97. CCA Study Notes: Cancer, Treatment, and Supporting Clients Living With Cancer

The Big Picture

Your body normally makes new cells for growth and repair. These cells usually divide in an orderly, controlled way. Cancer develops when cell division and growth become uncontrolled.

Cancer affects people of all ages and starts in different body systems. Treatment depends on the cancer, where it is located, its size, and whether it has spread.

People living with cancer also need physical, emotional, and social support. CCAs play an important part in providing this support while protecting the client’s privacy.

Look for Nova Scotia CCA Notes throughout this page for current provincial guidance.

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Course Notes: Key Ideas You Need to Know

What Cancer Is

Cells throughout the body reproduce for tissue growth and repair. Normally, this cell division follows an orderly and controlled pattern.

Cancer is a group of diseases involving uncontrolled cell division and growth. This uncontrolled growth leads to a lump or mass of cells.

Cancer starts in different body systems.

Understanding Tumours

A tumour is a new growth of abnormal cells.

Tumours fall into two main groups.

Benign Tumours

Benign means noncancerous.

Benign tumours:

• grow slowly
• stay contained within one area
• do not usually cause death

Malignant Tumours

Malignant tumours are cancerous. They invade and destroy other cells or tissues.

Malignant tumours:

• grow rapidly
• often invade other tissues
• may affect several body systems
• can cause death

What Metastasis Means

Metastasis is the spread of cancer to other parts of the body.

Cancer cells break away from the original tumour and travel to other body parts. New tumours then grow in those areas.

Death occurs if the cancer is not treated or controlled.

Common Cancer Sites

Common cancer sites include:

• lungs
• breasts
• prostate
• colon and rectum
• uterus
• urinary tract
• skin

Cancer occurs in all age groups. It is the second leading cause of death in Canada.

Some cancer statistics and patterns include:

• In 2020, breast cancer accounted for one out of every four cancers diagnosed in Canadian women.
• In 2020, 13% of all cancer deaths in women were expected to result from breast cancer.
• Prostate cancer is the most common cancer among Canadian men when nonmelanoma skin cancer is excluded.
• Prostate cancer is the third leading cause of cancer death among men in Canada.
• Acute lymphoblastic leukemia, a type of blood cancer, is the most common cancer in children.

Factors That Contribute to Cancer Development

The exact causes of cancer are unknown. Certain factors contribute to its development.

These factors include:

• a family history of cancer
• smoking
• alcohol abuse
• a high-fat, high-calorie, low-fibre diet
• exposure to radiation, including sun exposure
• exposure to certain cancer-causing chemicals
• hormones
• viruses

Warning Signs of Cancer

Important warning signs include:

• a new or unusual lump or swelling in the breast, testicles, or another area
• a sore on the body or in the mouth that does not heal
• a mole or wart that changes noticeably in shape, size, or colour
• an ongoing cough, hoarseness, or croaky voice
• trouble swallowing
• blood appearing in urine, stool, or phlegm
• unusual bleeding or discharge from the nipple or vagina
• changes in bladder habits, including painful or difficult urination
• constipation or diarrhea that continues for more than a few weeks
• indigestion that does not go away
• weight loss, fever, or fatigue without an explanation
• aches or pains with no known explanation
• a new skin growth, or skin patches that bleed, itch, or turn red

Goals of Cancer Treatment

Cancer treatment depends on:

• the type of tumour
• the tumour’s location
• the tumour’s size
• whether the cancer has spread

Treatment has greater success when cancer is detected as early as possible.

One treatment or several treatments might be used. Treatment goals include:

• curing the cancer
• stopping the cancer from spreading
• slowing the cancer’s growth
• relieving symptoms caused by the cancer

The three most common treatments are surgery, radiation therapy, and chemotherapy. Stem cell transplantation also treats some cancers, especially cancers affecting bone marrow.

Surgery

Surgery removes tumours and treats cancer contained within one area.

Surgery involves removing:

• malignant tissue
• surrounding tissue
• lymph nodes that might contain cancer cells

Surgery has a greater chance of success when the tumour has not spread to other areas.

Radiation Therapy

Radiation therapy uses high-energy rays directed at a tumour to destroy cancer cells. Like surgery, it treats localized cancers ⓘ.

Radiation therapy is used:

• alone
• with surgery
• with chemotherapy

Treatment usually continues over a period of weeks.

Radiation therapy destroys living cells. Normal cells sometimes get destroyed along with cancer cells.

Adverse effects include:

• discomfort
• nausea and vomiting
• fatigue
• anorexia, which means loss of appetite
• diarrhea

Skin breakdown sometimes occurs in the area receiving radiation. A physician might order special skin care procedures.

Important: Markings placed on the body to show where radiation will be given should not be washed off.

Chemotherapy

Chemotherapy is also called cytotoxic therapy.

Chemotherapy uses strong drugs that enter the bloodstream and target cancer cells throughout the body. The drugs are given orally or intravenously.

Chemotherapy affects normal cells as well as cancer cells. Its adverse effects ⓘ are sometimes severe.

The digestive tract may become irritated. Nausea, vomiting, and diarrhea may result.

Other adverse effects include:

• stomatitis, which is inflammation of the mouth
• alopecia, which is hair loss

Chemotherapy can decrease the production of blood cells. As a result, the client:

• may tire easily
• has a risk of bruising
• has a risk of bleeding
• has a risk of infection

Stem Cell Transplantation

Stem cell transplantation involves putting healthy stem cells into the body.

It is sometimes necessary when bone marrow stops working and does not produce enough healthy stem cells.

Stem cell transplantation can help the body make enough:

• white blood cells
• red blood cells
• platelets

This can reduce the risk of life-threatening infections, anemia, and bleeding.

The name of the procedure also depends on the source of the stem cells. It is also known as bone marrow transplantation or umbilical cord blood transplantation.

There are two sources of stem cells:

• Autologous stem cell transplantation: uses cells from the client’s own body.
• Allogenic stem cell transplantation: uses stem cells from donors.

Stem cell transplantation is not widely available across the country. Certain cancer centres undertake trial cases.

Supporting a Client Living With Cancer

Clients living with cancer have physical care needs.

Ways to support the client include:

• providing relief or control of pain
• ensuring adequate rest and exercise
• providing fluids and good nutrition
• preventing skin breakdown
• preventing bowel elimination problems
• managing adverse effects of radiation therapy and chemotherapy

Pain medications result in constipation. Chemotherapy results in diarrhea.

Emotional and Social Support

Clients living with cancer often have significant emotional and social needs. Their families and loved ones also need support.

Common emotions include:

• anger
• fear
• depression

Surgery sometimes changes the appearance of the affected area. The client might feel unwhole, unattractive, or unclean afterward.

Talk to the client. Do not avoid the client because you feel uncomfortable.

Protect the Client’s Privacy

The client’s personal information stays private.

Never discuss the client or details about the client with anyone who is not involved in the client’s care.