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Anish RCC
Anish RCC
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INDEX Page No
1. introduction------------------------------------------------------------- 4
2. Aim -------------------------------------------------------------- 4
3. Objectives ------------------------------------------------------------- 5
5. Literature Review------------------------------------------------------- 6
5.3. Diagnosis------------------------------------------------------------- 9
5.4. Treatments------------------------------------------------------------10
6. Justification----------------------------------------------------------------16
7. Hypothesis-----------------------------------------------------------------17
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8.1.3 Types of Secondary-----------------------------------------------19
14. Bibilography----------------------------------------------------------------------27
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A critical evaluation of the effectiveness of lung cancer
treatment in RCC (Regional Cancer Centre) Kerala, India
1. Introduction
Diseases is one of the abnormal condition of the organisms of our body reacting
with foreign particle it will damage our body functions with particular symptoms
and signs some time it will affect organs also
Treatment means particular care provided for the patients to cure diseases by
medication or surgery
Cancer is the one of the abnormal growth of unwanted cells in any part of the body
without any control and caught all the tissues .Mainly cancer tissues are
transmitted through blood and lymph through other parts of body (Ernest H.
Rosenbaum – 2008)
2. Aim
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3. Objectives
I had select regional cancer institute (RCC) to doing this research it is situated on
the southern part of India
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• One of the Asia’s biggest cancer treatment center
• RCC doing researches on the cancer they have well equipped research center
also
5Literature review
The following literature review done for the researcher to the purpose of his
research
5.1Lung cancer
Lung cancer means a massive growth of tissue forms in the Larynx it blocks the air
passage inspiration and respiration of the normal body and delays the blood
purification there are two types of lung cancer
These are diagnosis by the cells shape when it views on the microscope
The main symptoms of lung cancer are Cough productive sputum, Haemoptysis,
chest pain, weight loss (Joe Billy Putnam, Ritsuko Komaki – 2003)
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There are more than 200 types of cancer. Most of the cancer named as the organ or
which they can affect it. For example the cancer which affect on the organ lung is
called lung cancer and the cancer saffect on the basal cells of the skin called as
basal cell carcinoma
Body is made of thousands of cells. Mainly cancer will affect on the cells .cells
have very short life period these cells are undergoing mutation(cell division)and
produce new cells this automatic synthesis is need for a healthy body. The cells are
old and damaged these will be die or replaced sometimes these are not replaced it
causes unwanted cell growth and forms a massive tissue called tumors it causes
cancer
• Benign tumor
• Malignant tumors
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Benign tumors are not causes cancer it can be removed by operation and it
cannot come back and not to be spread on the other part of body
Malignant tumors are cancerous one it could be spread other part of the body
through blood and lymph (Stephen Falk, Chris Williams – 2010)
Lung cancer is the uncontrolled growth of cells in the lungs it may be tumors .there
are two types of cancer 1)small cell lung cancer(it means cancer forms small
round cells in lungs) 2)non small lung cancer(the cancer grows in lungs other than
small cells)
The lung cancer cells sometimes travelled to other part of body through blood and
lymph and grows in other organs called secondary cancer
Small cell cancer have two stages limited and extensive lung cancer ,in limited
lung cancer r affect only in the lung .Extensive lung cancer may affect other part
of the body
Non small cancer mainly four stages the most crucial stage is stage 4(Walter Scott –
2000)
Stage 1
In stage one cancer cell only affect in patient lungs not in lymph glands .lymph
glands is one of the systems in human body important for immune system
Stage2
in this stage cancer cells slightly affect on the lymph glands near to the affected
lung sometimes it may affect on the chest wall
Stage 3
In stage 3 cancer cells moved from lymph glands to other side of the chest near to
the patient collarbone then the tumor will affect on patient heart
Stage4
This is the crucial stage mainly affect on the patient liver and the bones
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Symptoms
Coughing of blood
A continual cough
Breathing problem
Gruffness
Sometimes patients have the problem like tiredness and weight loss (W. Hinkelbein
– 2009)
5.3Diagnosis
CT scan
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CT scans means it has take a serious of x-ray of lungs and test for any part of the
patient lungs look abnormal but it is not a reliable test for finding the lung cancer
Bronchoscopy
It is a test doing with insertion of thin tube through patient nose or mouth into his
lungs it is a short procedure which last about 20 minutes, if the middle part of
patient lung is affected bronchoscopy is compulsory
FNA biopsy
It is mainly done if the patients edges of lungs is affected .A ct scan or ultra sound
is used to insert a needle through the patient chest and a small pieces is removed
from his lungs for biopsy
Mediastinoscopy
In this procedure surgeon insert a tube into the patient chest making a small cut
above the breast bone this is done nearly to see the surroundings between the
patient lungs and nearby lymph nodes for this procedure small percentage of
general anesthesia is used (Lorraine Johnston – 2001)
5.4Treatments
Mostly the cancer treatment is depend upon which type of cancer patient have and
the spread stage and treatment will center on improving the patient symptoms and
quality of live rather than curing the diseases
Surgery
Chemotherapy
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In this treatment mainly uses the medicine like etoposide like drug contains
