Overview
Hodgkin’s Lymphoma is one of the most described lymphomas both histologically and clinically. It is, however, uncommon and can be associated with a poor prognosis if not diagnosed and treated in the early stages. The disease has been observed in individuals of both genders and all ages (Lawrence, 1980). There is still a lot of knowledge to be learned about the disease, its pathogenesis, associated health factors, and best treatment options. Mostly, B lymphocytic white blood cells are the oncological cells seen in tissue samples. Hodgkin’s lymphoma, just like other lymphomas, occurs as a solid lymphocytic tumor in contrast to leukemia that occurs as a blood tumor in circulation.
Considering the variants, classification and histological definitions of the disease, Hodgkin’s lymphoma has been discovered to be one of the few curable cancerous tumors considering the treatment regimens that are in place. Chemotherapy is the best treatment option for Hodgkin’s lymphoma in earlier stages; in more advanced stages, radiation therapy can be incorporated. The greatest problem currently with the disease is the development of side effects such as tumor lysis syndrome hence the need to research on newer and better treatment options. Through this intervention, the quality of life among patients being treated for Hodgkin’s Lymphoma and other lymphomas can improve significantly.
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On histopathology, the common findings on lymph node tissue biopsy among patients with this disease are the Reed Sternberg cells. By this appearance, a histological classification can be made and prognosis established.
Nursing Assessment
At the initial stages, it is recommended that the patient is exposed to multiple diagnostic procedures to establish any underlying pathologies, comorbidities, prognostic factors, the course of the disease and all requirements of staging Hodgkin’s Lymphoma. Other basic laboratory tests that are performed as baseline investigations should also be conducted before initiating therapy. If the patient is under review, supervision or is reporting due to a relapse, the comparison has to be made with an initial presentation to surely establish the progress of the patient. Where necessary, referrals can be made to well-equipped institutions.
Nursing care of patients with lymphoma requires a lot of efforts in ensuring the patients respond well to their medication and adhere to the prescribed medications. Based on the aggressive approach in the course of the disease and treatment, patients can undergo secondary factors that may be complex to deal with. In advanced stages, combination therapy is the only treatment option available whereby a patient undergoes immunotherapy, chemotherapy, radiotherapy and biological therapy. The treatment option entirely lies on the physician who makes a decision based on the laboratory findings and staging. Ann Arbor system is the most used staging technique for lymphomas.
The nursing team can also be of assistance in such decisions by putting into consideration other patient factors such as finances and comorbidities. Nurses also supervise the patients throughout their stay to provide support to the patient and their family by counseling them and establishing any contributions from their side that can enhance the recovery of the patient. Relapses are also common among these patients; therefore, they should be constantly under supervision all through during their remission stages (Obadan, 2016). Where oxygen and fluid support are required with extensive tissue involvement, the best nursing care should be provided.
Factors Affecting Care (Age, Gender, Genetic)
There are a variety of factors that are implicated for complicating Hodgkin’s disease by either propagating the progress of the disease are reducing the expected response to treatment. Generally, the advanced stage of the disease has been associated with poor response to first-line therapy hence the need to give additional therapy. However, patient factors also play a role in the same.
Patients above the age of 60 years are considered to have a poor prognosis at any stage even if the therapy is initiated. Elevated serum LDH can also complicate the condition as it indicates the high degradation of the blood cells. If a patient reports a relapse, further therapy success will fully depend on the ability of the remnant tumor cells to respond to therapy. Genetic factors have been known to play a role in the etiology; however, no definite studies have fully linked the therapeutic plans for genetic factors. Care for Hodgkin’s lymphoma also has no gender predilection.
Cultural Ethical and Psychosocial Aspects
With the increased education and healthcare delivery in various communities, the populations have developed adequate knowledge of cancers and how they endanger one’s health (Obadan, 2016). However, most persons are not aware that some cancers can actually be treated. This is why some patients become reluctant to undergoing therapy. This is why a thorough education and general awareness need to be conducted to inform the general population about the feasibility of treating Hodgkin’s lymphoma. Patients also need proper guidance accompanied by counseling that should involve family members to get adequate support throughout the treatment process.
Evidence-Based Practice
Distribution of oncology units is a key issue that affects the treatment of cancers. Many patients do not survive some of the curable cancers such as Hodgkin’s lymphoma due to their inability to access health facilities that can provide them with adequate care. For those who manage to access the oncology units in distant regions always suffer fatigue associated with traveling hence limiting their general health during treatment and overall satisfaction (Lis et al., 2009). It is also inevitable that individuals that live around an oncology unit tend to learn a lot from the healthcare givers and broaden their knowledge on health-seeking behavior and treatment options for various cancers.
Promotion of Health and Recovery
The first strategy in the achievement of recovery is self-awareness and education of patients on facts about the disease. Understanding the disease gives them a general overview of what is required of them in the efforts to fight the disease. The patients need to be made to know that there are possibilities of obtaining a cure with the therapy options in place. After a well explained information about the disease, they should decide if they are ready to undergo the treatment or not. The patient should not be let to decide this on their own; professional help is required in decision making. The decision should be all-inclusive whereby family members are involved.
In cases whereby the patient has consented to therapy, the best available treatment should be offered regardless of their social class or ethnicity. The treatment should be offered by a team that explores all the body systems involved and give a better approach to the disease that is patient individualized. A general approach has been associated with ignoring some therapy components leading to treatment failure.
All patients with Hodgkin’s disease and being managed outside exclusive hospital care should be under follow up. There is a need for frequent visits to establish the body response to therapy and development of side effects (Obadan, 2016). New complaints should also be taken into account and handled appropriately. However, complete nursing care is the most recommended plan that can be used in the treatment to achieve full recovery and promote their health.
Community Resources
Community resources that must be available for managing patients with Hodgkin’s disease must consist of a fully functional oncology unit for the patients to seek medical treatment. In scenarios where this is not available, there should be a reliable health facility whereby the patients can obtain support treatment before referring to a better facility. There should also be specialists that can be helpful in making diagnoses of cancers and recommending for the best-recommended treatment. The family members and other community members should be supportive in scenarios where the patient needs this kind of support to ensure that standard treatment is offered before an advanced grade or stage is attained.
Government policy should also insist on having health facilities evenly distributed to various locations. In so doing, patients do not necessarily move long distances all in a bid to access healthcare. For diseases that require a lot of finances to manage, the government can come up with support programs to help patients who are undergoing economic and financial challenges. It is also advisable to sponsor research studies to improve the treatment plan for some of the curable cancers.
Conclusion
Hodgkin’s lymphoma is one of the best-understood lymphomas with several studies concerning how treatment should be performed. However, some advanced stages are associated with poor response to medication hence reduced survival rates. Some patients also practice poor health-seeking behaviors and report for initial investigations when the prognosis is girded. To handle these problems, a treatment plan for these patients should be improved and awareness created to enhance the health-seeking behaviors of cancer patients. In so doing, the disease can be identified in the earliest stages and treated effectively.
References
Lawrence, W. (1980). Hodgkins Disease and the Lymphomas. Annals of Surgery , 191 (1), 118. doi:10.1097/00000658-198001000-00024
Lis, C. G., Rodeghier, M., Grutsch, J. F., & Gupta, D. (2009). Distribution and determinants of patient satisfaction in oncology with a focus on health-related quality of life. BMC Health Services Research , 9 (1). doi:10.1186/1472-6963-9-190
Obadan, O. (2016). A rare case of Hodgkin's lymphoma in an accessory spleen. Internal Medicine: Open Access , 06 (05). doi:10.4172/2165-8048.c1.003
