Introduction
The cancer assessment helps in identifying the normal functioning and extension of the disease pathology. Clinical clues of advanced diseases can be inferred with physical examination. It is important to infer the normal variations in assessment findings for the older adults.
Definition
It is the general head-to-toe assessment of all the body systems to identify the functioning, and any signs and symptoms of diseases or pathologies related to cancer. The findings will inform the healthcare professional on the patient’s overall condition.
Purposes
- To identify the presence of dysfunctions of any organ at the early stage.
- To understand the progress in the pathology or the stages of cancer disease for determining the treatment for the patient.
- To obtain a database for formulating nursing care plan.
Indications
- Routine protocol as a part of physical examination/screening before progressing to detailed investigation.
- Should follow up any unusual findings up with a focused assessment specific to the affected body system.
Warning signs of cancer (CAUTION):
C: Change in bowel or bladder habits.
A: Sore that does not heal.
U: Unusual bleeding or discharge.
T: Thickening or lump in the breast or elsewhere.
I: Indigestion or difficulty in swallowing.
O: Obvious change in a wart or mole.
N: Nagging cough or hoarseness.
Past Medical and Surgical History
The past medical and surgical history can often reveal pertinent information from childhood and adult illnesses, previous surgery, and an infectious, traumatic, or reactive systemic process rather than a neoplastic process.
Drug Allergy History
A drug allergy history related to medications, latex, food, vaccination, etc.
Medication History
Current prescription and patient compliance to therapy.
Social and Family History
- Exposures to hazardous materials, environmental toxins, and accidental radiation exposure.
- Family history for genetic disorders, diabetes, heart disease, allergic and autoimmune diseases, and cancer.
Habitual History
Tobacco exposure, specifically cigarette, cigar, pipe, and chewing tobacco history, should be recorded. Alcohol consumption should be quantified as type, frequency, and duration of use. Recreational drug use and lifestyle risk factors for communicable diseases such as human immunodeficiency virus (HIV), hepatitis, and tuberculosis should also be recorded.
Key aspects of cancer assessment:
1. Physical Assessment
- Cancer Type & Stage – Identify tumor location, size, and metastasis.
- Symptoms & Side Effects – Monitor pain, fatigue, nausea, and weight loss.
- Laboratory & Imaging Tests – Use blood tests, biopsies, CT scans, and MRIs for diagnosis.
2. Psychosocial & Emotional Assessment
- Mental Health Screening – Assess for anxiety, depression, and coping mechanisms.
- Quality of Life Evaluation – Identify social support, financial concerns, and emotional distress.
- Holistic Needs Assessment (HNA) – Helps tailor personalized care plans.
3. Functional & Nutritional Assessment
- Mobility & Daily Activities – Evaluate physical limitations due to cancer or treatment.
- Nutritional Status – Monitor weight changes, appetite, and dietary needs.
4. Treatment Response & Follow-Up
- Effectiveness of Therapy – Track tumor response to chemotherapy, radiation, or immunotherapy.
- Long-Term Monitoring – Ensure early detection of recurrence or complications.
Special Considerations
- Evaluate tumor type, size, and metastasis to determine disease progression.
- Monitor for treatment-related complications, such as chemotherapy-induced neuropathy or radiation burns.
- Assess pain levels and response to analgesics, as cancer pain can be complex.
- Screen for anxiety, depression, and coping mechanisms, as emotional distress is common.
- Provide counseling and support groups to help patients and families navigate the emotional impact.
- Address financial concerns, as cancer treatment can be costly and affect access to care.
- Evaluate mobility and daily activities, as cancer and its treatments can cause fatigue and weakness.
- Monitor nutritional status, ensuring adequate intake to support recovery.
- Assess for cachexia (severe weight loss), which may require specialized dietary interventions.
- Consider age-related changes that may affect treatment tolerance.
- Use child-friendly approaches to reduce anxiety and improve cooperation.
- Adjust treatment plans for those with diabetes, cardiovascular disease, or renal impairment.
- Track tumor response to therapy and adjust treatment as needed.
- Monitor for late effects of cancer treatment, such as secondary malignancies or organ damage.
- Ensure early detection of recurrence through regular screenings and follow-ups.
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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