platinum this drug streams into blood and engulf the cancer cells chemotherapy is
very effective in small cell lung cancer. Chemotherapy is given to the patient
repeated cycle normally chemotherapy is given to the patient three to six cycle
Radiotherapy
Radio therapy is the system to kill the cancer cells using radiation in non cell small
cancer in stage 3 we can use radio therapy it is useful to improve the symptoms of
cancer sometimes cure is not possible
Combined treatment
If in crucial stage of cancer medical experts are used surgery, radio therapy and
chemotherapy it will help to cure small cell cancer and non small cancer of patients
Endobronchial treatment
this treatment mainly used for the cancer in trachea or in the bronchi it can used to
prevent the early stage of cancer transmission it can used to clear the air passage
through trachea it can used when all the treatments are failed (Frank V. Fossella, Joe
Billy Putnam, Ritsuko Komaki – 2003)
One of the research conducted in RCC India found that leading causes of cancer
death in men is lung cancer and breast cancer in women if we taken 1 lack men
800 mens will suffer from lung cancer the ratio in women is 500 in 100000
One of the main reason of lung cancer is cigarette smoking and the lung cancer risk
increases with smoking duration it also related with tar of nicotine settled down in
lungs and the how much amount of smoke inhaled
The research found that older smokers uses the cigarette more than younger
smokers so we can found the lung cancer mainly affect in older people (Nathan A.
Berger - 2010 -)
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5.6Other causes of cancer
It depended upon patients job if he worked on the cancer mining and construction
sites if he inhaled cancer causing agents like asbestos there is a possibility of lung
cancer.asbetos particles are settled down in lungs and block the air passage and
damage the cells coal, vinyl chloride, nickel chromate, arsenic and some organic
chemicals like cloromethyl ethers are lung cancer causing agents
Repeated x-ray radiation and other type of radiation also causes lung cancer and
researcher found that some gases like radon causes lung cancer it occurs naturally
in soil and rocks it can damage the cells of lungs and causes for tumors
In researcher point of view some people body don’t have the ability to neutralize
the cancer causing agents such people are more sensitive to cigarette smoking and
cancer causing chemicals and gases (Lois Swirsky Gold, Centre for Studies in Risk
and Regulation – 2002)
the researcher go through the book of Sujal R Desai got some important
information about clinical features
the most common symptoms of cancer are chronic sough related sputum
production and chest wall pain shoulder pain and sometimes patient felt tiredness
and head ache and the expansion of lung cancer into other part of the body lead to
more clinical symptoms and signs and this time patient feels breathlessness and
chest pain due to pericardial participation this pericardial action occurs cardio
vascular diseases (Fergus Macbeth, Robert Milroy, William Steward – 1996)
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2. In any cancer subpopulations of cels differ in their rate of proliferation and
susceptibility to cytotoxic drugs .these drugs kill cancer cells by first order
kinetics ,i.e a certain fraction of cells present are killed by one treatment
3. Drug regimens which can effectively palliate large tumor burdens may be
curative when applied to minute residual tumour cell population after
surgery and /or irradiation
5. Formerly cancer were treated with one drug at a time .Now ,more commonly
,a combination of
2-6 drugs is given in intermittent pulses to achieve total tumour cells kill,giving
time in between for normal cells to recover
d) Empirically by trial and error; optimal schedules are mostly devolved by this
procedure (KD Tripathi MD 2005)
The anticancer drugs are either kill cancer cells or modify their growth however,
selectivity of majority of drugs is limited and they are one of the most toxic drugs
used in therapy
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In addition to prominent role in leukemia’s and lymphomas, drugs are used in
conjunction with surgery, radiotherapy and immunotherapy in combined modality
approach for many solid tumors, especially metastatic (Carmen Avendaño, J. Carlos
Menéndez – 2008)
Anti metabolites-methotrexate,6-Mercrptopurine,6-Thioguanine
Vincas alkaloids-vincristine,vinblastine
Taxanes-paclitaxel,docetaxel
Antibiotics-Actinomycine ,Doxorubicine,Daunorubicine
Miscellaneous-Hydroxyurea,procarbazine,cisplatine,carboplatine
Estrogens-fosfestrol
Antiestrogen-Tamoxifen
Antiadrogen-flutamide
Majority of the cytotoxic drugs have more profound effect on rapidly multiplying
cells, because the most important target action are the nucleic acids and their
precursors. Many cancers have a lower growth fraction than normal bone marrow,
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epithelial linings reticuloendothelial system and gonads .these tissues are
particularly affected on dose dependent manner by majority of drugs
Bone marrow
Lymphoreticular tissue
GIT
Skin
Alopecia occurs due to damage to the cells in hair follicles .dermatitis is another
complication
Gonads
Foetus
Particularly all cytotoxic drugs given to pregnant women profoundly damage the
developing foetus –abortion, foetal death, teratogenesis
Carcinogenicity
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Secondary cancers ,specially leukemia’s,lymphomas and histocytic tumors appear
with greater frequency many years after the use of cytotoxic drugs .this may be due
to depression of cell mediated and humoral blocking against neoplasia (Frederick
Valeriote, Thomas H. Corbett, Laurence H. Baker)
6. JUSTIFICATION
The researcher has selected RCC Trivandrum for conducting the research because
the researcher worked as a nurse in chemotherapy ward of this organization and so
it is very much easy and convenient for the researcher to conduct the study, collect
the data from the respondents and formulate the findings from that. The researcher
could be worked as the part of the cancer research center and got the good
knowledge of the lung cancer diseases and medication, and treatment technologies
and also a brief idea about anti cancer drugs and the complication of it.
