Category: Cancer

The human body consists of an uncountable amount of living cells. Normal cells grow then divide into new ones, dying in the end. Cancer can appear when normal body cells begin to grow at an abnormal rate. The growth rate of cancerous cells is different from one of the normal cells because instead of dying, they continue growing to create new cells. Moreover, these abnormal cells are also able to invade other tissues within a human body, a quality that is not possible for healthy cells (American Cancer Society Melanoma Skin Cancer 1).

Skin Cancer

There are two different types of skin cancer: non-melanoma skin cancer, which is considered very common and not very serious, and the malignant melanoma that is considered serious but less common than non-melanoma cancer. Melanoma skin cancer begins in melanocytes and can appear anywhere on the skin, but the most prevalent areas are neck and face, the legs in females and chest, and back in males. Melanoma can also easily for in other parts of the body, although these cases are far less spread. Non-melanoma skin cancer, or otherwise called basal and squamous cell skin cancer, is the most common type of skin cancer. However, it rarely spreads to other parts of the body and is usually less concerning as it is treated differently to melanoma.

The Structure and Function Relationship in the Body

Skin cancer is very often considered a disease connected with the cell cycle, although it is not actually the case, as cancer cells can easily grow and divide. The actual problem is understanding why the cancerous cells grow and divide while healthy cells do not. Simply put, skin cancer is a disease closely connected with cell growth control or with the checkpoint system. Modern scientists are trying to develop a medication that will affect the checkpoint system of cancer cells, as without it, the cancer cells can die (The Theme of Regulation in the Cell Cycle, Cellular Growth, and Cancer 8).

Current Research

The recent research conducted by the American Cancer Society suggested that there are two different ways UV rays cause skin cancer. The first way is connected with exposure to the sun in childhood. Such early exposure to the sun causes changes in DNA that then can cause further development of skin cancer. Some researchers speculate that this is the reason for melanoma on the legs and back, parts of the body that are not as exposed to the sun in adulthood. The second way is connected with skin cancer on the neck, face, and arms, areas often exposed to the sun in adults, especially in men. Moreover, scientists are exploring melanomas that start from UV exposure and the changes in DNA they cause in order to figure out whether they should be treated in different ways (American Cancer Society Melanoma Skin Cancer Overview 4).

The Importance of Skin Cancer Awareness

Raising awareness for skin cancer is important for two main reasons: taking some simple steps can prevent it, and at earlier stages, it is straightforward in treatment. Thus, the topic of skin cancer is important because of its danger to society, as in 2015, the American Cancer Society accounted for more than 73,000 cases of skin cancer (American Cancer Society Skin Cancer Facts 5).

Works Cited

American Cancer Society, Melanoma Skin Cancer. 2015. Web.

Melanoma Skin Cancer Overview and Research. n.d. Web.

Skin Cancer Facts. n.d. Web.

The Theme of Regulation in the Cell Cycle, Cellular Growth, and Cancer. n.d. Web.

Abstract

Testicular cancer is one of the rarest forms of cancer that affects men. It is more prevalent in men aged between 15 and 35 years. It develops in the testicles, and its symptoms include painless lumps or swellings in the testicles, fluid buildup in the scrotum, pain around the groin area, and discomfort in the scrotum. Treatment depends on the severity of the cancer. The most common remedies include chemotherapy, radiotherapy, surgery, and stem cell transplant. Physicians recommend regular self-examination of the testicles as a preventative measure. Individuals are advised to watch out for abnormal swelling or lumps in the testicles or scrotum. Testicular cancer is a curable disease if diagnosis early.

Introduction

Testicular cancer is a common disease among men, and develops in the testicles. It mainly affects males between the ages of 15 and 35, and manifests through the occurrence of lumps or swellings in either of the testicles. There are four main types of testicular cancer, namely germ cell testicular cancer, lymphoma, Sertoli cell tumors, and Leydig cell tumors (Govindan, 2008). The diseases incidence is low and accounts for approximately 1% of all cancer cases in men (Verville & Bozzone, 2009). The most common type is germ testicular cancer and has two subtypes, namely seminomas and non-seminomas. It is a treatable and curable disease. Therefore, early detection and diagnosis is necessary.

Nature and Causes

The main risk factors for testicular cancer include family history, HIV or Aids, abnormal testicle development, race, age, undescended testicle, hypospadias, fertility problems, vasectomy, testicular injuries, inguinal hernia, and family history (Govindan, 2008). Abnormal development of testicles increases the risk of testicular cancer development. Individuals whose families have histories of this cancer are at high risk. The most affected age group is that of young men between the ages of 15 and 35. Testicular cancer can occur at any age. However, incidence rates among older men are low. Testicular cancer is more prevalent among while men than black men. The development of undescended testicles is known as sryptorchidism (Lin, 2015). This condition involves the failure of scrotum to descend from the abdominal region into the scrotum. Current research has revealed that certain genes could be involved in the development of testicular cancer. In that regard, a history of the disease in a family increases the likelihood of its development in other family members (Verville & Bozzone, 2009).

Signs and Symptoms

The main symptom of testicular cancer is the occurrence of painless lumps or swelling on both or one of the testicles. The main signs include a feeling of heaviness and a dull ache in the scrotum (Verville & Bozzone, 2009). One scrotum may become harder than the other one or it could appear bigger. In many cases, victims experience a sudden accumulation of fluid in the scrotum, lower back pain, shortness of breath, and swellings on one or both legs (Lin, 2015). In rare cases, breasts become tender or enlarge due to the effect of a hormone known as gynecomastia. In rare cases, certain Leydig cell tumors secrete estrogen that causes early puberty in boys. The symptoms of advanced testicular cancer include low back pain, headaches, chest pain, shortness of breath, and belly pain (Lin, 2015).

Laboratory Tests Used in Diagnosis

Tests used to diagnose testicular cancer include blood tests, ultrasound scans, and magnetic resonance imaging (MRI) scans (Hamilton, 2007). The main purpose of conducting blood tests is to check blood for the presence of proteins referred to as tumor markers (Hasan, 2011). The blood of a patient with testicular cancer contains a very high concentration of protein markers. Physicians test blood for three types of protein markers, namely alpha feta protein (AFP), human chorionic gonadotrophin (HCG), and lactate dehydrogenase (LDH) (Hamilton, 2007). Abnormally high levels of these proteins signify the presence of testicular cancer. Ultrasound scans are effective in the diagnosis of testicular cancer because they identify the changes in the testicles normal morphology such as swellings and abnormal lumps (Hamilton, 2007). In addition, they are used to determine whether a lump is cancerous or malignant, and whether it is located in the testicle or the scrotum. In many cases, physicians conduct scans of both the scrotum and the testicles. A scan of an affected testicle shows the presence of solid lumps and a fluid-filled cyst (Hamilton, 2007).

Role of Periodic Acid-Schiff Stain in Diagnosis

During the diagnosis process, periodic acid-Schiff stain (PAS) is used to enhance the visualization of cancerous cells during the examination of samples under the microscope (Lin, 2015). The stain gives the cells a distinct color for better observation. Intratubular germ cell neoplasma cells are indications of the presence of testicular cancer. PAS is used to improve the visualization of PAS-positive vacuoles in cells that contain intratubular germ cell neoplasma. PAS is commonly used to stain neutral mucus substances such as glycoprotein (Lin, 2015).

Prevention and Treatment

Several remedies are used to treat testicular cancer. They include surgery, radiation therapy, chemotherapy, high-dose chemotherapy, and stem cell transplant (Hasan, 2011). In certain cases, more than one treatment remedies are used. The type of treatment method applied depends primarily on the type of cancer and the stage of development (Lasley, 2011). Surgery involves the removal of the affected testicle and lymph nodes. In case tumors have spread to other body parts, they are removed too. Radiation therapy uses high-energy radiation to annihilate cancerous cells. Approaches used include internal and external radiation treatment (Hasan, 2011). Chemotherapy involves the use of drugs to treat cancer by destroying them or stopping their growth (Lasley, 2011). High dose chemotherapy and stem cell transplant involves administering doses of chemotherapy and using stem cell technology to replace cancerous blood-forming cells (Hasan, 2011). Testicular cancer can be prevented by performing regular testicular self-examinations and contacting a physician in case swellings or lumps are detected.

Conclusion

Testicular cancer is a rare type that mainly affects men between the ages of 15 and 35 years. The cause is unknown. However, researchers have identified several factors that increase the risk of development. They include family history, abnormal testicular development, age, and race. Major symptoms include painless swellings, aches in the scrotum, and a feeling of heaviness in the scrotum. The most common type of testicular cancer is the germ cell testicular cancer. It manifests in two main types, namely seminomas and non-seminomas. Several methods and approaches are used in the treatment of testicular cancer. The most commonly used approaches include surgery, radiation therapy, chemotherapy, and high-dose chemotherapy and stem cell transplant. In some cases, different methods are used to increase the effectiveness of treatment in cases where the cancer has reached advanced stages. Physicians recommend regular testicular self-examination as a prevention strategy.

References

Govindan, R. (2008). The Washington manual of oncology. New York, NY: Lippincott Williams & Wilkins.

Hamilton, W. (2007). Cancer diagnosis in primary care. New York, NY: Elsevier Health Sciences.

Hasan, H. (2011). Testicular cancer: current and emerging trends in detection and treatment. New York, NY: The Rosen Publishing Group.

Lasley, I. (2011). 21^st century cancer treatment. New York, NY: Isaac Lasley.

Lin, D. W. (2015). Testicular cancer, an issue of urologic clinics. New York, NY: Elsevier Health Sciences.

Verville, K., & Bozzone, D. M. (2009). Testicular cancer. New York, NY: Infobase Publishing.

Introduction

The rate of cervical cancer prevalence in Australia is 7 cases per 100,000 women (Cervical Cancer: What is Cervical Cancer? 2014). Cervical cancer has been cited as the cause of approximately 1.7% of all deaths caused by cancer in Australia (Cervical Cancer: What is Cervical Cancer? 2014). Its prevalence in Australia declined significantly after the introduction of the National Cervical Screening Program (Cervical Cancer: What is Cervical Cancer? 2014).

Cervical cancer is a preventable disease with early diagnosis and proper utilisation of diagnostic procedures. Precancerous lesions undergo several stages of growth before they develop into invasive cancer that is difficult to treat. Understanding the role of imaging and radiation therapy in the diagnosis and treatment of cervical cancer is important, especially for effective prevention and management. In addition, it can contribute significantly toward the reduction of deaths and new cases of cervical cancer reported every year in Australia and other parts of the world. Imaging is one of the procedures conducted during diagnosis to determine whether cancer has spread to other parts of the body (Cervical Cancer in Australia, 2016).

Radiation therapy is a treatment remedy that involves the use of high-energy radiation to annihilate cancerous cells. In certain cases, radiation therapy is used as the only treatment method. Proper treatment is based on proper cancer staging that is conducted using medical imaging technologies. Evaluation of past research studies and medical literature will be conducted in order to obtain more information regarding the topic.

Imaging

Advances in imaging technology have improved the diagnosis of cervical cancer by enhancing the precision of determining its spread to other body parts. Advanced diagnosis methods have lowered their prevalence. The incidence of cervical cancer in Australia in 2015 is shown in the table below.

Table 1: 2015 prevalence of cervical cancer in Australia by age group (Cervical Cancer in Australia, 2016).

The most common imaging technologies used in the diagnosis of cervical cancer include computed tomography (CT), Ultrasound (US) and magnetic resonance imaging (MRI). Others include positron emission tomography (PET), ultrasonography, and lymphangiography.

Role of imaging in cervical cancer diagnosis

Ultrasonography is used to identify uterine and cervical leiomyomas and evaluate the urinary tract for the incidence of obstruction in cases where cancer has spread to other body organs (Saksouk, Coombs, Reuter, & Lin, 2015). In addition, it is used to determine the size of the cervix. It has low contrast resolution. Therefore, it is not an effective imaging technique to visualise tumours. Computed tomography is now widely used and has become a common technique because of technological advancements.

