Nursing Care Plans for Colon Cancer – Best Nursing Care Plans (2022)

This article discusses Nursing Care Plans for Colon Cancer plus its causes, symptoms, preventions, treatments, and interventions.

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Disclaimer: The information presented in this article is not medical advice; it is meant to act as a quick guide to nursing students for learning purposes only and should not be applied without an approved physician’s consent. Please consult a registered doctor in case you’re looking for medical advice.

Introduction

Colon cancer is a type of cancer that begins in the large intestine (colon). Colon cancer typically affects older adults, though it can happen at any age. It usually begins as small, noncancerous (benign) clumps of cells called polyps that form on the inside of the colon. Over time some of these polyps can become colon cancers.

Polyps may be small and produce few if any, symptoms. For this reason, doctors recommend regular screening tests to help prevent colon cancer by identifying and removing polyps before they turn into cancer.

If colon cancer develops, many treatments are available to help control it, including surgery, radiation therapy, and drug treatments, such as chemotherapy, targeted therapy, and immunotherapy.

Colon cancer is sometimes called colorectal cancer, which is a term that combines colon cancer and rectal cancer, which begins in the rectum.

Nursing Care Plans for Colon Cancer – Symptoms of Colon Cancer

Signs and symptoms of colon cancer include:

1. A persistent change in the bowel habits, including diarrhea or constipation or a change in the consistency of the stool
2. Rectal bleeding or blood in stool
3. Persistent abdominal discomforts, such as cramps, gas, or pain
4. A feeling that the bowel doesn’t empty completely
5. Weakness or fatigue
6. Unexplained weight loss

Many people with colon cancer experience no symptoms in the early stages of the disease. When symptoms appear, they’ll likely vary, depending on cancer’s size and location in the large intestine.

Nursing Care Plans for Colon Cancer – Causes of Colon Cancer

Doctors aren’t certain what causes most colon cancers.

In general, colon cancer begins when healthy cells in the colon develop changes (mutations) in their DNA. A cell’s DNA contains a set of instructions that tell a cell what to do.

Healthy cells grow and divide in an orderly way to keep the body functioning normally. But when a cell’s DNA is damaged and becomes cancerous, cells continue to divide — even when new cells aren’t needed. As the cells accumulate, they form a tumor.

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With time, the cancer cells can grow to invade and destroy normal tissue nearby. And cancerous cells can travel to other parts of the body to form deposits there (metastasis).

Nursing Care Plans for Colon Cancer – Risk Factors of Colon Cancer

Factors that may increase the risk of colon cancer include:

Older age. Colon cancer can be diagnosed at any age, but a majority of people with colon cancer are older than 50. The rates of colon cancer in people younger than 50 have been increasing, but doctors aren’t sure why.

African-American race. African-Americans have a greater risk of colon cancer than do people of other races.

A personal history of colorectal cancer or polyps. Persons that have already had colon cancer or noncancerous colon polyps may have a greater risk of colon cancer in the future.

Inflammatory intestinal conditions. Chronic inflammatory diseases of the colon, such as ulcerative colitis and Crohn’s disease, can increase the risk of colon cancer.

Inherited syndromes that increase colon cancer risk. Some gene mutations passed through generations of your family can increase your risk of colon cancer significantly. Only a small percentage of colon cancers are linked to inherited genes. The most common inherited syndromes that increase colon cancer risk are familial adenomatous polyposis (FAP) and Lynch syndrome, which is also known as hereditary nonpolyposis colorectal cancer (HNPCC).

Family history of colon cancer. You’re more likely to develop colon cancer if you have a blood relative who has had the disease. If more than one family member has colon cancer or rectal cancer, your risk is even greater.

Low-fiber, high-fat diet. Colon cancer and rectal cancer may be associated with a typical Western diet, which is low in fiber and high in fat and calories. Research in this area has had mixed results. Some studies have found an increased risk of colon cancer in people who eat diets high in red meat and processed meat.

A sedentary lifestyle. People who are inactive are more likely to develop colon cancer. Getting regular physical activity may reduce your risk of colon cancer.

Diabetes. People with diabetes or insulin resistance have an increased risk of colon cancer.

Obesity. People who are obese have an increased risk of colon cancer and an increased risk of dying of colon cancer when compared with people considered normal weight.

Smoking. People who smoke may have an increased risk of colon cancer.