Well, another fact for selecting this organization for the research is the
convenience for sampling and studying to the researcher.
7. HYPOTHESIS
Before stating the hypothesis for this research the researcher would like to define
what a hypothesis is. A hypothesis is a statement the validity of which is to be
proven. It is a statement made without any reason or calculation. Sometimes
hypothesis can be proved right and sometimes wrong. In this research, the
researcher puts forward the following hypothesis;
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The effectiveness of delivering oral hygiene among the elderly residents of beech
house care home is not very high.
This hypothesis can be proven right or wrong and the finding will be the
contribution of the researcher towards beech house in improving its quality of care.
8. RESEARCH METHODOLOGY
Research methodology is nothing but the method of doing the research. The
process and steps of research is elaborated in a methodology. The type of research,
objectives, review of literature, the sampling technique and all such significant
matters related to the research are mentioned.
Primary and secondary research methods are the two main research methods.
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Various articles, reports, project findings can be consulted and analysed for this
purpose. This is actually a cheap affair when compared to primary research and
that is the best advantage of secondary or desk research.
Secondary research is the research method in which the researcher uses the data
which have already been collected by other s and such data are called Secondary
data.
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data is needed in addition.
Secondary data also provides the researcher a ground to do data comparison.
The first disadvantage of the secondary research is that the data used i.e. the
secondary data is old and can be outdated.
Another disadvantage of secondary data is that it is vast and also inaccurate. It
can sometimes lead to the evolution of new problems and varied contradictory
conclusions.
Also these secondary data were originally collected for some particular purpose.
This can lead to several problems as it may not be appropriate to the purpose in
hand.
Sometimes the secondary data may also be aggregate in some form disabling
the individual observation.
The secondary data may be biased and therefore shaped according to the
mindset of the researcher who primarily would have collected it.
Therefore it can be seen that the secondary data has advantages and disadvantages
as well.
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There are different types or sources of secondary data for a secondary research.
Some of the most common among them are;
Books
Journals
Newspapers
Articles in magazines and websites
Reports and publications
Government statistics and company reports
Now in this research the researcher is intending to use the secondary sources of
data like the books, articles in magazines and newspapers, information from the
websites, reports of the organization and so on for the collection of th secondary
data.
The researcher can go through various books to collect data on the theory of lung
cancer. Also information regarding oral health of the cancer patient and its care can
be collected through books.
Various articles which have been published in magazines and newspapers about
the lung cancer treatment and causes symptoms can be reviewed.
Also the reports and brochures of the organization can be analyzed to study its
actual position in the field of the theory of research.
The literature review is possible from all these variety of secondary sources.
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It is a research method in which the researcher collects the data himself for the
purpose of a specific study or inquiry. Such data is original in character and is
generated by surveys conducted by individuals or research institutions.
(Bhattacharyya, D. 2006)
The first point of advantage to be noted for primary research is that the data is
freshly collected here. The researcher collects the data directly from the
respondents through various techniques like questionnaires, interview schedules
and so on.
The data will be up to date and relevant.
Accurate data can be collected because the purpose is already set while data
collection. That is it addresses specific research issue.
Greater control over the information is possible and therefore can be shaped as
per the requisites of the researcher.
Primary data collection helps to create a direct link with the respondents and
hence the whole process is natural and original.
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Detailed information can be collected on spot.
Confidentiality of the information is possible in primary research unlike
secondary research where the secondary data is made available publicly free.
Despite of all these advantages, primary research has its own disadvantage as well.