However, it has several limitations that include contrast enhancement, inconsistency in the direct visualisation of primary cancer tumours, inaccuracy with regard to detection of tumours that invade the bladder, and inclusion of metastasis in images of normal-sized lymph nodes. A CT is performed by taking several cross-sectional images of the cervix and adjacent organs.

The roles of CT in cervical cancer staging include evaluation of cervix size and detection of abnormalities involving lymph nodes (Choi, Ju, Myung, & Kim, 2010). It is also useful in determining whether cancer has spread to other body regions and organs. In addition, it facilitates the identification of obstruction in the ureter (Cervical Cancer in Australia, 2016). Its effectiveness and efficiency are limited by the use of tissue discriminator media because it does not aid in the determination of lymph nodes architecture.

MRI is used by many doctors because of its cost-effectiveness and ability to produce high tissue contrast resolution. The main role of MRI in diagnosis is the determination of cervix size and identification of cervical invasion (Saksouk et al., 2015). Moreover, it is used to study the characteristics of lymph nodes. MRI is performed using radio waves that are absorbed by affected tissues and released to form a pattern that is translated by a computer to form a detailed image of the body parts imaged (Rigon, 2012).

PET is effective in the detection of abnormalities in lymph nodes regions (Saksouk et al., 2015). It can be used together with CT to determine the dimensions of cancer tumours (Choi et al., 2010). It is conducted using glucose that contains radioactive atoms that are absorbed by cancer cells. Lymphangiography is used to identify the presence of abnormalities in lymph nodes as well as their sizes and architecture. This method is highly effective because the contrast material used during imaging remains in the lymph nodes for a significant period of time. Therefore, doctors can use the lymph nodes with the contrast material to make plans regarding radiation treatment.

Ultrasound is an important technique that aids in cancer staging by showing the presence of tumours in the vagina and adjacent organs (Saksouk et al., 2015). In addition, it is used to evaluate the size of the tumours. This technique is usually applied in advanced stages of cervical cancer. A transabdominal ultrasound is conducted by passing a transducer over the lower belly of a patient, and the sound waves are relayed to a computer screen that transforms them into an image.

Role of radiation therapy in the treatment of cervical cancer

Radiation therapy is one of the approaches used by physicians to treat cervical cancer. It involves the use of high-energy x-rays to destroy cancerous cells (Radiotherapy for Cervical Cancer, 2014). The two approaches used during treatment include internal and external therapy. Internal therapy (brachytherapy) involves the destruction of cancer cells using radiation that originates from implants placed within the body.

Such implants remain in the womb for specific periods of time either hours or days depending on the treatment regimen. They are effective because the affected area receives high doses of radiation without any effect on the skin and surrounding tissues (Radiotherapy for Cervical Cancer, 2014). In contrast, external therapy involves the destruction of cancer cells using radiation from a linear accelerator (linac) outside the body (Radiotherapy for Cervical Cancer, 2014).

The treatment period could last between 5 and 8 weeks depending on the type and location of cancer, general health status, the reason for treatment, and size of tumours. External-beam radiation therapy is the most common radiation technique used by doctors because it does little damage to tissues and focuses radiation more accurately when compared to internal radiation therapy (Rajaram, Chitrathara, & Maheshwari, 2012).

The radiotherapy team develops individualised treatment plans for patients based on their cancer staging results. The plan involves the determination of how much radiation the patient needs and the specific regions or organs of the body that need to be targeted. A treatment plan includes a CT scan that defines the treatment port. Internal radiation therapy involves the insertion and removal of a radiation source into the womb (Rajaram et al., 2012).

External beam radiotherapy involves the use of a linear accelerator. A radiation therapist marks the treatment field using ink for easier and accurate focusing of radiation beams. The amount of radiation administered is dependent on the cancer type and results obtained from the simulation process (Rajaram et al., 2012).

Conclusion

Proper treatment of cervical cancer depends on proper diagnosis. Imaging is an important aspect of cervical cancer diagnosis because it aids in cancer staging. Cancer staging is critical in determining the treatment method to use based on the size and location of cancer. The size and location of the cancer are determined using various medical imaging techniques such as computed tomography (CT), positron emission tomography (PET), ultrasonography, lymphangiography, Ultrasound (US), and magnetic resonance imaging (MRI). Results obtained from imaging are used to choose the best treatment method or procedure.

Radiation therapy is one of the most effective treatment methods that involve the use of radiation to annihilate cancer cells. Imaging uses different techniques to produce images of affected tissues and organs, while radiation therapy destroys cancer cells using high-energy radiation emitted by a linear accelerator. The linac directs a specific amount of radiation toward various treatment ports from different angles.

References

Cervical Cancer in Australia. (2016). Web.

Cervical Cancer: What is Cervical Cancer? (2014). Web.

Choi, H. J., Ju, W., Myung, S. K., & Kim, Y. (2010). Diagnostic Performance Of Computer Tomography, Magnetic Resonance Imaging, and Positron Emission Tomography or Positron Emission Tomography/Computer Tomography for Detection of Metastatic Lymph Nodes in Patients with Cervical Cancer: Meta-Analysis. Cancer Science 101 (6), 1471-1479.

Radiotherapy for Cervical Cancer. (2014). Web.

Rajaram, S., Chitrathara, K., & Maheshwari, A. (2012). Cervical cancer: Contemporary Management. Philadelphia, PA: Jaypee Brothers Publishers.

Rigon, G., Vallone, C., Starita, A., Vismara, M. F., Ialongo, P., & Signore, F. (2012). Diagnostic Accuracy of MRI in Primary Cervical Cancer. Open Journal of Radiology 2, 14-21.

Saksouk, F. A., Coombs, B. D., Reuter, K. L., & Lin, E. C. (2015). Cervical Cancer Imaging. Web.

Introduction

Radiation therapy is common in treatment for cancerous tumors in their early stages of development. The action of the radiation beam focused on a tumor is effective in the locality of the specific tumor alone. The radiation kills cancerous cells in the specific area (Verville 2).

If the tumor or cancerous cells have spread to other parts of the body, they may not be killed by the radiation therapy. For this reason, radiation treatment for any cancerous cells is only effective as a cure when all the cancerous cells are located in one area of the body. This is common for most cases of testicular cancer, which affects men.

Histology Of Testicular Cancer

Most testicular cancers are a result of cancerous germ cells. Majority of cases of testicular cancer feature the development of seminomous testicular cancer (Verville 4). It is easy to treat this type of cancer using radiation therapy. This therapy is used as one of the many therapies that are used to treat the cancer.

Radiation therapy is a more effective therapy for seminomous testicular cancer than for non-seminomatous cancer. The cancerous cells in seminomous testicular cancer are easily eliminated, while the cells in non-seminomatous cancer are not easily killed by radiation doses used for cancer treatment (Verville 7).

Stage-One Seminoma

The manner in which radiation is used to treat testicular cancer depends on the level of development of the cancerous tissue. If the cancer is localized in the testes, it is known as stage-one seminoma. This type of cancer can be treated with removal of the testes together with the cancerous tissue.

A mild dose of radiation is then used to kill any cancerous cells that may have spread from the locality of the testes to the tissue around and within the pelvis. Radiation may not be required for treatment of most stage-one seminomas.

However, radiation therapy is used as a precaution since there is a small but definite possibility of presence of cancerous cells in the adjacent tissue. Surgical removal of the testes and the cancerous tissue is usually a sufficient cure for this type of cancer when it is accompanied by close post-operation monitoring (Verville 8).

The post-operation surveillance of the patient may continue for a range of a few years to a decade. In addition, the intensity of examination of the patient and the frequency with which examination is performed decrease with time. Radiation therapy is normally applied to the tissue in the para-aortic region (Verville 15). However, to reduce the radiation effect, radiation therapy is sometimes applied to the tissue within pelvic regions alone.

Stage-Two Seminoma

When the cancerous cells have spread to the tissue surrounding the testes, the cancer is known as stage-two seminoma. At this stage, the cancer may have spread to the tissue in the pelvis and the lymph nodes. However, the cancer is considered a stage-two-B seminoma only when the considerable cancerous tissue has grown in the lymph nodes and a stage-two-A seminoma when a small amount of cancerous tissue has grown in the lymph nodes.

The stage one-A cancer is easier to treat with radiation and surgery (Verville 25). The exposure to radiation during this treatment is greater than the exposure used for treatment of a stage-one seminoma. On the other hand, patients with stage-two-B seminoma have lower chances of survival. Less than ninety-five percent of the patients survive this type of cancer when treated with radiation alone.

Cancerous tissue usually develops in other parts of the body after treatment with radiation therapy. In most cases, chemotherapy is used instead of radiation. Further treatment with radiation therapy may be required if the cancer persists after treatment with chemotherapy. However, only a small number of patients fail to heal after undergoing chemotherapy (Verville 31).

Stage-Three Seminoma

When the cancer spreads to other tissue in other parts of the body other than the pelvic region, it is known as a stage-three seminoma. Radiation therapy alone is not effective for this type of cancer. This is because the cancerous cells are not localized in the testes. Application of radiation therapy in all the affected parts of the body could be lethal due the high dose of radiation. It is also difficult to establish the expected effectiveness of such treatment. Thus, chemotherapy is primarily used for treatment of stage-three seminoma (Verville 37). Radiation may be applied in the localities that develop cancerous tissue.

Non-Seminomatous Testicular Cancer

Non-seminomatous testicular cancer exhibits an inherent variation of the cancerous cells in all patients. In addition, the cancerous cells are difficult to kill using radiation therapy. Thus, radiation therapy is not used as a primary method of treatment of this cancer (Verville 19).

Radiation Therapy And Procedure

The kind of radiation used to kill the cancer cells is usually modified to minimize its effect on non-cancerous cells. The radiation beam is usually focused on the affected area and it penetrates normal tissue with little side effect. However, the radiation beam kills the cancerous cells, which may be embedded deep in the body.

The technology used to deliver the radiation has significantly improved since it was first used. Modern equipment is able to focus the radiation beams on specific tissue with high precision. Although the radiation passes through skin and other tissue, burns are not likely to occur as they usually did before development of modern equipment (Washington & Leaver 102).

The oncologist performing the radiation therapy and the patient are required to go through a rehearsal of the procedure. The oncologist determines the areas that require radiation therapy. Radiation therapy requires careful planning and calculation since the dose of radiation to be used in radiation therapy is usually precise. An examination of the patients skeleton is necessary to assess whether the bones are likely to obstruct radiation from the reaching the targeted area.

The position of other organs is also determined to aid calculation of the amount of radiation required to penetrate all tissue. Temporary and permanent marks are made on the body of the patient to aid the execution of radiation therapy during the treatment session. X-ray pictures are necessary to enable the technologist visualize the area to be treated properly (Washington & Leaver 29).

A verification of the plans and procedures is necessary before the actual radiation therapy is performed. A linear accelerator is used to produce and focus the radiation beams on the affected tissue. Multiple radiation treatments are necessary for effective radiation therapy.

The radiation procedure is performed every day for about a month. However, the number of treatment cycles may vary depending on the complexity of the procedure and the response of the patient to the treatment (Washington & Leaver 61). Radiation therapy is usually painless and side effects are barely noticeable to the patient. Patients are able to continue using their normal work schedule and adhere to a routine with mild physical stress.

Patients Response and Side Effects

The effect of radiation therapy in a patient depends on each individual. While some patients may report a certain degree of discomfort while subjected to certain high doses of radiation, others may not. There are treatments for the side effects that may be experienced by the patient (Washington & Leaver 51). Those patients who undergo radiation therapy involving treatment of the tissue in the pelvic region experience bowel discomfort.

Infertility is also a common side effect arising from radiation therapy. In cases where the testes are still functional, they may be shielded from radiation to minimize damage to the tissue. The immune system of the patient may also be affected by radiation therapy. White blood cells are reduced by intense radiation therapy (Washington & Leaver 46). Radiation has adverse effects on the bone marrow, which is responsible for production of the white blood cells.

However, these side effects are temporary, and will only persist for a short while after completion of radiation therapy. Due to drastic changes in composition of blood, it is necessary to monitor the effect of radiation therapy on blood count (Kasper & BarCharts 83). Reports of fatigue and general discomfort from the patient are signs that the composition of blood is getting affected beyond comfortable levels.