Alcohol. Heavy use of alcohol increases your risk of colon cancer.

Radiation therapy for cancer. Radiation therapy directed at the abdomen to treat previous cancers increases the risk of colon cancer.

Nursing Care Plans for Colon Cancer –  Prevention of Colon Cancer

Screening colon cancer

Doctors recommend that people with an average risk of colon cancer consider colon cancer screening around age 50. But people with an increased risk, such as those with a family history of colon cancer, should consider screening sooner.

Lifestyle changes to reduce your risk of colon cancer

One can take steps to reduce the risks of colon cancer by making changes in their everyday life. Take steps to:

• Eat a variety of fruits, vegetables, and whole grains. Fruits, vegetables, and whole grains contain vitamins, minerals, fiber, and antioxidants, which may play a role in cancer prevention. Choose a variety of fruits and vegetables so that you get an array of vitamins and nutrients.
• Drink alcohol in moderation, if at all. If you choose to drink alcohol, limit the amount of alcohol you drink to no more than one drink a day for women and two for men.
• Stop smoking. Talk to your doctor about ways to quit that may work for you.
• Exercise most days of the week. Try to get at least 30 minutes of exercise on most days. If you’ve been inactive, start slowly and build up gradually to 30 minutes. Also, talk to your doctor before starting any exercise program.
• Maintain a healthy weight. If you are at a healthy weight, work to maintain your weight by combining a healthy diet with daily exercise. If you need to lose weight, ask your doctor about healthy ways to achieve your goal. Aim to lose weight slowly by increasing the amount of exercise you get and reducing the number of calories you eat.

Colon cancer prevention for people with a high risk

Some medications have been found to reduce the risk of precancerous polyps or colon cancer. For instance, some evidence links a reduced risk of polyps and colon cancer to the regular use of aspirin or aspirin-like drugs. But it’s not clear what dose and what length of time would be needed to reduce the risk of colon cancer. Taking aspirin daily has some risks, including gastrointestinal bleeding and ulcers.

These options are generally reserved for people with a high risk of colon cancer. There isn’t enough evidence to recommend these medications to people who have an average risk of colon cancer.

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Nursing Care Plans for Colon Cancer – Diagnosis of Colon Cancer

Digital rectal examination (DRE) – physical examination wherein the doctor inserts his lubricated and gloved finger into the anus to check for any abnormalities and presence of blood

Blood tests – the doctor may order a blood test to check for the chemical released by the colon tumor, called the carcinoembryonic antigen (CEA), which is also sometimes referred to as a “tumor marker.”

Imaging:

• Colonoscopy – insertion of a long, thin tube with a video camera to visualize the entire colon
• Flexible sigmoidoscopy – similar to colonoscopy but only views the distal part of the colon (sigmoid colon and rectum)
• CT colonography – also known as virtual colonography; used to produce detailed images of the bowel.

Determining the extent of the cancer

For a person diagnosed with colon cancer, the doctor may recommend tests to determine the extent (stage) of cancer. Staging helps determine what treatments are most appropriate for the patient.

Staging tests may include imaging procedures such as abdominal, pelvic, and chest CT scans. In many cases, the stage of cancer may not be fully determined until after colon cancer surgery.

The stages of colon cancer are indicated by Roman numerals that range from 0 to IV, with the lowest stages indicating cancer that is limited to the lining of the inside of the colon. By stage IV, the cancer is considered advanced and has spread (metastasized) to other areas of the body.

Nursing Care Plans for Colon Cancer – Treatment of Colon Cancer

The type of treatments that are most likely to help a patient depends on the particular situation, including the location of cancer, its stage, and other health concerns. Treatment for colon cancer usually involves surgery to remove cancer. Other treatments, such as radiation therapy and chemotherapy, might also be recommended.

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Surgery for early-stage colon cancer

If the colon cancer is very small, the doctor may recommend a minimally invasive approach to surgery, such as:

1. Removing polyps during a colonoscopy (polypectomy). If the cancer is small, localized, completely contained within a polyp, and in a very early stage, the doctor may be able to remove it completely during a colonoscopy.
2. Endoscopic mucosal resection. Larger polyps might be removed during colonoscopy using special tools to remove the polyp, and a small amount of the inner lining of the colon in a procedure called an endoscopic mucosal resection.
3. Minimally invasive surgery (laparoscopic surgery). Polyps that can’t be removed during a colonoscopy may be removed using laparoscopic surgery. In this procedure, a surgeon performs the operation through several small incisions in the abdominal wall, inserting instruments with attached cameras that display the colon on a video monitor. The surgeon may also take samples from lymph nodes in the area where the cancer is located.

