ABSTRACT
Patients who present to their GP with 'red flag' symptoms for possible bowel cancer (such as change in bowel habit or rectal bleeding) are urgently referred to an acute trust as a '2 week wait' (2WW) patient and require assessment and investigation in an efficient and timely manner. The burden that is created by ever increasing numbers of referrals requires a service that is reliable and flexible in meeting demand. This article presents the development of a nurse-led 2WW service that was implemented as a direct result of this pressure. The development of the national guideline is discussed and the rationale for a nurse-led service is provided, along with the processes followed to ensure patient safety. The inclusion of a telephone side to service provision is also examined and the challenges faced by the team are discussed.
Subject(s)
Intestinal Neoplasms/nursing , Practice Patterns, Nurses'/organization & administration , Referral and Consultation , Waiting Lists , Humans , Time Factors , United KingdomSubject(s)
Antineoplastic Agents/therapeutic use , Heterocyclic Compounds, 1-Ring/therapeutic use , Intestinal Neoplasms/drug therapy , Neuroendocrine Tumors/drug therapy , Pancreatic Neoplasms/drug therapy , Peptides, Cyclic/therapeutic use , Stomach Neoplasms/drug therapy , Gastrointestinal Tract , Humans , Intestinal Neoplasms/nursing , Neoplasm Metastasis/prevention & control , Neuroendocrine Tumors/nursing , Pancreatic Neoplasms/nursing , Stomach Neoplasms/nursingABSTRACT
During my clinical placement in a hospice in my first year of training, a patient with bowel cancer was admitted.
Subject(s)
Adaptation, Psychological , Death , Intestinal Neoplasms/nursing , Nurse-Patient Relations , Students, Nursing/psychology , Hospice and Palliative Care Nursing , Humans , Interprofessional Relations , Social SupportABSTRACT
BACKGROUND: Somatostatin analogs (SSAs) are a mainstay therapy for the treatment of carcinoid syndrome associated with neuroendocrine tumors (NETs). They are effective for a range of gastroenteropancreatic NETs (GEP-NETs). Lanreotide depot (Somatuline®) is an SSA that is approved for the treatment of GEP-NETs to improve progression-free survival (PFS). OBJECTIVES: The article reviews the efficacy, safety, and administration of lanreotide depot and relates those attributes to considerations and preferences of oncology nurses and their patients. METHODS: A review of the literature on the use of lanreotide for the treatment of NETs and carcinoid syndrome was conducted. In addition, the literature on drug delivery and routes of administration was surveyed to provide context for comparative studies related to clinical and patient preferences. FINDINGS: Lanreotide depot prolongs PFS and is well tolerated by patients who expressed satisfaction in the ability to control symptoms related to carcinoid syndrome. Nurses cited several benefits to using lanreotide depot in the clinical setting, including more time saved to address other patient care issues. Attributes of lanreotide depot-including its efficacy, safety and tolerability, dosing and administration, and cost-may contribute to healthcare decisions regarding the treatment and management of NETs.