Special Cases of Radiation Therapy Treatment

Radiation therapy is highly effective in treating most cases of testicular cancer. However, there are chances of development of complications after radiation therapy. The probability of these complications occurring is small. Moreover, radiation therapy may cause new type of cancers in the patient.

The chances of occurrence of a new type of cancer in a patient after undergoing radiation therapy are few. Exposure to high doses of radiation, particularly to the non-cancerous tissue is the major cause of development of other cancers in the patient. Other therapeutic procedures such as chemotherapy and surgery may amplify the side effects caused by radiation therapy (Kasper & BarCharts 81).

Although the effectiveness of radiation therapy varies with every patient, it is useful in treatment of almost all types of cancers. It is particularly useful in treating cases of testicular cancer where surgery and chemotherapy are ineffective or partially effective (Kasper & BarCharts75). Symptoms causing considerable degree of discomfort are also minimized using radiation therapy. Treatment to reduce such symptoms is done when the cancer has spread to areas such as the spinal cord.

While radiation therapy is being performed, the ability of non-cancerous tissue near the cancerous growth to withstand certain doses of radiation is taken into account. Some organ tissues are sensitive to radiation and may suffer permanent damage if they are exposed to certain high levels of radiation. If other therapeutic procedures are being used in treatment of the testicular cancer, they may affect the manner in which radiation therapy is applied to the patient (Washington & Leaver 41).

Conclusion

Radiation therapy presents a useful solution in treatment of testicular cancer. This type of cancer has one of the highest rates of patient survival. This high rate of survival can be attributed to the use of radiation to kill the remnant cancerous cells after performing radical orcheitomy, which involves removal of the affected testes form the scrotum. Orchietomy is also used to diagnose a patient with testicular cancer after assessment of other symptoms and clinical examination.

Works Cited

Kasper, Michael E., and Inc BarCharts. Radiation therapy. Boca Raton, FL: BarCharts, Inc., 2009. Print.

Verville, Kathleen. Testicular cancer. New York: Chelsea House, 2009. Print.

Washington, Charles M., and Dennis T. Leaver. Principles and practice of radiation therapy. 3rd ed. St. Louis, Mo.: Mosby Elsevier, 2010. Print.

Abstract

Gastric cancer or stomach cancer is one of the major health challenges in the contemporary world. While different strategies to deal with gastric cancer exist, it is imperative to determine the optimal treatment for every individual patient. Gastric cancer is usually caused by normal cells that change to become cancerous. The condition is regarded as one of the major causes of cancer-related deaths globally.

Introduction

Cancer is a group of diseases that affect the cells in our bodies. It usually occurs when normal cells in the body change into abnormal cells (Shah, Pinheiro & Shah, 2007). The transformed cells continue to grow and eventually cause harm to the normal functioning of the body.

Cancer occurs when normal cells fail to effectively perform their respective functions. For example, instead of having a natural life span in which a normal cell dies and allows daughter cells to carry on the function of that cell, a cancer cell no longer responds to signals that tell it to stop functioning and to die. In addition, cancer cells divide continuously, making an endless supply of daughter cells. Cancer cells therefore live longer and continue to divide and expand non-stop.

Stomach is an organ of digestion located immediately after the esophagus. Usually, food is passed from the mouth through the esophagus and into the stomach (Shah, Pinheiro & Shah, 2007). This paper provides a discussion about gastric cancer or stomach cancer and examines various aspects of the condition.

Description of Gastric Cancer or Stomach Cancer

Gastric cancer or cancer of the stomach occurs when normal cells of the stomach change to become cancerous cells. According to Shah, Pinheiro and Shah (2007), gastric cancer usually refers to adenocarcinoma of the stomach. Drawing from a study by Cabebe (2016), gastric cancer is one of the major causes of cancer-related deaths globally. Ordinarily, gastric cancer affects the wall of the stomach and extends the esophagus all the way to the point linking to the duodenum.

A review of literature reveals two forms of gastric cancer. The first type is referred to as adenocarcinoma or gland-forming cancer and is the most prevalent. Ostensibly, gland-forming cancer is responsible for most cases of gastric cancer. This type of cancer is further categorized into two forms. The first type is referred to as intestinal type and is characterized by swellings that develop around the stomach walls. The swellings are usually caused by cancerous cells.

The second type is diffuse gastric cancer which permeates parts of the stomach as abnormal cells continue to grow. The other form of gastric cancer is referred to as gastrointestinal stromal tumor. This type of gastric cancer is usually as a result of problems that are caused by cells offering support to the stomach. The cells fail to provide the much needed support and this causes serious damage to the walls of the stomach. Despite the fact that this type of cancer may be spotted somewhere within the gastro-intestinal tract, they are mainly experienced in the stomach.

Causes of Gastric Cancer

Most cases of gastric cancer are due to haphazard genetic activities. This is because of the transformation that affects the DNA of cells in the stomach. If the transformation goes undetected, cancer cells begin to appear leading to gastric cancer. As earlier explained cancer cells normally multiply hysterically and are able to reach another state where they can easily evade automatic death that all cells in the body are required to go through in order to create room for the development of other cells.

Other than gastric cancer being caused by the damaging of DNA cells in the body, it may also be passed from parents to children. Families that have a history of gastric cancer are likely to pass it from one generation to another. In addition, cancer of the stomach can be caused by bacteria infection. Typically, these are bacteria that are directly linked to the development of gastric cancer within the victims stomach. The bacteria bring about irritation that causes destruction to the cells within the stomach. Gastric cancer can also result from excessive use of alcohol or persistent heart burn.

Signs and Symptoms of Gastric Cancer

According to Cabebe (2016), symptoms are not that obvious during the early stages of gastric cancer. The symptoms become clear as the patient progresses to an advanced stage of the condition. There is thus a danger that gastric cancer may be detected when it is too advanced for curative procedures to be carried out. As noted by Layke and Lopez (2004), up to 80 % of gastric cancer patients tend to be asymptomatic in the early days of the condition.

Despite the challenge noted above, it is still important to be familiar with the signs and symptoms of gastric cancer. They include inability to correctly digest food, feeling nauseated, lack of appetite, and weight loss among others.

Diagnosis of Gastric Cancer and Laboratory Tests

The ultimate goal of carrying out laboratory tests is to make sure that doctors are able to access results that will simplify the treatment process. Usually, obtaining the right laboratory results assists doctors to come up with the most appropriate therapy for the patient. Tests that may be done on suspected gastric cancer patients include tests to check the functioning of the liver. Imaging studies may also be undertaken to help during the diagnosis of gastric cancer.

According to Kazansky (2001), laboratory tests provide very valuable data for the diagnosis of gastric cancer. An examination of the gastric contents is extremely important. A considerable diminution of the amount of hydrochloric acid or its total absence is one of the symptoms of gastric cancer. Apparently, methods of ascertaining the presence of cancerous cells either individually or in groups, in gastric contents have been discovered so that gastric cancer can be diagnosed without mistakes (Kazansky, 2001). These include esophagogastroduodenoscopy, a technology that involves an imaging process. The option has been used quite extensively to diagnose gastric cancer.

Treatment Options Available for Patients and Prognosis

The options available for treating gastric cancer include radio therapy, chemotherapy, and surgery. Ostensibly, surgery is considered to be the most effective of the three and is thus used quite extensively. However, other options may be used depending on the stage at which a patient has reached.

According to Malfertheiner (2005), there are three main strategies under development to improve the clinical outcome of patients with advanced gastric cancer. These are adjuvant treatment, neo-adjuvant treatment, and peri-operative therapy. Research also indicates that the risk of developing gastric cancer may be greatly minimized by one taking well balanced meals. Patients should therefore be encouraged to have a good plan for eating healthy.

Conclusion

Without a doubt, gastric cancer a major health challenge in the world today and needs attention from all stakeholders. As explained in this paper, there are different strategies of dealing with the problem. This notwithstanding, medical practitioners must ensure that proper diagnosis is done before embarking on any treatment plan. People should also be educated on the importance of eating meals that are properly balanced.

References

Cabebe, E. C. (2016). Gastric Cancer. Web.

Kazansky, V. I. (2001). Cancer and Its Prophylactics: Modern Theory of Malignant Tumours. Honolulu, Hawaii: University Press of the Pacific.

Layke, J. C. & Lopez, P. P. (2004). Gastric Cancer: Diagnosis and Treatment Options. American Family Physician, 69(5): 1133  1141.

Malfertheiner, P. (2005). New Developments in the Management of Gastric Cancer. New York: Karger Medical and Scientific Publishers.

Shah, M. A., Pinheiro, N. A. & Shah, B. (2007). 100 Questions & Answers about Gastric Cancer. Boston, MA: Jones & Bartlett Learning.

The nature and essence of decision-making process in a hospital setting is fundamentally different from other processes employed in other fields such as business and management. While any decision-making process in the latter fields is always oriented towards profit making, it always becomes difficult when decisions affecting hospitals are made since they not only affect the hospitals affairs and administration, but they also affect patients with specialized needs (Davidson & Clarke, 1990). In such circumstances, clarity, acceptance and balance have to be factored in when making decisions such as deciding whether a hospital requires a new cancer treatment unit as the case seems to suggest.

The case clearly raises several issues of concern. The major concern, it seems, is making a decision on whether to implement a plan of creating a specialized cancer treatment unit or recommending improvements for the existing emergency and ambulatory care. Any recommendation made in a community-based healthcare setting must first and foremost seek to offer creative and cost-effective remedies to the issues at hand, and with the realization that patients must be assisted to attain their abilities to the fullest (Davidson & Clarke, 1990).

The cancer treatment unit is being fronted by committee members and other work colleagues. However, it should not escape mention that the upgrading of emergency and ambulatory care is desperately needed within the neighborhood. To make a suggestion, it would be more prudent to start with the needs directly affecting community members such as improving the emergency and ambulatory care before embarking on building an expensive cancer treatment unit.

The social economic status of community members also comes across as a significant area of concern. Using such theoretical concepts such as the Maslows hierarchy of needs and cost-benefit analysis, it is clear that building a cancer treatment unit in the community will not be in the best interests of the community members, the very people that the hospital is expected to serve. According to Maslow, needs should be met starting from the most basic needs upwards (Davidson & Clarke, 1990).

This is not meant to suggest that a cancer treatment unit is not important to the community and the wider populations. To the contrary, what should be of concern at the moment is to meet the peoples most basic needs in terms of providing emergency and ambulatory care before setting up the unit. This line of thinking has been informed by the fact that the hospital is located in a low-income area.

Another area of concern comes in terms of infrastructure and personnel needed to run the cancer treatment unit in the event that such a recommendation is passed. From the case, it is apparently clear that the hospital does not have the requisite infrastructure needed to install such a facility, translating to the fact that it has to dig deep into its pockets to fund the space, housing and personnel needed to run the project.

A simple cost-benefit analysis audit on such an undertaking will inarguably punch holes in the implementation plan since any project undertaken in the interests of the patients must also be sustainable in the long run (Davidson & Clarke, 1990). As the case rightly suggests, the local community will be the major loser if such a project is implemented since it is in dire need of the most basic healthcare services such as emergency and ambulatory care.

Lastly, indecisiveness and loyalties are a major issue in any decision making process. Although it is only human to be torn in between two or more areas of interests as the case portrays, it is important that decisions are made as objectively as possible. Personal agendas and loyalties should not override professional decision making processes. In healthcare settings, decisions that favor efficient delivery of healthcare services must supersede all other decisions irrespective of whether the other decisions are influenced by the management or fellow members of staff (Davidson & Clarke, 1990).

Reference List

Davidson, K.W., & Clarke, S.S. (1990). Social work in healthcare: A handbook for practice, volume 1. Routledge. ISBN: 0866568468.

