LEARNING OBJECTIVES
After studying this chapter, you should be able to:
• describe the impact of cancer as a chronic condition
• describe the targeted responses required to prevent and mitigate the impact of chronic cancer at a population level
• discuss how nurses can promote behaviour change to help meet specific supportive care needs
• discuss the potential contribution of all nurses in meeting chronic care needs for the person affected by cancer
• describe advanced practice roles in cancer within the chronic conditions framework.
Introduction
Cancer is a disease in which the usual controls of cell division are lost following a series of mutations and uncontrolled cell growth occurs. Cancer can be experienced as an acute illness, but is increasingly viewed from a health system policy perspective as a chronic condition (AGDH, 2015). Cancer is one of the leading causes of morbidity and mortality in Australia (AIHW, 2014a).
Despite significant improvements in prevention and screening, the overall incidence of cancer is increasing, largely due to the ageing population. Modifiable lifestyle factors are also contributing to cancer incidence. Collectively, overweight and obesity, physical inactivity and unhealthy eating are second only to tobacco as preventable risk factors for cancer (Cancer Council Australia, 2015). In Australia, it is estimated that there will be 169 648 new cases of cancer nationally by 2024, based on an average annual increase of 3.3 per cent per year from 2010 (AIHW, 2014a). Current trends predict that one in two Australians will be diagnosed with cancer by the age of 85. Similarly, in New Zealand cancer is the biggest cause of illness, disability and premature mortality (17.5 per cent) within the context of an ageing population (NZMOH, 2014). With the growing numbers of people being diagnosed with cancer there will be an increased demand on the health system and, importantly, primary health care systems to support the needs of individuals living with cancer or in the shadow of cancer. It is important to understand that many other people are also affected indirectly when a family member or someone else close to them has cancer.
Survival and prevalence
While the incidence of cancer is increasing, survival prospects from cancer are also increasing in response to effective population-based screening programs, earlier detection rates, better diagnostic methods, lifestyle modifications and advances in treatments.