that she could gain an insight of her husbands current health status and future consequences, as well as become able to promote Johns adherence towards the positive medical therapies. It may be difficult for the medical staffs initially to educate John and his wife, because being an electrician; he may have little or no knowledge about cancer and might be worrier or frightened about the negative health outcomes. Thus, initially after establishing a positive relationship with John and his wife, the nurses need to empathize them and support their initial understanding about the disease and then gradually increase the depth of information. The health care providers can also provide them online resources, to gain better insight of the disease. Finally, after completing the educational sessions, the success of the program would be evaluated. The evaluation of the educational sessions conducted for John would be done through assessing the criteria of improved health status, awareness regarding his disease status, adherence to follow up, reduced risk of secondary symptoms and the improvement of his quality of life (Biagi et al., 2011). To assess the short and long term effects of the educational sessions and the consequences of cancer treatment, quality of life assessment tool would be used here. Conclusion Although cancer has no cure, but there are several specific and advanced therapies, which can help the patient to improve the living standard. However, cancer therapies reduce the quality of life in the cancer survivors. Thus, the essay evaluated these risk factors and issues experienced by cancer survivors and the ways to prevent these issues to progress, for improving the overall health status of the patient. In this essay, the case of a 65 years old patient, John has been focused, who have diagnosed with bowel cancer and treated via chemotherapy. The essay provided a brief description of the required education for John prior his discharge from the hospital as well as the self management practices to deal with the physical, emotional, social, psychological and spiritual issues as a cancer survivor. Finally, the essay also included the key communication skills required by the care givers and the strategies to evaluate the success of the educational sessions References Baxter, N. N., Sutradhar, R., Forbes, S. S., Paszat, L. F., Saskin, R., Rabeneck, L. (2011). Analysis of administrative data finds endoscopist quality measures associated with postcolonoscopy colorectal cancer.Gastroenterology,140(1), 65-72. Biagi, J. J., Raphael, M. J., Mackillop, W. J., Kong, W., King, W. D., Booth, C. M. (2011). Association between time to initiation of adjuvant chemotherapy and survival in colorectal cancer: a systematic review and meta-analysis.Jama,305(22), 2335-2342. Bretthauer, M. (2011). Colorectal cancer screening.Journal of internal medicine,270(2), 87-98. Burt, R. W., Cannon, J. A., David, D. S., Early, D. S., Ford, J. M., Giardiello, F. M., ... Jasperson, K. (2013). Colorectal cancer screening.Journal of the National Comprehensive Cancer Network,11(12), 1538-1575. Centers for Disease Control and Prevention (CDC. (2011). Vital signs: Colorectal cancer screening, incidence, and mortality--United States, 2002-2010.MMWR. Morbidity and mortality weekly report,60(26), 884. Fong, D. Y., Ho, J. W., Hui, B. P., Lee, A. M., Macfarlane, D. J., Leung, S. S., ... Taylor, A. J. (2012). Physical activity for cancer survivors: meta-analysis of randomised controlled trials.Bmj,344, e70. Foster, C., Fenlon, D. (2011). Recovery and self-management support following primary cancer treatment.British journal of cancer,105, S21-S28. Inadomi, J. M., Vijan, S., Janz, N. K., Fagerlin, A., Thomas, J. P., Lin, Y. V., ... Hayward, R. A. (2012). Adherence to colorectal cancer screening: a randomized clinical trial of competing strategies.Archives of internal medicine,172(7), 575-582. Lithner, M., Johansson, J., Andersson, E., Jakobsson, U., Palmquist, I., Klefsgard, R. (2012). Perceived information after surgery for colorectal canceran explorative study.Colorectal Disease,14(11), 1340-1350. O'Connor, E. S., Greenblatt, D. Y., LoConte, N. K., Gangnon, R. E., Liou, J. I., Heise, C. P., Smith, M. A. (2011). Adjuvant chemotherapy for stage II colon cancer with poor prognostic features.Journal of clinical oncology,29(25), 3381-3388. Poston, G. J., Tait, D., O'Connell, S., Bennett, A., Berendse, S. (2011). Diagnosis and management of colorectal cancer: summary of NICE guidance.BMJ: British Medical Journal,343. Qian, H., Yuan, C. (2012). Factors associated with self-care self-efficacy among gastric and colorectal cancer patients.Cancer nursing,35(3), E22-E31. Siegel, R., DeSantis, C., Jemal, A. (2014). Colorectal cancer statistics, 2014.CA: a cancer journal for clinicians,64(2), 104-117. Silver, J. K., Baima, J. (2013). Cancer prehabilitation: an opportunity to decrease treatment-related morbidity, increase cancer treatment options, and improve physical and psychological health outcomes.American Journal of Physical Medicine Rehabilitation,92(8), 715-727. DeSantis, C. E., Lin, C. C., Mariotto, A. B., Siegel, R. L., Stein, K. D., Kramer, J. L., ... Jemal, A. (2014). Cancer treatment and survivorship statistics, 2014.CA: a cancer journal for clinicians,64(4), 252-271. Glimelius, B., Tiret, E., Cervantes, A., Arnold, D. (2013). Rectal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up.Annals of oncology, nursing 24(suppl_6), vi81-vi88. Gustavsson, B., Carlsson, G., Machover, D., Petrelli, N., Roth, A., Schmoll, H. J., ... Gibson, F. (2015). A review of the evolution of systemic chemotherapy in the management of colorectal cancer.Clinical colorectal cancer,14(1), 1-10. Kreso, A., O'brien, C. A., van Galen, P., Gan, O. I., Notta, F., Brown, A. M., ... Pollett, A. (2013). Variable clonal repopulation dynamics influence chemotherapy response in colorectal cancer.Science,339(6119), 543-548. Stoffel, E. M., Mangu, P. B., Gruber, S. B., Hamilton, S. R., Kalady, M. F., Lau, M. W. Y., ... Limburg, P. J. (2014). Hereditary colorectal cancer syndromes: American society of clinical oncology clinical practice guideline endorsement of the familial riskcolorectal cancer: European society for medical oncology clinical practice guidelines.Journal of clinical oncology,33(2), 209-217. Van Cutsem, E., Cervantes, A., Nordlinger, B., Arnold, D. (2014). Metastatic colorectal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up.Annals of oncology, mdu260.