Introduction

Gua Sha has been used widely as the Chinese traditional medicine for quite a while as the means of enhancing microcirculation of blood and, thus, increasing the process of healing. Although Gua Sha is typically viewed as complementary medicine, it may be used for addressing clinical issues in the healthcare setting (Siqueira et al. 26). Particularly, it can be used as the means of addressing myalgia in cancer patients that are undergoing therapy. In their article The Effect of Gua Sha Treatment on the Microcirculation of Surface Tissue: A Pilot Study in Healthy Subjects, Arya Nielsen et al. address the issue of applying the Gua Sha treatment as the tool for managing myalgia occurring in cancer patients as a result of chemotherapy. Despite the fact that the use of convenience sampling may have contributed to the creation of research biases, the choice of the Laser Doppler imaging (LDI) as the means of retrieving the relevant data along with the incorporation of the latest software (Moor Software V.3.01) for the analysis of the research data makes the outcomes of the study rather significant and provides the foundation for the design of a Gua-Sha-based myalgia treatment tool.

Summary

Nielsen et al. explore the effects of Gua Sha therapy as the means of addressing myalgia in cancer patients undergoing chemotherapy. Despite the fact that the technique has a long history and has been established in the traditional Chinese medicine as a legitimate tool for improving blood circulation for quite a while, the framework has not been the focus of researchers attention, which is why its effects on patients with myalgia are yet to be studied. Nielsen et al. have studied the effects of Gua Sha on cancer patients that have developed myalgia as a result of chemotherapy sessions. The relevant information was collected using Laser Doppler imaging (LDI). The authors used quantitative analysis as the primary tool for interpreting the data received in the course of the study. The Moor Software V.3.01 was used as the primary analysis tool. The results of the study indicated that the use of Gua Sha has a significant positive effect on the management of myalgia in cancer patients undergoing chemotherapy; particularly, a fourfold increase in positive patient outcomes has been registered (Nielsen et al. 461). However, despite the evident positive effects that Gua Sha has on patients well-being, a significant question has not been answered. Particularly, it has not been identified whether Gua Sha has any effect on the integrity of capillary functions. Therefore, a follow-up study is required.

Strengths

The fact that the study explores the problem by using the latest technological advances as the means of data collection and analysis should be viewed as doubtless advantages of the research. The incorporation of the LDI tool as the means of retrieving the relevant data can be viewed as a relatively new and, therefore, an efficient strategy for retrieving the required information. Despite the fact that the technique was suggested in 1987, it has been introduced to several upgrades and improvements over the past few years, which makes it a rather trustworthy device for acquiring the necessary information. Thus, the adoption of the said tool can be viewed as one of the advantages of the research (Nielsen et al. Addendum: Safety Standards for Gua Sha (Press-Stroking) and Ba Guan (Cupping) 446-447).

Among other strengths of the article, the fact that it does not shy away from discussing the negative effects of Gua Sha needs to be mentioned. Particularly, the authors address the phenomenon of extravasation, which typically occurs when using the said technique. Indeed, the subject matter has been the reason for concern among healthcare experts, thus, making them take the Gua Sha technique with a grain of salt as a possible therapy and treatment against myalgia (Nielsen et al. Addendum: Safety Standards for Gua Sha (Press-Stroking) and Ba Guan (Cupping) 446). However, the authors also provide concise yet convincing clarifications about the nature of the identified adverse effect, mentioning that its threats to the patients well-being are overrated ().

The incorporation of different Gua Sha tools into the study as the means of providing the patients with the said services should also be viewed as a strength of the research. It is crucial to make sure that every possible opportunity for proving the chosen framework efficiently should be exhausted before the conclusion regarding its efficacy should be made. The use of different Gua Sha tools, in turn, helps build the foundation for an all-embracing analysis of the efficacy of the identified technique.

Weaknesses

The fact that one of the essential questions has not been answered throughout the study, however, makes the research somewhat incomplete. Particularly, the authors of the study did not specify whether the use of Gua Sha on patients with myalgia may possibly lead to the damage of the capillary functions and, therefore, to more drastic outcomes in the target population. As a result, there is a significant loophole in the overall strongly canvas of Nielsen et al.s argument concerning the application of Gua Sha to the process of managing the needs of patients with myalgia.

Furthermore, the choice of the sampling strategy might be considered somewhat flawed since it opens the possibility of research biases. As the description of the framework provided by the authors shows, the research was conducted in the setting of a local hospital; therefore, the inpatients thereof were viewed as the target population, from which the sample was taken. Thus, it could be argued that the sample was represented by a rather homogenous population. Indeed, the article mentions that most of the study participants were Caucasian women (Nielsen et al. 459). Therefore, there is a chance that the research outcomes may have been different if the sample was not so homogenous.

Nevertheless, the study results can be deemed as rather credible. The research itself was carried out flawlessly, and the analysis was conducted in a very careful manner. Thus, the study results provided the foundation for designing a new and improved approach toward the management and prevention of myalgia among patients undergoing chemotherapy. While claiming that the said approach should constitute the rest of the treatment strategies would be wrong, Gua Sha should definitely be included in the list of the approaches that should be used along with the traditional treatment techniques to enhance patient outcomes and contribute to a faster recovery.

Implications

As stressed above, the study has opened a plethora of opportunities for further research. For instance, the effects of Gua Sha on the capillary functions of cancer patients skin can be explored in more detail so that a well put together framework for managing the needs of the target population could be developed. By focusing on eradicating the negative side effects of the therapy, one will be able to design the approach that will help handle the issue of myalgia successfully and prevent its further development in cancer patients undergoing chemotherapy. As a result, the quality of care is bound to improve considerably, thus, creating the foundation for faster patient recovery. It should be noted, though, that further studies will have to be carried out among a more diverse population. More importantly, the sampling strategy must allow retrieving less biased results.

Conclusion

Gua Sha has been a rather well-known specimen of alternative therapy, yet it has not been used in the healthcare setting as the means of managing a relevant issue. Therefore, the idea of using it as the treatment of myalgia in cancer patients undergoing chemotherapy is a rather new way of looking at the subject matter. Nevertheless, the study carried out by Nielsen et al. has proven that the approach clearly has potential and, thus, should be incorporated into the nursing inventory used for addressing the issue of myalgia management.

Despite the fact that the research conducted by Nielsen et al. has its problems, it provides a clear and detailed analysis of the issue. Furthermore, it suggests the solution that has not been considered before and may provide the foundation for a new and improved strategy. Combined with the current approach for managing myalgia, the framework in question is bound to make a difference in the field of managing cancer patients needs. Thus, the article should be considered an extremely useful addition to the existing body of research regarding the management of myalgia.

Works Cited

Nielsen, Arya, et al. The Effect of Gua Sha Treatment on the Microcirculation of Surface Tissue: A Pilot Study in Healthy Subjects. Explore, vol. 3, no. 5, 2007, pp. 456-466. Web.

Nielsen, Arya, et al. Addendum: Safety Standards for Gua Sha (Press-Stroking) and Ba Guan (Cupping). Complementary Therapies in Medicine, vol. 22, no. , 446-448. Web.

Siqueira, Matheus de, et al. The Effects of the Gua Sha Technique (Western View) on the Recuperation of Flexibility of the Sterior Chain in Parkinson: Case Study. European Journal of Research in Medical Sciences, vol. 4, no. 1, pp. 24-31. Web.

Introduction

Cancer treatment and management are one of the main challenges facing the healthcare industry in the UK. According to Fawcett and McQueen (2011), there are more than 200 types of cancer originating from different causes, presenting with different symptoms and requiring different forms of treatment or management (p. 2). Change in lifestyle with specific reference to eating habits is one of the risk factors increasing cases of cancer (Fawcett & McQueen 2011). A report released in 2010 by Cancer Research UK (2010) shows that 324, 579 people were diagnosed with various forms of cancer in 2010. The report further asserts that 28% of all deaths in the UK are as a result of cancer. In 2010, 157,250 cancers related to deaths were recorded in the UK. According to MacMillan Cancer Support (2012), there were approximately 1.7 million people living with cancer in the UK. This figure is expected to double by 2030 (MacMillan Cancer Support 2012). The above trend underscores the importance of effective cancer treatment plans.

According to Hubbard (2010), healthcare professionals are required to make complex decisions on cancer treatment and prevention. One of the reasons that explain the complexity of cancer treatment is the high degree of uncertainty. Additionally, the lack of adequate clinical trials to prove the efficacy of a particular cancer treatment increases the complexity of treatment (Hubbard 2010). According to Nutt and Wilson (2010), organizations in different economic sectors are increasingly incorporating the concept of multidisciplinary teams (MDTs) in an effort to deal with complex situations. The healthcare industry in the UK has integrated the concept of MDT in an effort to lower the rate of mortality as a result of cancer. The decision to incorporate the concept of MDT in cancer treatment is informed by the heterogeneous nature of the disease. Consequently, it is imperative for multiple interventions to be undertaken in order to deal with the disease more effectively.

Problem statement

There has been a marked increase in the relevance of MDTs in the operation of firms within the healthcare industry (Blazeby & Wilson 2006). Cancer treatment decisions are mostly made within the context of MDTs. These sentiments are echoed by Nutt and Wilson (2010) who assert that MDTs are double edged swords with regard to solving complex problems. Their effectiveness emanates from the fact that they are comprised of different professionals who possess diverse and exceptional skills and knowledge on various healthcare issues. The heterogeneous nature of the team enhances its creativity in solving complex problems as a result of information pooling (Nutt & Wilson 2010). However, decision making in MDTs is faced with a number of challenges. Blazeby and Wilson (2006) assert that little is known about decision making in MDT meetings. To improve the relevance of MDTs within the healthcare sector, it is imperative for healthcare professionals to understand the challenges that hinder the decision-making process.

The heterogeneous nature of MDTs is one of the elements that increase the complexity of the decision-making process. Nutt and Wilson (2010) are of the opinion that the degree of commitment amongst members in heterogeneous teams is relatively low compared to homogenous teams. This may lead to conflict amongst team members hence hindering the effectiveness with which decisions are made (Smidts, Pruyn & Riel 2001). Additionally, the likelihood of MDTs experiencing poor communication and coordination is relatively high (Schmitt 2012). Gopal (2009) asserts that a lack of effective communication is one of the problems experienced by multidisciplinary teams MDTs. This hinders cooperation and information sharing which are paramount in the operation of MDTs.

Despite the aforementioned challenges, research on the factors that hinder decision making in MDTs is not exhaustive. Inadequate team management skills may limit the MDTs ability to treat and manage cancer. There are a number of aspects that must be taken into account in order for MDTs to be successful. For MDTs to be successful, an effective decision-making process must be integrated. Some of the key requirements include effective communication, good leadership, patient involvement, effective guidelines and standards, and good team dynamics.

Justification

Considering the complexity associated with treating and managing cancer, it is imperative for healthcare professionals to develop effective treatment plans. If this is not done, cancer will continue being one of the leading causes of death in the UK. However, this is only possible through the formulation and implementation of effective decisions. Currently, caring for cancer patients is increasingly becoming a multidisciplinary event. This arises from the fact that there are various types of cancer whose effects and forms of treatment vary. Consequently, it is paramount for decisions on the treatment plan to be made by all the healthcare professionals and support staff. Intervention by diverse healthcare professionals will reduce the rate of mortality as a result of cancer significantly.

Research objectives

This study will be guided by a number of objectives which include;

1. To identify the significance of the MDMs in the decision-making process.
2. To explore the decision-making process in MDTs.
3. To explore factors associated with impeding the decision-making in Cancer MDTs.

Research questions

In line with the above objectives, the following research questions will be considered.

1. What is the significance of MDMs in the decision making process in MDTs?
2. What are the main factors that hinder decision making in MDTs?
3. What are the main elements that should be taken into account in the decision-making process in MDTs?

Contribution to knowledge

The findings of this study will be of great significance to healthcare professionals and other stakeholders in the healthcare industry in their quest to provide optimal care to cancer patients. First, the study will contribute towards a great appreciation of the importance of multidisciplinary teams in solving complex decisions on how to treat cancer. As a result, their contribution to the medical field will be enhanced. Secondly, healthcare professionals will gain insight into the factors that may hinder the effectiveness of MDTs. As a result, they will be able to counter such hindrances hence improving their operational efficiency. By highlighting the significance of multidisciplinary team meetings in making cancer treatment decisions, the study will enable healthcare professionals to appreciate the role of teamwork. As a result, healthcare professionals will appreciate the importance of information sharing in dealing with the complex issues that are associated with cancer treatment.

