As the U.S. population grows in number and in age, the question of how we will continue to provide health care for our citizens is a critical one. An imminent nursing shortage—as evidenced by the lack of sufficient students currently enrolled in nursing programs—has made nursing one of the most in-demand careers in coming decades, with the Bureau of Labor Statistics expecting better than average job growth for the field between 2010 and 2020. And with the population of older Americans expected to increase as baby boomers reach retirement age, nurses specializing in treating patients with cancer—a disease that disproportionately affects those over 55—might be in especially high demand. Unfortunately, the overall shortage of trained nurses could mean a decline in the quality of oncological care. Oncology nurses are a crucial component of quality cancer treatment across the spectrum of care. However, as the Oncology Nursing Society states, “the shrinking nurse workforce ultimately will result in fewer nurses who choose oncology nursing as a career, stay in oncology nursing, and become certified in oncology nursing. The quality of cancer care may be negatively impacted as a result.”
This only proves how valuable nurses are to providing effective care to patients battling cancer, a disease that takes many shapes and continues to leave more questions than answers about its causes, treatments, and outcomes. Cancer is a frightening diagnosis for most people to receive, and the job of the health care professional, particularly one specifically trained in cancer care, is to help the patient through the long process beginning with the initial diagnosis. This process will often include surgery, radiation, chemotherapy, alternative therapies, follow-up care, palliative care, or hospice. Throughout this long process, the oncological nurse will provide direct care to patients; educate patients and their families; coordinate care across the health care spectrum; and act as a consultant to other health care professionals.
Melanoma, Gastric and Ovarian Cancer Care: An Examination of Risk Factors, Prevention and Diagnosis
Once the diagnosis of cancer has been made, a doctor will make a determination of how far the cancer has progressed. This staging process helps the patient’s medical team decide what might be the most appropriate treatment. In its early stages, cancerous cells can often be removed surgically. Chemotherapy and radiation therapy can be used in addition to surgery or by themselves when surgery is not possible. Other possible treatments include biological therapy (or biotherapy), which helps boost the immune system’s response to cancer and other diseases, photodynamic therapy, and complementary treatments such as acupuncture and meditation. Some of these treatments have very unpleasant side effects for patients, and if this is the case, palliative care is an essential part of the recovery process.
Because of its high rate of early detection, melanoma is often removed easily without a need for major surgery (in some cases, it can even be removed during the biopsy process). Those with more advanced melanoma might need additional treatment. Plastic surgery might be necessary if a lot of skin was removed from the cancerous area. Those who have had melanoma are at high risk for developing it again, so proper preventative measures and continuing follow-up care will be necessary for the rest of the patient’s life. Survival rates for melanoma are over 90% when the cancer is confined to the primary site, and considerably less (below 70%) when it has already spread to regional lymphnodes.
Treatment for gastric cancer almost always includes a partial or total gastrectomy. Chemotherapy and radiation therapy will probably be used in addition to surgery to help stop further spreading of cancerous cells. After stomach surgery, a patient’s diet will probably have to be altered to prevent gastrointestinal problems such as cramps, bloating, and nausea. Supplemental vitamin D, calcium, and iron might also be required. The survival rate for stomach cancer is just over 60% for early stage, localized cancer and under 30% for cancer that has spread.
In the case of ovarian cancer, a laparotomy will be performed and the ovaries, fallopian tubes, uterus, and nearby lymphnodes are removed. (For women that might want to become pregnant, less aggressive surgery might be appropriate if the cancer has not spread.) Post-operative symptoms for those who have had this procedure are similar to those of menopause due to the body’s sudden loss of hormones. Chemotherapy is often used in conjunction with surgery; radiation therapy is rarely used in cases of ovarian cancer. Survival rates for ovarian cancer when caught early are over 90%.
For each diagnosis of cancer, a team of health care professionals becomes responsible for the well being of a patient whose life has suddenly been changed forever. Oncology nurses, perhaps more than other members of the health care team, have a special role as an educator and advocate for patients and their families as they navigate the often difficult waters of cancer treatment. As hospitals and treatment centers find ways to cut costs, nurses are a critical part of maintaining quality of care for patients whose very life depends on the type of treatment they receive. Finally, and perhaps most importantly, nurses often provide that intangible human connection that can be so important to a patient’s chance at a positive outcome. For all these reasons, oncology nurses are, and will continue to be, an invaluable part of cancer care in the twenty-first century.