Bowel Cancer Symptoms and Treatment

Introduction

Bowel cancer which is also called colorectal cancer is reported with different factors and shows several signs and symptoms in patients like Sam (YouTube, 2017). This disease creates significant challenge for healthcare professionals due to its complex nature that has potential life-threatening consequences (Bouvier et al., 2020). Bowel cancer is prevalent in Australia and becomes the fourth most diagnosed cancer following prostate and breast cancer (AIHW Canberra,2020).

Risk factors, signs and symptoms of bowel cancer

The several risk factors which can cause bowel cancer such as sedentary lifestyle; high use of alcohol, tobacco, sugary and processed foods and beverages; family history; age; increased exposure to the radiation; inflammatory bowel disease (AIHW Canberra,2020). Some of these risk factors could be the reason of Sam’s bowel cancer such as age and busy lifestyle. The risk of having bowel cancer increases with age over 50 years but now in Australia the cases of bowel cancer are increasing for young adults (Bowel cancer Australia, 2024). In case of Sam, since his age is 33 it can be a factor for him to develop bowel cancer but it cannot be specifically reasoned to be so.

The common signs and symptoms of bowel cancer includes persistent change in bowel habits such as diarrhoea or constipation along with blood in stool, which is accompanied by abdominal discomfort or pain, unexplained weight loss, extreme fatigue or tiredness without any specific reason, feeling of incomplete bowel emptying (O’Donoghue et al., 2019). These all are the symptoms that Sam is suffering in our case study.

Studies of Imaging and Investigations

Different imaging studies and investigations are used to identify the bowel cancer’s diagnosis, stages which help to manage or treat it at early stages. As per Bowel cancer Australia, (2021) in terms of diagnosing the bowel cancer, the Colonoscopy is considered as gold standard. This process enables visualizing the rectum as well as the colon, which allows to know where exactly the cell mutation is. Biopsy is another process which includes gathering samples of tissue for the microscopic evaluation to know the existence of the cells that are cancerous alongside the type of the cancer.

Moving further, techniques of imaging like CT scan or the MRI method pioneer critical functions. The CT scan offer comprehensive visualization of the pelvis region and the abdomen part, that helps to evaluate the range of how much the tumor spread along with the existence of the metastates.According to Shah & Itzkowitz (2022) the scans of MRI seem to be more appropriate when the outcomes of CT scan does not provide any conclusion, as CT scan could assist to assess the involvement alongside invasion of the tumor to the organs.

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Moreover, blood tests that include tracking the levels of carcinoembryonic antigen provide invaluable information regarding the response of the treatment as well as regarding the identification of recurrence of cancer. An increase in the levels of CEA might connect with the existence of the bowel cancer along with its growth. People that possess a historical context of having bowel cancer or other particular genetic syndromes through generations might go through genetic evaluations for recognizing the mutations that are in association alongside the elevated threat of the colorectal cancer formation (Young et al., 2021). 

Role and responsibilities of HCPs

The health care team members which will help Sam to manage his symptoms at stage four colon cancer includes nurses, surgeons, and allied health professionals.

The allied health professionals is a multidisciplinary team which includes social workers, occupational therapists, dietitian, cancer care coordinator, medical oncologists, physiotherapists etc. who plays different roles in terms of emotional wellbeing, body positioning, diet, assessing living and work environment (Cancer council NSW, 2021).

Nurses collaborate with multidisciplinary teams for following individualised and personalised treatment plans which are based on specific condition of the patient such as medication adherence to manage pain and other symptoms (Myers et al., 2019). Surgeons might include surgery or chemotherapy or radiation therapy, for providing targeted therapy and immunotherapy for the same in advanced cases. (Goodman et al., 2021).

Symptoms management at end of life

Symptom management at the end of life for individuals like Sam with bowel cancer usually focuses on providing comfort to improve the quality of life. The different symptom management with the medicines and non-pharmacological approaches are:

Pain management: At this stage of bowel cancer pain management is important which usually involves the use of opioids and adjuvant medications. The most common pain medications used at end-of-life stage are morphine and hydromorphone. The non-pharmacological therapies include physical and cognitive therapies such as massage and distraction therapy (Henson et al., 2020). One medicine that is used for pain management is Celebrex which offers relief (Saxena et al., 2020). Acupuncture and reflexology are the two non-pharmacological interventions for the pain management of bowel cancer (Grant et al., 2022).