Literature review

The National Health Service in the UK incorporated the MDT model in 2000 in an effort to ensure that cancer treatment and care is in line with the available evidence. As a result, the status of MDTs in making key decisions on cancer treatment has increased significantly (Patkar & Acosta 2011). MDTs enables healthcare professionals to share information on how to care for cancer patients. This leads to the development of an effective treatment plan hence improving the quality of care provided. According to Patkar and Acosta (2011), effective cancer treatment plans enhance survival amongst cancer patients. Therefore, it is imperative for healthcare professionals to appreciate the role of MDTs in making optimal decisions that will improve cancer treatment and management.

In light of the aforementioned complexity with regard to cancer treatment and management, this section seeks to evaluate the contribution of MDMs in the process of making cancer treatment decisions. The process that multidisciplinary teams follow when making decisions on how to treat cancer and manage cancer is also evaluated. Moreover, the author explores the factors that impede decision making in cancer MDTs.

Multidisciplinary meetings (MDMs)

Considering the complexity associated with cancer treatment and management, it is essential for healthcare professionals to ensure that a high level of coordination and knowledge sharing is attained (Chew 2004). This can be achieved by integrating the concept of multidisciplinary care. Previous studies show that effective multidisciplinary meetings in cancer treatment increase cooperation amongst healthcare professionals. This arises from the interaction that is created amongst healthcare professionals from diverse areas of specialization (Devitt, Phillip &McLachlan 2010). In an effort to develop effective treatment plans, multidisciplinary teams convene meetings regularly. The meetings are aimed at discussing the most effective options for treating and managing cancer (Ministry of Health 2012). Such team meetings are critical in the operation of multidisciplinary teams. Consequently, it is imperative for healthcare professionals to be effective in planning and conducting MDMs.

Significance of MDMs in decision making

Improved treatment planning

Multidisciplinary meetings play a fundamental role in the process of making decisions on how to treat and manage various forms of cancer. Firstly, the meetings enable multidisciplinary team members to identify new issues that should be integrated into the treatment process. Devitt, Phillip, and McLachlan (2010) opine that MDMs enable healthcare professionals to adopt a holistic approach in treating and managing cancer. Moreover, MDMs enable healthcare professionals to discuss various issues regarding the patient and to follow-up on their progress with regard to a particular treatment (Ueno & Cristofanilli 2012). MDMs also create a perfect opportunity for healthcare professionals to share expert opinions on various issues associated with the treatment process. According to Wheless, McKinney, and Zanation (2011), one of the aspects discussed during MDMs relates to newly diagnosed malignancies. This leads to the formulation of preliminary treatment plans on the basis of available evidence. The findings of the discussion are communicated to the patient. As a result, the likelihood of developing an optimal treatment plan in addition to identifying new issues is increased (Sandok 2011). Therefore, one can assert that MDMs provide a perfect peer-reviewing opportunity which improves the effectiveness and efficiency of the decision making process.

Secondly, MDMs are very effective in improving the efficiency with which cancer treatments are conducted. According to Devitt, Phillip, and McLachlan (2010), multidisciplinary meetings are very effective in reducing the amount of time that a patient needs to access treatment. This arises from the fact that effective treatments plan are developed and implemented. MDMs are characterized by a high educational benefit. As a result, healthcare professionals who attend MDMs develop a greater understanding of diverse traditional health disciplines. According to Abdulrahman (2011), multidisciplinary meetings provide valuable teaching opportunities to junior doctors and medical students. Furthermore, MDMs lead to an improvement in the level of interaction amongst healthcare professionals from diverse areas of specialization (Patkar & Acosta 2011). In summary, MDMs contribute to improvement in cancer treatment by creating an environment that stimulates the generation of new knowledge. Moreover, MDMs provide an opportunity for high-quality, efficient, and evidence-based recommendations on how to manage and treat cancer patients to be made.

Improved communication and coordination of services

The success of multidisciplinary teams in the decision making is influenced by the degree of cooperation amongst the members (Monaghan & Sharma 2005). According to Monaghan and Sharma (2005), a high degree of collaboration between health professionals must be ensured in the process of treating and managing cancer (Lee & Ok 2007). To achieve this, an effective communication system amongst team members must be ensured. MDMs lead to improved communication between diverse healthcare professionals (Patkar & Acosta 2011). Patkar and Acosta (2011) further assert that this reduces delays for patients on the medical admissions unit to a minimum and produces a more appropriate inpatient stay (p.133). By integrating effective communication amongst team members, the likelihood of the team attaining high effective communication enables team members to share knowledge and skills hence developing a high level of interaction and cooperation.

MDMs play also play a fundamental role in the development of trust amongst the team members. This arises from the fact that the effectiveness with which the treatment plan s developed is dependent on the contribution of all the team members. According to Patkar and Acosta (2011), the absence of trust makes a team be dysfunctional. On the other hand, Lee and Ok (2007) assert that multidisciplinary team meetings enhance the relationship between diverse healthcare professionals due to the inclusion of healthcare professionals from diverse diagnostic disciplines. Thus, one can assert that the working relationship developed amongst healthcare professionals plays an essential role in the development of an effective cancer treatment plan. As a result, the patients quality of life, and hence their survival is enhanced.

Evaluation of cancer clinical trials

Multidisciplinary meetings provide team members with an opportunity to discuss diverse clinical trials. Ueno and Cristofanilli (2012) define clinical trials to include the various research studies that are conducted with the objective of discovering new methods and approaches of diagnosing, treating, preventing, and managing cancer. By evaluating available cancer clinical trials, multidisciplinary team members are able to compare new and standard treatment methods. As a result, the team is able to make effective decisions on the treatment approach to deal with various types of cancer. Ueno and Cristofanilli (2012) further assert that clinical trials enable MDTs to be effective with regard to staging and classifying cancer. According to Ueno and Cristofanilli (2012), cancer classification and staging enable physicians to determine treatment more reliably, to evaluate results of management more accurately and to compare worldwide statistics (p. 509). Abdulrahman (2011) further asserts that MDTs are more effective and accurate in making treatment decisions compared to individuals. In cases where individual treatment decisions are accurate, MDMs increase the credibility of relying on such decisions. In summary, the evaluation of clinical trials provides doctors with an opportunity to improve and protect the patient.

Improved equality

According to Tanfani and Testi (2012), all cancer patients should be given an opportunity to access high quality cancer care services (p.179). For example, all cancer patients living within the vicinity of a healthcare facility that is adequately equipped with a radiotherapy system should be provided with high-quality radiotherapy services. Such treatment increases the likelihood of the patient surviving. Tanfani and Testi (2012) assert that multidisciplinary meetings play a critical role in eliminating inequalities as a result of social class or geographical location. Thus, a multidisciplinary team is able to overcome geographical and social barriers that might limit the level of care given to patients.

Optimal utilization of resources

Multidisciplinary team meetings enable healthcare professionals to optimize the number of resources required to formulate a treatment plan for a particular type of cancer. Findings of a study conducted by Taylor (2010) reveal that a substantial amount of resources are consumed during team meetings. In the UK, there are approximately 1500 multidisciplinary teams whose obligation is to formulate cancer treatment plans. Taylor (2010) further asserts that this corresponds to over one million person hours of attendance at meetings each year (p.2). Moreover, some team members may incur additional cost and cost in the process of preparing materials that will enable them to participate in the MDMs. Taylor (2010) estimates the total annual cost for preparing and holding multidisciplinary meetings in cancer treatment to be 50 million pounds. The effectiveness of MDMs in the decision-making process is echoed by a study conducted by Sharma and Associates which is a US-based firm. The study was conducted by 253 colorectal clinical nurse specialists, doctors, and surgeons (Abdulrahman 2011). Ninety-six percent (96%) of the team members were of the opinion that MDMs leads to an overall improvement in the quality of care provided to colorectal cancer patients. On the other hand, 73% of the respondents were of the opinion that MDMs are very cost-effective (Abdulrahman 2011).

Definition of multidisciplinary teams (MDTs)

Healthcare professionals are increasingly appreciating the concept of teamwork in an effort to deal with the complex problems that they face in the course of providing care to patients (Foyle & Hostad 2004). One of the areas where the concept of teamwork is increasingly being integrated relates to cancer care. Bruner (2001) asserts that cancer is a chronic and multisystem disease. This makes its treatment to be very complex. Consequently, it is imperative for a multidisciplinary team approach to be adopted in providing care to patients. Dziegelewski (2013) defines a multidisciplinary team as a mix of health and social welfare professionals, with each discipline in most part working to an independent basis (p.117). This means that MDTs are comprised of different healthcare professionals. The duties and responsibilities of each team member are clearly outlined. The findings and opinions of individual members are consolidated in an effort to improve the quality of support and care offered to patients (Mauk 2010).

Decision making in cancer MDTs

Multidisciplinary teams are increasingly being integrated with the process of making decisions on how to treat and manage cancer. This trend is evident in both developed and developing countries. In the UK, the integration of MDTs in the process of making cancer decisions was motivated by the need to provide standardized and optimum care to patients. Additionally, the rationale for the integration of MDTs in the decision-making process emanated from the increment in the degree of complexity on how to treat and take care of cancer patients. As a result, various key professionals are incorporated into the decision-making process.

Some of the key professionals who constitute the multidisciplinary team in cancer treatment include medical oncologists, surgeons, clinical nurse specialists, radiologists, physicians, and pathologists (Mileshkin & Zalcberg 2009). All these parties work in collaboration with one another in the process of making decisions on the most effective plan to treat a particular type of cancer. Before making the treatment decision, multidisciplinary team members engage in intensive discussions on the holistic treatment plan to administer to the patient. The decision is based on a number of factors such as the type of cancer, the patients co-morbidities, biological makeup, and social circumstances. The MDT must take into account these elements so as to ensure that the treatment plan developed contributes towards improvement in the patients quality of life and hence survival (Mileshkin & Zalcberg 2009).

The decision-making process in MDTs

A comprehensive review of the problem

The first step involves a comprehensive analysis of the problem faced (Jalil 2012). The peer-review phase provides healthcare professionals with an opportunity to understand and focus on the subject under investigation. As a result, deviation from the subject matter is limited. Marchington and Wilikinson (2006) assert that the peer review process aids in establishing checks and balances on the healthcare problem faced thus increasing the effectiveness with which decisions are made.

Additionally, peer reviews play an essential role in nurturing a high degree of cohesion amongst the team members. Jalil (2012) asserts that this arises from the fact that the team members develop a positive perception and value for each other.

The peer-review phase also leads to the development of mutual appreciation amongst the team members. This culminates in a high level of trust between the team members hence enhancing information sharing. Jalil (2012) opines that it is important for the team leader to provide adequate support to team members during the peer review phase. This enhances their commitment to the predetermined goal (Jalil 2012)

Presentation of information gathered

The second step in the decision-making process entails the presentation of information gathered during the multidisciplinary care meetings (Jalil 2012). Some of the information collected relates to the patients pathological and radiological information and the patients medical history. The information enables healthcare professionals to develop effective treatment plans that suit the patients. The presentation phase also enables healthcare professionals to determine the nature and quality of information gathered. Consequently, information gaps that might affect the decision-making process are identified. Moreover, psychosocial aspects that might have been neglected in the peer review phase such as the patients co-morbid conditions are identified. In summary, this step presents a unique opportunity for healthcare professionals to seal information gaps that might exist. As result, the likelihood of developing an effective treatment plan is increased. Moreover, the information gathered ensures that the treatment plan developed is aligned to the patients needs. This leads to an improvement in the patients level of confidence regarding the treatment plan.

A comprehensive discussion of the treatment plan

In this step, the various allied healthcare professionals and support staff are incorporated into the decision-making process. This aids in gathering diverse viewpoints. To ensure that the opinions of all healthcare professionals are taken into account, it is important for the team members to be provided with adequate time. Additionally, team members opinions should be respected. This aids in the creation of an effective collaborative environment between the various team members (Chandrasekar 2011). Moreover, the inclusion of the team members plays a critical role in eliminating fragmentation of the care process due to lack of coordination in the treatment plan. Additionally, the discussion process aids in creating a unity of purpose and clarity with regard to the problem faced.