Therefore we can see that primary data employed in primary research has both
advantages and disadvantages like secondary data. Instead of all these matters both
primary data and secondary data are used by researchers today for the purpose of
their research. Since both of the research types have their own qualities and
features , they are employed somewhere or the other for something or the other.
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Questionnaires
Interview schedules
Direct interview method
Case studies
Surveys
Open discussions
Now the researcher will be using a few primary research techniques for the
purpose of his study.
Basically the researcher will be making use of self prepared questionnaires for
collecting the data. The questionnaires will be mailed to colleagues who worked
with him in RCC.
Also phone interview method will be adopted to collect data about the
organization, its care procedures and practices. And the interview with the doctors
help researcher to collect the new theories of lung cancer and its medication
9. RESEARCH DESIGN
Research design is the general design of the type of the research and how it will be
conducted. There are lots of research designs adopted by different researchers.
Here the researcher will be trying to conduct a qualitative research in an inductive
approach. In an inductive approach the researcher starts with specific observations
and then moves to broader generalizations and theories.
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quantitative form or in the form which are not subjected to rigorous quantitative
analysis. Generally the techniques of focus group, interviews, projective
techniques and depth interviews are used. A qualitative research is a research in
which an in depth studies is conducted. The qualitative aspects are more valued
here and not the quantitative ones. It also refers to collection of non numerical data
and explanations. Mostly qualitative studies are used for exploratory purposes.
(Kothari, C R. 2008.P.5).
There are probability sampling and non probability sampling methods adopted by
the researchers in their research work. Here the researcher is using non probability
sampling method, where not everyone has equal chance or probability of being
selected as a sample for research, but will be selected depending upon the
convenience of the researcher.
Convenient sampling shall be used by the researcher to pick the samples because
of the feature of convenience. As mentioned in the justification part , the researcher
worked as a nurse in chemotherapy ward and so it is really very much convenient
for the researcher to collect data from the respondents
The doctors in RCC shall be interviewed to collect data about the organization, its
care plans and policies regarding lung cancer treatment in patient.
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Questionnaires shall be used to collect data from the doctors in RCC to find out the
lung cancer and its symptoms, diagnosis and treatment
Now the data collected from all these sources shall help the researcher to analyze
them and find out the effectiveness of the oral hygiene in beech house care home.
The data collected shall be self analyzed by the researcher without the use of any
SPSS package.
The scope of this research study is with regards the applications and technology
used in the lung cancer treatment in RCC and the evaluate use of anticancer drugs
and its complication
Time is one limitation of the research because as the time period for the
completion of the research work was already set, it had to be finished at that point
of time at any cost. So the time available to conduct the study was limited.
The use of self prepared questionnaire is another limitation of this research.
Not using the SPSS package for analyzing the data collected shall become
another limitation of the research.
13. ETHICS
Ethics in the research is the fundamental norms and standards that the researcher
should follow throughout his research work. To maintain the ethical standards the
researcher has to give importance the following factors:-
Honesty
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To keep up the honesty in the research the researcher should not fabricate, or
misinterpret the data collected for the purpose of the study. One should report the
data with honesty.
Objectivity
The researcher should not progress the research with a bias. The bias in the data
analysis, data interpretation and the experimental design should be avoided and
avoid self deception.
Integrity
The agreement with the agency or the organization should be kept authentic and
the researcher should act sincerely and should be consistent in their action.
Carefulness
The careless faults and the negligence should be avoided. The work should be
critically and carefully analysed based on the genuine data retrieved by the
researcher. The various research activities should be properly recorded.
The researcher should honor the intellectual properties like, patents and copyrights.
Without the consent of the patents or the copyrighters the researcher should not use
the data in the research. The plagiarism should be avoided in the research.
Confidentiality
The confidentiality of the data collected for the purpose of the research should
given much priority. The confidential communication should be protected.
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Human Subjects Protection
The researcher should try to extract maximum benefit from the research and should
respect the human dignity, privacy and autonomy.
The main concern of the researcher should be on retaining the safety of the
respondents and should utilize the resources to make out an effective assessment as
the research progresses.
References
Cites
2) livekerala.blogspot.com/2010/04/regional-cancer-centre.cited on 26/8/10
4) lungcancersymptoms.org/cited on 22/8/10
BOOKS
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1)Current medical diagnosis & treatment 2002(Linda .S.Thompson Adams 2008)
3) Lung cancer: a practical guide to management - Page 104 Fergus Macbeth, Robert
Milroy, William Steward
5) Current diagnosis and treatment surgery - Page 354 Gerard Doherty, McGraw-Hill
Companies – 2009
6)Methods of Cancer Diagnosis, Therapy and Prognosis: General ... - Page 288
M. A. Hayat - 2008
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