Chapter 7 Flashcards
What is cancer?
Abnormal, uncontrolled multiplication of cells
Cancer staging: Refers to how far the cancer has spread in the body.
Three important factors:
The invasiveness of the tumour
Presence or absence of lymph node involvement
Presence or absence of distant metastases [Metastases is the process where cancer cells travel through the blood or body tracks to more distant parts o the body. I.e., breast cancer in the lungs, bone, and brain metastases]
Health disparities in Cancer with Canada
In Canada, Black, Indigenous, and people of colour are less likely to receive health care equal to that received by White people due to racism and discrimination; this extends into worse cancer detection, diagnosis, and treatment (Ahmed & Shahid, 2012).
Indigenous peoples receive less optimal cancer care and show worse survival rates after a diagnosis of cancer (Marrett, Hones, & Wishart, 2003)
Screening for cervical, breast and colorectalcancer has been shown in population based research to be consistently lower among immigrants and among people in the lowest income quintile (Lofters et al., 2018)
Lung cancer incidence is highest in people in low income groups, and lower education (Hajizadeh, Johnston, & Manos, 2020)
[Action is required in screening, diagnosis and treatment.
With respect to poverty, rural locations, and cultural barriers.
We need more integration of person centered, time efficient quality care with navigational support]
Typical treatment options for cancer
No single treatment is effective for all types of cancer. A combination approach may be needed.
Surgery
Radiation therapy: Destroys cells that divide rapidly.
Side effects: fatigue, weakness. Can also cause secondary cancers at a much later time. (Radium: is the discovery would allow destruction of rapidly multiplying cells)
Chemotherapy: Works by blocking metabolic processes involved in cellular division, and although it preferentially destroys cancerous cells, also damages healthy tissue.
Side effects: hair loss, nausea, ulcers, sleep problems
Might be primary or adjuvant [means that it is an axillary treatment that helps another one]
- Common to have surgery first, than chemo adamant.
Conventional Medicene
Explanations of health and illness are based on:
Empirical evidence and objective data
Logic and facts
Parsimony: Explaining health phenomena by the use of fewest causes. Also known as Occam’s razor. (Parsimony is the simplest solution which is also tends to be the right one in medicine –> Occam’s razor (the razor refers to cutting out the unnecessary explanations)
Rigorous evaluation of explanations through science
Explanations are tentative so we can be open to new or better evidence
Complementary and Alternative Medicine (CAM)
Diverse set of therapies, products, and healing philosophies. Also known as “integrative medicine.”
Mind-body interventions
Systems-oriented approaches
Manual healing methods
Take the person in as a whole account, not just a recipient of conventional medical system.
Mind-body Interventions
Psychotherapy and support groups
Meditation
Imagery/visualization (can help with side effects, like hot flashes, anticipatory nausea and vomiting from chemotherapy)
Yoga, dance therapy, other movement therapies
Music therapy and art therapy
Prayer
1) Carlson et al. relaxation and imagery helped depressed mood, and showed small decrease in anxiety and stress, reduced nausea and vomiting,
Mediation and yoga showed good improvements for cancer patients with stress and anxiety and improved fatigue.
2) Art therapy was examined in a 5 year minimized control trial control or therapy
It showed reduced anxiety, and depression while also increasing better quality of life. (in early stages of study)
System-orientated approaches
Traditional Chinese medicine
Acupuncture and acupressure
Herbs
Cupping
Moxibustion (burning of mugwort)
Naturopathic medicine
Diet/nutritional approaches
Community-based practices
Ayurveda
Homeopathic medicine
Community based practices –> sweat lodges (indigenous), or Latin American Codon Dotty Small healers
Homeopathic –> remedies create symptoms that are similar to the patient may be experiencing (i.e., nausea) but it is in tiny does and the remedies are very very diluted which have a curative effect
Manual Healing Methods
Osteopathic medicine
Chiropractic treatment
Massage therapy
Biofield therapeutics
Reflexology
Other types of body work: Feldenkrais method, Trager method
Bioenergetics
Culture and treatment approaches
Conventional medicine often see CAM as “alternative” instead of an integrative approach
For many cultural groups, CAM treatments are not alternatives, but primary treatments
In a review of Indigenous people with cancer, use of traditional medicine was common alongside conventional cancer treatment and was associated with spiritual, emotional and cultural benefits (Gall et al., 2018)
Health care providers need to be respectful when engaging in conversations about treatment options and use of CAM and traditional medicine
Indigenous treatment review in Australia, Canada and the US.
Other alternative treatments “unorthodox treatments”
Treatments that the conventional medical establishment considers unproven or potentially harmful (i.e., apricot pits, shark cartilage; but those are commonly used in other cultures)
Until recently, medical marijuana was considered alternative
Interesting link, for your interest on efficacy of medical marijuana for a variety of chronic medical illnesses, including cancer, from Washington DC:
Common medicine comes from plants i.e., penicillin comes from mold.
Medical marijuana has shown to reduce nausea, pain, appetite loss, and anxiety in people with cancer
Recent reviews show moderate quality evidence for pain reduction.
The placebo effect
A positive outcome to a treatment that a person believes to be an effective therapy
Expectations have a profound effect on healing
Complicated, because patients are supposed to provide informed consent to all treatment, so it’s difficult to tell someone it’s “just a placebo.”
Placebo substances can have known therapeutic actions but not for the illness or disease in question
Believing in a treatment can be just as effective as a treatment
Intercessory Prayer
This is when someone else prays for you.
In studies, ill patients have been randomized to being prayed for versus not being prayed for.
In one study, those who received prayer had fewer illnesses due to AIDS, less frequent doctor visits, and fewer days in the hospital (Sicher et al., 2008)
But when studies are examined all together, no significant effect of prayer on death rates or health, across a number of illnesses. (Only Individual studies have had an effect)
Ways of coping
Various coping strategies may be employed to achieve different purposes when facing life-threatening illness
Emotion-focused coping
Problem-focused coping
Meaning-based coping
Dynamic and static –> people use multiple coping strategies
Problem and focused coping
These are strategies focused on taking action and establishing a sense of control
Manage the problem causing distress
In the face of illness, seek information about diagnosis and determine options for treatment; living with illness and the prognosis
Hallmark: pursuit of personal and meaningful goals
Emotioned focused coping
These are strategies focused on changing one’s emotional reaction to life threatening illness
Examples:
Talking to someone who understands your feelings
Seeking support and reassurance
Distraction
Distraction as a way to gain some distance from emotions
Hallmark: regulates their level of distress, escape the impact of the stressful stions through distancing or reframing
Denial