Factors that impede the decision making in cancer MDTs

Jalil (2012) is of the opinion that it is becoming a standard practice for cancer patients to be discussed by a multidisciplinary team in order to formulate an expert-derived management plan (p.389). However, MDTs are not always very effective. Consequently, not all multidisciplinary team decisions are implemented in the process of providing care (Jalil 2012). Some of the factors that hinder decision making in cancer MDTs are evaluated herein.

Lack of adequate clinical information

Information is one of the most important elements in the process of making complex decisions (Shaw 2008). Deb (2006) asserts that healthcare professionals should be provided with sufficient background information about patients. These sentiments are further echoed by Mileshkin and Zalcberg (2009) who assert that adequate clinical information is paramount in the process of making decisions on how to treat and manage cancer. The availability of such information enables healthcare professionals to understand the patients needs (Mileshkin & Zalcberg 2009).

Some of the clinical information that must be availed to the multidisciplinary team relate to psychological morbidity. According to Roy-Byrne & Silver (2012), cancer patients experience various forms of psychological complications such as anxiety, loss of self-esteem, and depression. Such types of psychological co-morbidity may interfere with cancer patients ability to deal with the symptoms of the disease and the complications associated with the treatment (Roy-Byrne & Silver 2012). Consequently, cancer patients should be screened for psychological distress.

However, making such a diagnosis is very difficult. Roy-Byme and Silver (2012) assert that psychiatric symptomatology may be mimicked by treatment side effects or symptoms of cancer (2). Moreover, information about the patients social circumstances, preferences, and other concerns must be available to the MDTs. However, patients may be hesitant to reveal psychosocial issues with healthcare.

Lack of investigation results

Biomedical imaging is a critical component in the treatment of cancer. Jalil (2012) proposes that biomedical imaging enables healthcare providers to diagnose cancer symptoms at an early stage. As a result, they are able to reduce the rate of mortality. Biomedical imaging is increasingly playing a fundamental role in various phases of cancer management. Some of these phases include prediction, staging, prognosis, therapy planning and guidance, therapy response, and palliation. Results from the above investigative processes should be presented to the MDTs in order to improve their decision making capability. According to Wheless, McKinney, and Zanation (2011), MDTs have a significant influence on the quality of decisions made. However, MDTs do not always access the necessary information.

Non-attendance of key members

The success of MDTs in making decisions emanates from the contribution of all the team members. Consequently, the core disciplines should be integrated into the decision-making process in order to provide adequate care (Jalil 2012). The composition of MDTs is determined by the type of cancer. According to (Jalil 2012), some cancer patients may require additional expertise or specialist. MDTs are comprised of a core and non-core team members. The MDTs in treating and managing lung cancer varies from that of breast cancer. Some of the core team members involved in making decisions on how to treat lung cancer include; medical oncologist, respiratory medicine specialist, pathologist, and radiation oncologist. On the other hand, the core team members in the treatment of breast cancer include surgeon, pathologist, medical oncologist, pathologist, supportive care specialist, and a radiologist (Jalil 2012).

The absence of one of the core team members may hinder the MDTs decision making capability. This arises from the lack of the members expert input which may be integral in the decision-making process. According to Rosman, Shah, and Hussain (2013), it is important for the chairman of the MDT to determine whether there is sufficient member representation prior to making decisions on how to treat and manage cancer patients. Jalil (2012) asserts that making decisions in the absence of core and non-core members may lead to ineffective care for cancer patients.

One of the factors that increase the non-attendance of team members is lack of time. According to Smit (2007), adequate protected time is crucial in order for MDT meetings to be held successfully.

Jalil (2012) affirms that team members should have adequate time to enable them to attend and discuss various clinical aspects. This increases their contribution to the decisions on how to treat and manage cancer. On the other hand, lack of time limits the effectiveness with which multidisciplinary teams make decisions. A study conducted by Wheless, McKinney, and Zanation (2011) on the impact of MDT on head and neck cancer treatment shows that MDTs impact the diagnosis, treatment, and cancer staging. Sixty-eight (68%) of the patients considered in the study had their treatment plans changed.

Ineffective group dynamics

Grange (2008) defines group dynamics as the area of social science that focuses on advancing knowledge about the nature of group life, group development and the interrelations between groups and individuals (p.15). Team dynamics are an integral element in MDTs decision-making process. However, the effectiveness with which decisions are made in multidisciplinary teams is affected by a lack of mutual trust and respect, the existence of personal interests, and conflicts amongst team members (Khastar, Kalhorian, Khalouei & Maleki 2011). Moreover, the lack of equality during team discussions affects the quality of decisions made. A report by the Victorian Government (2012) asserts that nurses in the UK reported feeling marginalised if their contribution of patient-centred information was ignored (p.9).

Poor team leadership

According to Burkus (2011), poor leadership is one of the major hindrances in MDTs decision-making processes. MDTs are comprised of members from diverse professional backgrounds. This presents a major challenge in ensuring that team members work harmoniously. Wheless, McKinney, and Zanation (2011) assert that lack of cooperation limits information sharing amongst team members. As a result, the effectiveness and efficiency with which the team makes the decision is adversely affected. To operate efficiently, MDTs must have mature leadership that promotes democracy within the team. This will enhance open and creative discussion amongst team members (Wheless, McKinney & Zanation 2011). To achieve this, multidisciplinary team leaders must possess a number of leadership skills and qualities. First, the leader must encourage inclusiveness. This means that he or she should involve all the team members in the decision-making process (Carmeli, Atwater & Levi (2010). This will result in the development of a sense of belonging amongst the team members hence improving the level of collaboration and the quality of decisions made (Holbeche 2009). Moreover, the team leader must be able to communicate and negotiate effectively so as to enhance interaction within the team (Kawatra & Krishnan 2004).

Lack of patient involvement

Fabbro (2010) is of the opinion that cancer patients should be involved in the MDTs decision making process. Nevertheless, most healthcare professionals do not include patients in the decision making process. According to the European Commission (2012), patient involvement increases the amount of time need to make a decision. This arises from the fact that patients may disagree with the healthcare professionals opinion. Some healthcare professionals are of opinion that involving the patient may lead to patients bypassing them (European Commission 2012). Moreover, their inclusion may lead to a reduction in the level of trust developed between the doctor and the patient (Victorian Government 2012). Despite these challenges, failure to include patients in the decision-making process may limit MDTs ability to make effective decision. For example, the MDT may not understand the patients choices and preferences. Moreover, practitioners may not acquire personal information that may be beneficial in the decision-making process (European Commission 2012).

The benefits of involving patients in cancer treatment decisions can be well illustrated by a study conducted in the US. In the study, 269 patients suffering from different forms of urological cancer were considered. The following are the findings of the study.

Type of cancer Percentage of patients diagnosed

• Prostate cancer 34%
• Testicle cancer 5%
• Bladder cancer 23%
• Kidney cancer 35%

Healthcare professionals from different specialties reviewed all the four types of urological cancer through MDTs. Abdulrahman (2011) asserts that as a result of the meeting, diagnosis in 23% of cancer cases reviewed was adjusted while 17% of renal cancer cases reviewed were adjusted. This led to a significant change in the respective treatment plan. For example, the treatment plan adopted for bladder cancer cases was changed with a margin of 44% while that of testicle cases was adjusted with a margin of 29%. Moreover, the treatment plan with regard to renal cancer was also adjusted with a margin of 36% (Abdulrahman 2011). This shows that involving patients in MDTs has a significant impact on cancer treatment and management decisions.

Poor infrastructure

A number of tools and equipment are essential in order for multidisciplinary team meetings to be conducted successfully (Kandula 2007). First, the meeting room should be fitted with effective projection equipment. This provides the multidisciplinary team members with an opportunity to display various results such as medical imaging results. Additionally, the room must be fitted with secure interactive computer systems. Examples of such interactive facilities include videoconferencing and teleconferencing technologies. Such infrastructure increases the rate of attendance by the team members. In the absence of such facilities, the multidisciplinary team decision making capability is adversely affected. Effective infrastructure also increases the effectiveness and efficiency with which MDTs present and share various types of information. According to a study conducted by Jalil (2012), non-attendance, lack of imaging results, and pathology results are cited as the main barriers that hinder MDTs decision-making process. The findings of the study are illustrated in the chart below.

From the chart above, it is imperative for multidisciplinary team leaders to incorporate effective team leadership skills. This will improve the effectiveness with which the teams formulate optimal treatment plans. Considering the information challenges faced by MDTs in making cancer treatment decisions, it is imperative for healthcare professionals to integrate emerging clinical decision support systems. This will enhance the effectiveness with which MDMs are conducted (Patkar & Acosta 2011). The involvement of family members is also cited as another element that healthcare professionals should integrate into the MDTs. According to Hubbard (2010), family members can enable MDTs to access personal information regarding the patient. As a result, the likelihood of MDTs formulating optimal treatment plans is increased. Information sharing is also identified as a critical aspect that should be ensured in MDTs. According to Monaghan and Sharma (2005), the success of MDTs emanates from the cooperation of all the team members. An effective communication mechanism should be integrated in order to enhance information sharing.

Teleconferencing failures

Communication is paramount in the treatment and management of patients. Gurses and Xiao (2006) assert that the communication process is usually challenged by a number of aspects such as fragmentation in the healthcare processes. Gurses and Xiao (2006) are of the opinion that the integration of well-designed information communication tools can improve the reliability, efficiency, and consistency of the communication process. This can be achieved by integrating effective Information Communication Technology (ICT). According to Jalil (2012), ICT is increasingly being adopted by healthcare professionals in an effort to provide optimal care to cancer patients (Jalil 2012). Mileshkin and Zalcberg (2009) further assert that the use of teleconferencing for multidisciplinary teams is common across the UK, especially in the areas of cancer treatment (p.171).

According to Latifi (2009), the new technology enhances the effectiveness with which MDTs make decisions with regard to tertiary, secondary, and primary care. This arises from the fact that healthcare professionals are able to share expert knowledge on how to treat and to manage cancer. Moreover, teleconferencing technology increases the effectiveness of communication and collaboration between multidisciplinary team members in different locations (Al-adaileh 2008). Thus, healthcare professionals do not have to be physically present during MDT meetings. However, they can participate in the meeting through videoconferencing and teleconferencing technologies. Davies and Brown (2008) are of the opinion that the professionals contribution to the decision-making process may be hindered by technological failure.

Moreover, technological failure may limit the effectiveness and efficiency with which patient information is analyzed. As a result, the amount of time required to make cancer treatment decisions may increase. To eliminate this challenge, it is imperative for multidisciplinary teams to ensure that the information technology adopted is effectively designed in order to meet the teams information needs.

Lack of effective administrative and support processes

Burkus (2011) asserts that effective coordination is integral in the operation of MDTs. In order for decision-making to be effective in MDTs, a high level of coordination should be ensured before, during, and after the MDTs meetings. Booth, Edmonds, and Kendall (2009) assert that palliative care MDM needs effective administrative support in order to function effectively (p.45). Administrative support should not only be limited to facilities and personnel. However, adequate resources should also be provided to the team. According to Booth, Edmonds, and Kendall (2009), there are instances whereby MDTs struggle to access resources such as the MRI. As a result, the teams operational efficiency is adversely affected. Additionally, the lack of committed non-clinical support staff to manage the teams operations may affect the teams cohesiveness (Mileshkin & Zalcberg 2009). The coordinator should ensure that the MDTs meetings are held successfully. In order to achieve this, multidisciplinary team meetings should be comprised of a number of palliative care interventionists (Booth, Edmonds & Kendall 2009). Some of the coordinators duties include facilitating communication, ensuring the availability of the essential clinical information, arranging meetings, and recording decisions.

Methodology

The objective of this study is to explore the decision-making process in multidisciplinary teams. The report focuses on the decision-making process in managing cancer. As a result, the study is descriptive in nature. In an effort to develop a comprehensive understanding of the MDTs decision-making process, an effective research design is integrated. Maxwell (2005) defines research design as the approach used in order to order to ensure that the findings are logical. The decision to incorporate this approach was informed by the qualitative nature of the research. According to Maxwell (2005), qualitative research design enables the research to undertake a comprehensive review of the issue under investigation. As a result, a wide volume of data is gathered.