Subject(s)
Intestinal Neoplasms/drug therapy , Intestinal Neoplasms/mortality , Neuroendocrine Tumors/drug therapy , Neuroendocrine Tumors/mortality , Pancreatic Neoplasms/drug therapy , Pancreatic Neoplasms/mortality , Peptides, Cyclic/therapeutic use , Somatostatin/analogs & derivatives , Stomach Neoplasms/drug therapy , Stomach Neoplasms/mortality , Antineoplastic Agents/administration & dosage , Clinical Trials, Phase II as Topic , Clinical Trials, Phase III as Topic , Delayed-Action Preparations , Disease-Free Survival , Female , Humans , Injections, Intramuscular , Intestinal Neoplasms/diagnosis , Intestinal Neoplasms/nursing , Male , Neuroendocrine Tumors/diagnosis , Neuroendocrine Tumors/nursing , Neuroendocrine Tumors/pathology , Oncology Nursing/methods , Pancreatic Neoplasms/diagnosis , Pancreatic Neoplasms/nursing , Patient Preference , Prognosis , Somatostatin/therapeutic use , Stomach Neoplasms/diagnosis , Stomach Neoplasms/nursing , Time Factors , Treatment OutcomeSubject(s)
Adaptation, Psychological , Cooperative Behavior , Counseling , Interdisciplinary Communication , Intestinal Neoplasms/nursing , Sick Role , Caregivers/psychology , Cost of Illness , Humans , Intestinal Neoplasms/psychology , Patient Education as Topic , Power, Psychological , Quality of Life/psychology , Self Care , Self-Help GroupsSubject(s)
Analgesia, Epidural/adverse effects , Analgesia, Epidural/nursing , Catheters, Indwelling/adverse effects , Pain, Postoperative/etiology , Pain, Postoperative/nursing , Acute Disease , Adult , Analgesia, Epidural/instrumentation , Humans , Intestinal Neoplasms/nursing , Intestinal Neoplasms/surgery , Intestine, Small , Leiomyosarcoma/nursing , Leiomyosarcoma/surgery , Male , Oncology Nursing/methodsSubject(s)
Gastrointestinal Agents/therapeutic use , Intestinal Neoplasms/secondary , Intestinal Obstruction/drug therapy , Octreotide/therapeutic use , Palliative Care , Humans , Intestinal Neoplasms/complications , Intestinal Neoplasms/nursing , Intestinal Obstruction/etiology , Intestinal Obstruction/nursingABSTRACT
A one group repeated measures design was used to describe changes in body image in 45 patients treated with ostomy for bowel or bladder cancer. Body image was measured preoperatively and at two postoperative points: 1 month and in 6 months or postclosure. The Body Cathexis Scale, Draw-a-Person, and subjective responses to open-ended questions were used. There was a significant difference in Body Cathexis scores between the immediate 1 month postoperative period and 6 months later (F(2, 88) = 3.13, p = .049). Body image scores did not change significantly between the preostomy and first postostomy measures. Qualitative data suggested that cancer diagnosis and its associated concerns were paramount on subjects' minds preoperatively and thus negatively influenced body image before the creation of the ostomy. Although altered body image is an appropriate nursing diagnosis for patients with ostomy in both the preoperative and postoperative periods, other issues may be dominant especially in the preoperative period.
Subject(s)
Body Image , Intestinal Neoplasms/psychology , Ostomy/psychology , Urinary Bladder Neoplasms/psychology , Adult , Aged , Aged, 80 and over , Analysis of Variance , Female , Humans , Intestinal Neoplasms/nursing , Intestinal Neoplasms/surgery , Male , Middle Aged , Ostomy/nursing , Prospective Studies , Urinary Bladder Neoplasms/nursing , Urinary Bladder Neoplasms/surgerySubject(s)
Cancer Vaccines , Intestinal Neoplasms/nursing , Intestinal Neoplasms/therapy , Adult , Aged , Autoimmunity , Cancer Vaccines/immunology , Female , Humans , Male , Middle AgedSubject(s)
Bandages/standards , Endometriosis/surgery , Intestinal Neoplasms/surgery , Ovarian Cysts/surgery , Polyethylene Glycols/therapeutic use , Postoperative Care/methods , Wound Healing , Adult , Endometriosis/nursing , Female , Humans , Hydrogel, Polyethylene Glycol Dimethacrylate , Intestinal Neoplasms/nursing , Ovarian Cysts/nursingABSTRACT
Small bowel obstructions, which account for two-thirds of all intestinal obstruction, are caused by adhesions, hernias and cancer. Large bowel obstructions are usually the result of a malignancy, but may also be caused by diverticulitis or volvulus. Previously treated individuals with a known diagnosis of advanced cancer originating in the pelvis are at highest risk for developing intestinal bowel obstruction. Since 30 percent of Americans will develop cancer in their lifetimes, and colorectal cancer is the most common type, this represents a significant population at risk to be followed by nurse practitioners. The pathophysiology, assessment and management of an individual with a bowel obstruction is reviewed. Morbidity and mortality in this population is high. Wound healing problems, including infection, dehiscence, evisceration and fistula formation, contribute significantly to the morbidity and can cause long-term problems. In today's health care system, it's likely that patients will be discharged from the hospital earlier after bowel surgeries. Therefore, nursing care focusing on wound management is outlined.