Nausea and vomiting: Nausea and vomiting could be addressed with antiemetic Medications followed by dietary modification and relaxation technique. Fatigue may be managed so energy conservation strategies along with adequate rest and pharmacological interventions if required for the patient (Nadeem et al., 2020). The use of ondansetron medicine is used for this (Afzal et al., 2020). Acupuncture and dietary modification are the two non-pharmacological interventions for this (Berger et al., 2021).

Respiratory distress: Dyspnoea which is a condition experienced by patient due to shortness of breath could be managed with the help of oxygen therapy, body position therapy and medications like opioids or benzodiazepines to reduce anxiety while positioning techniques could help to optimise breathing pattern in the patient (Paparo et al., 2024). Fluorouracil is the medicine used by the experts (Vodenkova et al., 2020). Facial airflow and breathing exercises are the two non-pharmacological interventions used (Qin et al., 2021).

Constipation: Within the context of palliative caring, the constipation as well as symptoms of bowel obstruction necessitate proper hydration, bowel rest, and even other medications like methylcellulose in terms of getting comfort (Bonnefin et al., 2023). RestoraLax is a medicine which is used by experts to treat constipation in bowel cancer (Cusimano et al., 2020). Probiotics and biofeedback training are the two non-pharmacological interventions used (Cho et al., 2021).

Anxiety and agitation: The mental disturbances within the patients of bowel cancer requires assistance via methods of counselling, assisting groups, or even through spiritual care for eliminating the inner agitation or anxiety (Kojima et al., 2019). Benzodiazepines are the medicine used for treating anxiety and agitation among patients (Aziz et al., 2020). Therapeutic touch and bright light therapy are the two non-pharmacological interventions used (Muehlenpfordt et al., 2020).

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Medical, nursing, ethical, legal considerations for morphine

Morphine is commonly used medication at end-of-life stage therefore, there are some medical, legal and nursing considerations to follow with the use of this medicine. According to WHO, 2020 all the health care facilities which offers the palliative care to the patients should have the adequate supply of this opioid to manage patient’s symptoms. The nurses play a crucial role to give medication at end-of-life stage to the patient, therefore, their responsibility is to check the patient’s rights while giving this medication. In addition to check these rights they must track the patient’s comfort level, and thoroughly evaluating the probable unfavourable impacts. The nurses also ensure accurate documentation of the medication administration and report any distress or concern to the healthcare team (NSW Government, 2022; Hopper et al., 2024).

Nurses must also consider ethical principles like beneficence or autonomy while administering morphine. They should acknowledge the patient’s symptoms for pain and should administer the pain relief along with considering the potential risk of sedation in patients same for Sam in our case study (Ahmed, 2020).

Annotation

The healthcare study done by Shah & Itzkowit. (2022) explores the in-depth connections of pathophysiology in between colorectal cancer along with inflammatory bowel disease, and even investigates the treatment, strategies, and the preventative measures. The authors of this research possess significance authorities within the sphere of gastroenterology, which further improves the credibility of the article. This study is aimed to address the experts of healthcare who has speciality within oncology and gastroenterology, further serving information within a particular patient group. This study can be contrasted with the study of Ahmed, (2020), which gives a wider viewpoint upon colon cancer, however the research of Shah & Itzkowitz, (2022) investigates more deeply within the severe complications of the colorectal cancer within the IBD, that enhance further debates upon personalized strategies for management.

The study of Ahmed, (2020) offers information regarding how to manage and diagnose the colon cancer, also unravels epidemiology, components of risk, techniques of screening, alternative treatments, as well as trend of research. The author of this study possesses expertise upon gastroenterology, which gives more credibility to this research. Furthermore, the study seeks to address the experts in healthcare sector that are working within this caring area. The study of Shah & Itzkowitz, (2022) can be compared as the authors of the study emphasizes upon the colorectal cancers throughout the patients of IBD, however the study of Ahmed, (2020) offers thorough viewpoint upon the colon cancer specifically, with thorough debate upon managing bowel cancer throughout varied demographics.

The study of Benson et al. (2019), offers suggestions based upon evidences regarding the treatment and diagnosis of the small bowel adenocarcinoma. The authors of the study have expertise upon oncology as well as in gastrointestinal malignancies. The study seeks to address the surgeons, experts, oncologists and other healthcare professionals. This study supports the study of Shah & Itzkowitz, (2022) that also emphasizes upon the colorectal cancer through dealing with approaches to management regarding the small bowel adenocarcinoma.

Conclusion

Therefore, it can be said that bowel cancer creates formidable challenge for healthcare professionals as it requires multidirectional approach which includes early detection along with comprehensive diagnostic evaluation and development of personalised treatment plan especially for end-of-life care patient.

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