Maxwell (2011) further asserts that it is important for adequate and reliable data to be collected in order to reinforce the findings of a particular study. Thus, an effective method of data collection has to be integrated. In conducting this study, the researcher relied on secondary data. This entailed collecting data from published reports, journals, and other articles on decision making in cancer MDTs. To ensure ease of access to the data, the research relied on online sources. It was ensured that only credible articles were used. This played a significant role in enhancing the credibility of the study. A form illustrating a review of the core articles used in preparing this report is illustrated in appendix 1.

Analysis and discussion

The literature review above shows that the MDT model is increasingly being endorsed by numerous healthcare systems. In an effort to increase the likelihood of success amongst multidisciplinary teams, various healthcare systems are appreciating the contribution of multidisciplinary meetings in the decision-making process. According to Patkar and Acosta (2011), one of the reasons that explain this trend is the effectiveness and efficiency with which MDMs enable healthcare professionals to deal with complex situations. However, various challenges have been cited with regard to the decision making process in MDTs. Lack of adequate support is one of the challenges that MDTs are facing in their decision making processes. Moreover, MDTs are characterized by a lack of commitment among team members. This limits the platforms ability to deal with complex situations.

Currently, the healthcare sector in the UK is faced with numerous challenges. Some of these challenges emanate from new diseases and conditions that require specialized treatment. The study shows that healthcare systems are integrating the concept of teamwork in an effort to deal with such situations. According to Patkar and Acosta (2011), there are two main approaches that organizations can adopt in the process of developing teams. These approaches include forming homogeneous or heterogeneous teams. The nature of the team formed depends on the complexity of the challenge faced and hence the need to make effective decisions. However, it is imperative for policymakers and managers to ensure that MDTs function effectively (Wasbeek 2004). However, Blazeby and Wilson (2006) assert that not all MDTs decisions are implemented (p.457). The study cites the existence of conflict amongst team members as one of the factors that limit the implementation of decisions made by MDTs. As a result, the opportunity created by MDTs in solving complex healthcare problems is not fully exploited.

Implications to managers

Currently, organizations are increasingly facing intense competition as a result of the high rate of globalization (Abdullah, Ahsan & Allam 2009). To increase the likelihood of success, managers should make effective operational and management decisions. The quality of decisions made influences the effectiveness with which an organization achieves and sustains the desired competitive advantage. In an effort to attain the desired level of competitiveness, organizations in different economic sectors are incorporating the concept of project management. However, Al-adaileh (2011) asserts that the success of a particular project depends on the effectiveness with which the project manager constitutes the project team. This study shows that it is important for managers to adopt the concept of multidisciplinary teams. In order to achieve this, managers should develop to ensure that the project team is comprised of members from a different professional backgrounds. This will play a critical role in balancing the level of expertise amongst the team members hence improving the teams ability to deal with complex situations (Deb 2006).

The study highlights a number of issues that organizational managers should take into account in the process of making decisions in multidisciplinary teams. To ensure that projects are completed successfully and within the set timeframe, the project manager should convene multidisciplinary team meetings occasionally. Such meetings will aid in assessing the progress of the project. This arises from the fact that the meeting will provide the team members with an opportunity to discuss various issues associated with the project. For example, the team members will be able to determine the challenges that might hinder the completion of the project.

The study has also shown that it is imperative for organizational managers to integrate good team leadership and team dynamics. Some of the issues that managers should consider include good communication and cooperation amongst team members (Deb 2006). Moreover, managers should ensure that all the project team members are involved in the decision-making process (Ryan, Windsor, Ibragimova & Prybutok 2010). This will develop a perception of being valued hence increasing their contribution to the team. The study also highlights the importance of providing sufficient administrative support to the team and time.

The implication to policy makers

The study illustrates the importance of integrating stakeholders from different functional and disciplinary backgrounds in the decision-making process. In the process of formulating policies, it is imperative for policymakers to seek the experience and skills of diverse experts (DuBrin 2012). This increases the likelihood of solving complex problems. Moreover, MDTs increases the policymakers level of knowledge. This arises from the fact that the policymaker gains insight on various issues that must be taken into account before a particular decision is arrived at. According to Taylor (2010), a number of core and non-core members must be included in the MDT when making decisions on the most effective treatment plan to adopt in treating a particular type of cancer.

Academic implications

The study cites cancer as one of the major challenges facing the healthcare industry. This arises from the fact that cancer presents itself in different forms which might limit individual doctors ability to effectively treat the disease. As a result, it is important for healthcare professionals to collaborate in order to develop effective treatment plans. This will improve the effectiveness with which the disease is diagnosed and treated hence increasing the rate of survival from various forms of cancer. To achieve this, healthcare professionals should appreciate the role of multidisciplinary teams in the decision-making process.

The study has cited a number of challenges that healthcare professionals experience in their quest to make decisions through multidisciplinary teams. Some of these challenges include lack of cooperation amongst team members, poor leadership, ineffective communication, and lack of optimal administrative support. This presents a unique research opportunity to academicians with regard to the modalities that should be ensured in order to improve the multidisciplinary team decision making capability.

Conclusion

The study highlights the significance of MDMs in improving the effectiveness with which MDTs in cancer treatment can deal with complex situations by making effective decisions. The study shows that decision making in cancer MDTs is faced with a number of challenges. However, MDTs can be effective if a number of aspects are taken into account. Some of these aspects include good team leadership, communication, and cooperation. The paper cites the benefits associated with MDMs. Some of the benefits include the elimination of inequality, optimizing resource utilization, improved cancer treatment, and planning, improved communication and coordination of services, and effective evaluation of cancer clinical trials.

The report also outlines the challenges encountered in the process of making decisions on how to treat cancer through MDTs. The heterogeneous nature of MDTs is cited as one of the sources of the challenges faced by MDTs. This arises from the fact that MDTs are composed of members from diverse professional backgrounds. For example, treatment and management of cancer require the cooperation of healthcare professionals from diverse disciplines. Consequently, it is imperative for effective team leadership skills to be integrated.

Some of the hindrances in MDTs decision making process cited in the report include lack of adequate clinical information, non-attendance of key members, technological failures, ineffective team leadership, lack of effective administrative support and processes, failure to involve patients in the decision making process, lack of investigation results and ineffective group dynamics. Such knowledge is of great significance to healthcare professionals in their quest to improve the operation of MDTs hence enhancing the decision-making process. To achieve this, multidisciplinary team leaders must integrate effective team dynamics. This can be achieved by nurturing the culture of teamwork amongst the various healthcare professionals. Through teamwork, the level of commitment towards achieving the set goal is increased. As a result, the likelihood of success in the decision-making process will be increased.

From the study, it is evident that MDMs are very effective with regard to planning the treatment, improving communication and coordination of services, increasing the knowledge of the multidisciplinary team members on the disease, and improving equality with regard to cancer treatment. Consequently, the significance of MDMs in the decision-making process cannot be underestimated. In summary, one can assert that the likelihood of healthcare professionals succeeding in treating chronic diseases such as cancer through MDTs is very high.

Learning statement

As a management student, the course has been of great importance in my personal and academic development. One of the areas that the module has been of great significance relates to a team working. First, the course has provided me with an opportunity to appreciate the importance of multidisciplinary teams in the process of making a decision to solve complex problems. Through the study, I have appreciated the importance of integrating various parties in the decision-making process. Such inclusion in the team increases the likelihood of making effective decisions that improve the outcome of a particular aspect. This arises from the fact that the team members possess diverse knowledge and expertise.

The course has provided great insight into the qualities that I should nurture as a team leader. For example, I have appreciated the importance of including all the team members in the decision-making process. By including all the members in the decision-making process, I will be able to nurture information and knowledge sharing amongst various departments. This will culminate in the development of an effective working relationship and collaboration amongst the various departments. As a result, the likelihood of attaining the desired synergy will be increased. The course has also been of great insight with regard to the various challenges that hinder the decision-making process in multidisciplinary teams. As a team leader, I will be able to eliminate such hindrances hence increasing the likelihood of success in the decision-making process.

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Introduction

As in many developed nations, the treatment of cancer in Australia often involves a high number of state institutions, such as health centres. The Sydney Cancer Centre is one such state institution and is located at Royal Prince Alfred Hospital. This study sought to investigate the effectiveness of cancer treatment measures in the Sydney Cancer Centre.

The study objectives included finding out whether the facility provides the required health services to cancer patients and their families, to determine the number of cancer specialists and their education level in the facility, as well exposing the number of cancer patients served in a day. Overall, the study enhanced the proper understanding of the effectiveness (or the rate at which services are provided) through the analysis of the number of health specialists working in the Sydney Cancer Centre and the number of cancer patients attended per day.

The Sydney Cancer Centre is primarily charged with providing cancer-related treatment to the New South Wales region. The facility is renowned, both nationally and internationally, due to its large concentration of cancer specialists. As a result, the Centre is capable of treating various types of cancer. The Sydney Cancer Centre offers comprehensive care programmes to cancer patients and their families, exclusively at the Centre as well as through its affiliation with the Sydney Local Health District (SLHD) and the University of Sydney. In 2013, the facility is slated to transition into the Chris OBrien Life-house at RPA in order to become a global treatment and research facility for cancer and cancer related diseases (Sydney Cancer Centre, 2012).

Sampling and Data Collection and Methods

The study focused its attention on the effectiveness of cancer treatment measures in the Sydney Cancer Centre. To achieve this core objective, the study narrowed its scope on a single, but knowledgeable, respondent. In this instance, the respondent who was chosen had been receiving cancer treatment in the facility for the last twelve months. To find the best candidate for this interview, a sampling frame was used. Even with a list of patients receiving cancer-related treatment in the facility to choose from, I preferred a random selection model, hoping to enhance the interviews participation and accuracy.

Ultimately, an actively practising medical professional who was receiving cancer-related treatment at the facility was selected to be the subject of the interview. An in-depth interview was conducted on the workmate. Before the interview, the respondent was presented with a written consent letter seeking his participation in the study, which he willingly signed. This was to show that his consent was sought and he was not forced to take part in the study.

An in-depth interview features a technique used mostly when expert opinion is required. It also applies where detailed information from experts is required (Graham et al, 2002). I was very pleased with the subject from a researchers perspective. The candidate was an expert in the cancer field, working at the Sydney Cancer Centre for the last five years. He is aware of all the sites available cancer treatment measures and can answer as a patient as well as a practitioner. Moreover, in-depth interview techniques allow the respondents to be treated with great respect, as they are given the opportunity to answer questions they feel do not infringe on their personal or professional values.

The 30-minutes long, in-depth interview was conducted face-to face at the facilitys recreational centre. This location was chosen following the respondents request to be interviewed within the facility. This method was considered the best method for gathering the data since the study topic (evaluation of the effectiveness of the cancer treatment methods offered by the facility) required detailed information. The data was recorded down by the researcher for later analysis and report writing. A theme list was used to guide the researcher regarding the themes that should be featured. This assisted in the organisation of the questions as well as the report.

According to Alvesson and Skoldberg (2000), interviewing involves several steps. Each step is important in the ultimate interview process in order to make a complete and informative interview. The interviewer first has to understand the goal of the study. It is important to take care in defining the goals or the purpose of a survey aid in order to make the interview process meaningful and objective.

Goals of study help in deciding which questions to ask the respondent in order to amass the most information on the topic. For a good interview, a theme list has to be prepared to help the researcher in interviewing. With the theme list, the researcher can successfully and competently cover all areas of the study. It also supports collection of quality data. It is also important that the theme list be piloted to test its capability for answering questions on the topic (Graham et al, 2002).

The last step in the interviewing process is conducting the interview itself. This is vital, as it involves the actual collection of data which will later be analysed to complete a research report (Alvesson & Skoldberg, 2000). The main aim in interviewing is to gather relevant information required for the study. A researcher has to make sure that the respondent is under no undue stress during the interview and must try to keep the environment comfortable. Any unclear statements or unique responses by the respondents should be probed in order to get additional insight. As a researcher, the experience was a good one and allowed me the opportunity to collect, analyse, interpret and report primary evidence collected from an experienced professional.

