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For the purpose of this assignment you are the Cancer Care Coordinator at the hospital where John receives his adjuvant chemotherapy for colorectal cancer. John is currently receiving his last cycle of chemotherapy and you will be meeting with him to provide education with regards to his discharge and self-management plan following the end of his active treatment.
Although curative resection is a choice of treatment in patients with colorectal cancer, the recurrence of the cancer is one of the most common and serious concern experienced the patients and their families (Makhoul, Alva, & Wilkins, 2015). The present case study discusses about John, who was diagnosed as colorectal cancer. He has undergone a high anterior resection for the tumour as an adjuvant treatment. None of the lymph nodes or the margins were involved. It indicated 18% proportional reduction in the recurrence and 2% increase in the survival rates with adjuvant chemotherapy. The main purpose of the essay is to develop a discharge and self-management plan for discussion with John before discharge. The plan would consist of a follow up regimen for John in reference to available evidences, the signs and symptoms of recurrence of colorectal cancer, the survivorship issues experienced in all the dimensions of health, the preventive strategies of the occurrence of the issues, and health education to promote improvement in the quality of life.
The discharge plan will consist of follow-up care and the symptoms associated with the recurrence of the disease.
Studies reveal that more intense follow-ups increase the curative resection rate and improvement in the survival rate (Steele, et al., 2015). The main purpose of follow-up care for colorectal cancer is to detect the recurrence of the cancer at an early stage. The follow-up care consists of physical examination, carcinoembryonic antigen (CEA) testing, colonoscopy, computed tomography (CT) abdomen CT chest, positron emission tomography (PET) or rectosigmoidoscopy (Makhoul, Alva, & Wilkins, 2015). According to the evidence, John has been detected with stage IIb (American Cancer Society, 2009) cancer. According to the staging, the follow-up regimen for John would consist of physical examination every 3 to 6 months for 2 years and every 6 months for 5 years. CEA testing must be also be done every 3 to 6 months for 2 years and every 6 months for 5 years. Colonoscopy must be done at 3 to 6 months after surgical resection, then at 1 year, 3 years and every 5 years till the detection of an advanced lesion. CT abdomen and pelvis, and CT chest must be conducted one every year for 5 years (Makhoul, Alva, & Wilkins, 2015).
Following such regime would help in early detection of a returned cancer. It would help in maintaining better health condition, managing side-effects and promote the identification of the long-term side-effects or late effects. It would further help in watching for the signs and symptoms of cancer recurrence. The risk of recurrence is highest in the first five years of treatment and thus, follow-up care is essential in this period to prevent the occurrence of complications (Veen, et al., 2015).
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