Thematic Analysis of Interview Transcript

In order to analyse the data collected from the respondent, content analysis was used. I first re-read the interview in order to get to know the data. According to Graham et al (2002), getting to know the data before analysis allows for proper analysis. Secondly, I gave each question an identification number. Graham et al (2002) argues that serialising questions eases sorting and improved quality data checks. The analysis was done in accordance with the theme list.

One of the major themes analysed in this study was the effectiveness of cancer treatment measures at the Sydney Cancer Centre. This was measured through the average level of education held by the doctors and nurses, their years of experience and, most importantly, the nature of the treatment measures offered to patients.

The interview also sought to find out the average number of patients treated in a single day at the facility. The number of patients per day averaged 100 to 150 for both outpatient and inpatient treatments. This is a high number by local and international standards when it comes to a specialist facility treating one of the most dreaded and mysterious of diseases. On the other hand, the average number of surgeons and nurses in the facility at any given time is approximately 55. Therefore, a surgeon or a nurse attends to about 2 to 3 patients on any single day. From this information, it can be deduced that the patients waiting time is minimal.

Consider the following question. Can you please name and explain all the treatment measures offered by the facility?

Answers

1. Colon Imaging, Endoscopic Visualization, and Biopsy
2. Pathologic Staging
3. Polypectomy for Malignant Polyps
4. Surgical Therapy
5. Adjuvant Chemotherapy
6. Radiation Therapy
7. Colonoscopic Surveillance
8. Pathology and Chemotherapy

Code List for Question 3N

Key:

1 = Measure is available

0 = Measure is not available

Using the data summarised above, it is arguable that the Sydney Cancer Centre has almost all the necessary treatment measures for the various types of cancer. From the respondents answers, each treatment measure was put into a category. The researcher used prior knowledge acquired through secondary research to categorise the treatment measures and their respective effectiveness. The responses given were entered in view of what other leading cancer treatment facilities offer. It was therefore deduced that cancer treatment in Sydney offers some of the latest and most professional and effective methods available.

Role of a Researcher on an Interviewee and the Data Collected

A researcher plays an important role during an interview. It is the role of the researcher to familiarise themselves with background information on the respondent to understand the respondents lifestyle and demographic information. For example, using the theme list the researcher prepared above, the researcher guided the interview process.

The researcher is responsible for introducing questions of the study and should state clearly why he/she is conducting the interview. The researcher also plays the role of interviewing the respondent and decides on the best method for asking the questions. Poorly framed questions would not get the right response or may irritate the respondent (Alvesson, 2002). Therefore, during an interview, the researcher has to ensure that the questions are simple, specific, within the study topic and capable of being answered. In a nutshell, the researcher guides the interview process and ensures they get the required information, using the proper technique. It is also the work of researcher to ensure each question is answered appropriately, and, if not, they must seek more information with regard to the initial question (Graham et al, 2002).

Quality data is complete, accurate, consistent and up-to-date (Stewart, 1995). Using the theme list, the researcher should compare what has been written down or recorded with theme list to ensure complete data. The researcher also should ensure the accurate information is collected according to the respondent. Data should not be manipulated.

For instance, the research I undertook required detailed information on the competency of health specialists and the cancer treatment measures of the Sydney Cancer Centre. It was upon me as the researcher to ensure the information recorded is up-to-date and that the respondent would not give outdated data. To this effect, I allowed the respondent to use records to answer certain questions. I was keen on taking the date the records were made to ensure current information.

Due to the busy schedule of the respondent (an actively practising medical professional and a cancer-treatment patient), I consulted with him before fixing a date and the venue for the interview. The interview process required a proper understanding of the theme list to ensure the questions are appropriately answered. The task required impressive listening skills and a quality interpretation of responses, to put them down in the most accurate manner.

A Reflection on Analysis Approach and the Steps Involved

Use of an in-depth interview to collect data in public health is widely preferred because detailed information can be collected. Health information is mostly collected from experts. Different approaches are used to analyse data from in-depth interviews. The data is mainly qualitative (Reinharz & Davidman, 1992). In this study, I mainly used content analysis, which allows the researcher to analyse information in the interview transcript by way of drawing from the major themes and points.

In the analysis, I re-read the data in the transcripts to get and know the data. Then it was possible and easy to identify the themes in the data. I identified unique responses those that appeared in almost all transcripts in the first part of analysing the data. This first process was involving and time consuming, but important. I discovered repeating information as well as responses that never matched the question. This enabled a deeper understanding of the major themes in the data.

The next step of data analysis allowed me to rate the effectiveness of the cancer treatment measures employed by the facility. I first serialised the questions, giving them an identification number. According to Graham et al (2002), identification numbers enable easy tracking of the questions in case the data needs to be pre-checked.

The coding of the data was easy in this case. For instance, the question on the effective of treatment measures was coded according to the treatment measures mentioned. Each treatment measure was assigned a numeric value for easy interpretation. Through coding the data, it was possible to know which treatment measure has the most or least impact. Analysing other major themes was performed similarly. Data transformation allowed for the measuring of the effectiveness of cancer treatment procedures and the competency of facility members and specialists.

In analysing the data, I had to ensure the data collected was of high quality in terms of accuracy, completeness and timeliness. This is because Graham et al (2002) argue data quality is an important step in data analysis. Inappropriate conclusions can be made from analysing data that is not of the required quality. Next, I was required to choose the most appropriate method of analysing data. I had to re-read the data and code, analyse and compile it. I had to interpret the results and write a report.

Conclusion

The authenticity of a report written from a study conducted depends on the quality of data collected by the researcher, in this case, by me. The study culminating in this report utilised in-depth interviews as its major primary data collection method. In-depth interviews are a method of data collection used mostly in qualitative research, which was important in this instance. The method is known for giving detailed information on the area of study.

As a result, it is widely applied in the study of public health and the research of the field. Graham et al (2002) argues that qualitative data is analysed using a range of approaches. They depend on the method that had been used in the collection of the data. However, data gathered through in-depth interviews is better analysed using content analysis, a data analysis method that allows the data analysts to re-read the data collected. This re-reading is important in that it aids in the understanding the themes highlighted in the responses.

Data coding and identifying the responses that are recurring in the data eases data analysis in qualitative research and it is a crucial process as well. As highlighted in the report, the process of data collection through interviewing requires the interviewee to pay attention to the respondent. It is also important to use that information and choose the best method of recording the data. The interviewee should have a theme list to guide the researcher throughout the interview. It is the role of the researcher to make sure the respondent is not under tension when responding to questions. The researcher should also probe for more information from the respondent.

Lastly, a data analyst has a major role of translating data into information, from which relevant conclusions can be drawn. The research task has enabled me to gain experience in the practical field of qualitative research. Specifically, I was able to put into practice the skills I have acquired in school as an interviewer and as a data analyst. I appreciated that the task helped me improve my interviewing skills as well as my analysis of qualitative data.

References

Alvesson, M. & Skoldberg, K. (2000). Reflexive methodology: new vistas for qualitative research. London: Sage.

Alvesson, M. (2002). Postmodernism and social research. Philadelphia, PA: Open University Press.

Graham, C., May, CR & Perry, MS. (2002). Qualitative research and the problem of judgment: lessons from interviewing fellow professionals, 19(3): 285.

Reinharz, S. & Davidman, L. (1992). Feminist methods in social research. New York: Oxford University Press.

Stewart, M. (1995). Patient-centred medicine: transforming the clinical method. Thousand Oaks: Sage publications.

The Sydney Cancer Centre (2012). About us. Web.

Nutrition assessment is a vital tool that can give proper diagnostics of what a patient is suffering from and the nutrition components that the patient lacks. Poor nutrition can cause several diseases that include diarrhea and colon cancer. This paper forms a comprehensive analysis of a malnourished white female patient, aged 87 years, and weighs 85 pounds. This patient is 5 feet tall. She has colon cancer and diarrhea. This paper gives a clear and comprehensive analysis of the patients clinical situation and provides a clearly defined plan for managing the condition.

The nutrition evaluation for cancer patients is often neglected. This is even though patients poor nutritional status can adversely affect the prognosis and treatment of these patients. Diet has for a long time been considered as a determinant in the risk development associated with colon cancer. However, it is difficult to ascertain for sure, which components of the diet are the most vital in increasing the risk for colon cancer (Sizer, Piche
& Whitney, 2012).

There is strong, compelling evidence that suggests that red meat and high fat intake are the leading causes of colon cancer. High consumption of fat from animals has positively been associated with colon cancer. The high cholesterol values that are as a result of fat intake correlate significantly well with the later development of tumors (Sizer, Piche
& Whitney, 2012).

The consumption of fatty fish and a reduction in the consumption of unhealthy fats can reduce the risk of colon cancer that is brought about by the consumption of animal fat. Obesity and a sedentary lifestyle are also some of the major risks for colon cancer. It is vital for patients with colon cancer to maintain a remarkably healthy diet (Wilson, 2010). This will help them to withstand the after-effects of treatment. These side effects may arise due to surgical, radiation therapy, chemotherapy or any combination of these treatment methodologies, which are used on cancer patients. A healthy diet for colon cancer patients should include the following

1. Fluids that prevent dehydration of the patient.
2. A lot of protein to helps maintain the muscle mass and repair damaged body tissue.
3. The patient needs fats and carbohydrates to help in the production of calories that will supply the body with energy.
4. Vitamins and minerals will maintain normal body functioning (Wilson, 2010).

The side effects that are associated with colon cancer treatment can cause weight loss. The effects can also cause an unhealthy nutrition status, which includes diarrhea, constipation, fatigue nausea, and many other effects on the normal body environment (Wilson, 2010).

Some fatty acids, for example, the omega 3 fatty acids, have been established to have benefits in the nervous system and appetite, in cancer patients. Studies have shown that fish oils stimulate appetite, and omega 3 fatty acids have many protective properties against cancer and many other chronic diseases. Patients can take an increased dosage of these fatty acids with 100 percent of each vitamin and all other minerals that are required for each day (Wilson, 2010).

A diet that includes a lot of fibers has a large protective effect against colon cancer. In addition, diets that are rich in vegetables and high fibers have demonstrated to be significantly protective against colon cancer. Fiber decreases the fecal transmitting time, by increasing the bulk in stool (Wilson, 2010, p. 78).

It dilutes the levels of concentration of other colonic constituents. This minimizes the contact between the colon epithelium and the carcinogens. The fiber is neither digested nor absorbed in the small intestines. Under the presence of colonic flora, the fiber undergoes fermentation and reduces fatal pH and leads to the generation of short chain fatty acids. These short chain fatty acids protect the isolated colonic epithelial cells (Wilson, 2010).

The patient can manage many of the side effects that are caused by the treatment for colon cancer, while knowing that the surgeries that she will undergo can lead to the loss of electrolytes and fluids. The patient can supplement her diet with lots of caffeine and reduce consumption of alcohol by taking alcohol free drinks. She should also take many sports drinks that have electrolytes and other liquid supplements. The patient should also add the consumption of multivitamin to counteract the mat absorption of some vitamins (Balch, 2006).

When the patient is undergoing chemotherapy, she may feel nauseous and become dehydrated. Liquids and some clear bland food will reduce these side effects. In order to alleviate diarrhea, the patient should take clear liquids and eat low fiber and low fat foods. She should avoid the heavy and greasy foods raw fruits or vegetables, and should also avoid the consumption of strong spices (Balch, 2006).

Medical conditions, as well as other factors, can cause diarrhea including diet. The patient should increase her water consumption since diarrhea can cause intensive dehydration if not checked (Balch, 2006). She should also minimize her total fat intake. Excess fat in the body leads to elevated levels of bile acids, which in turn digest the excess fats. Excess bile produced can also transform the probiotics found in the large and small intestines, which leads to tumor growth and cell damage. In addition, the patient should include lean meat and dairy products that are low in fat contents, in her diet. Finally, she should increase her consumption of healthy fats and omega 3 fats.

References

Balch, A. (2006). Prescription for nutritional healing. New York : Avery.

Sizer F., Piche
L., and Whitney E. (2012). Nutrition: concepts and controversies. Toronto: Nelson Education.

Wilson et al. (2010). Nutrition guide for physicians. Totowa: Humana.