Surgery for more advanced colon cancer

If cancer has grown into or through the colon, a surgeon may recommend:

1. Partial colectomy. During this procedure, the surgeon removes the part of the colon that contains cancer, along with a margin of normal tissue on either side of cancer. A surgeon is often able to reconnect the healthy portions of the colon or rectum. This procedure can commonly be done by a minimally invasive approach (laparoscopy).
2. Surgery to create a way for waste to leave the body. When it’s not possible to reconnect the healthy portions of the colon or rectum, a patient may need an ostomy. This involves creating an opening in the wall of the abdomen from a portion of the remaining bowel for the elimination of stool into a bag that fits securely over the opening. Sometimes the ostomy is only temporary, allowing the colon or rectum time to heal after surgery. In some cases, however, the colostomy may be permanent.
3. Lymph node removal. Nearby lymph nodes are usually also removed during colon cancer surgery and tested for cancer.

Nursing Care Plans for Colon Cancer Based on Nursing Diagnosis

Nursing Care Plans for Colon Cancer: Nursing Care Plan 1 -Diagnosis: Deficient Knowledge 

Related to a new diagnosis of colon cancer.

Evidenced by the patient’s verbalization of “I want to know more about my new diagnosis and care.”

Desired Outcome

At the end of the health teaching session, the patient will be able to demonstrate sufficient knowledge of colon cancer and its management.

Nursing Interventions	Rationales
Assess the patient’s readiness to learn, misconceptions, and blocks to learning (e.g., denial of diagnosis or poor lifestyle habits)	To address the patient’s cognition and mental status towards the new diagnosis and to help the patient overcome blocks to learning.
Explain what colon cancer is and its symptoms. Avoid using medical jargon and explain in layman’s terms.	To provide information on colon cancer and its pathophysiology in the simplest way possible.
Educate the patient about his/her colon cancer treatment plan. If a patient is for systemic anti-cancer therapy (SACT) and/or radiotherapy, explain the treatment protocol that will be administered, its purpose, risks, and possible side effects. If the patient is for surgery, explain the procedure to the patient.	To give the patient enough information on the treatment plan so that he/she can provide or deny informed consent.
Demonstrate how to perform blood sugar monitoring.	To empower patients to monitor his/her blood sugar levels at home.
Inform the patient of the details about the prescribed medications (e.g., drug class, use, benefits, side effects, and risks) for supportive care, such as pain medications, anti-emetics, and bowel medications. Explain how to properly self-administer each of them. Ask the patient to repeat or demonstrate the self-administration details to you.	To inform the patient of each prescribed drug and to ensure that the patient fully understands the purpose, possible side effects, adverse events, and self-administration details.
Use open-ended questions to explore the patient’s lifestyle choices and behaviors that can be linked to the development of colon cancer. Teach the patient on how to modify these risk factors (e.g., smoking, excessive alcohol intake, low fiber, and high-fat diet, obesity, sedentary lifestyle, etc.).	To assist the patient in identifying and managing modifiable risk factors related to colon cancer.

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Nursing Care Plans for Colon Cancer: Nursing Care Plan 2 -Diagnosis: Imbalanced Nutrition: Less than Body Requirements

Related to abdominal pain and cramping secondary to colon cancer

Evidenced by:

• abdominal cramping
• stomach pain
• bloating
• weight loss
• nausea and vomiting
• loss of appetite

Desired Outcome

The patient will be able to achieve weight within his/her normal BMI range, demonstrating healthy eating patterns and choices.

Nursing Interventions	Rationale
Explore the patient’s daily nutritional intake and food habits (e.g., mealtimes, duration of each meal session, snacking, etc.)	To create a baseline of the patient’s nutritional status and preferences.
Create a daily weight chart and a food and fluid chart. Discuss with the patient the short-term and long-term nutrition and weight goals.	To effectively monitor the patient’s daily nutritional intake and progress in weight goals.
Help the patient to select appropriate dietary choices to increase dietary fiber, caloric intake, and alcohol and coffee intake.	To promote nutrition and healthy food habits, as well as to boost the energy levels of the patient. Dietary fiber can help reduce stool transit time, thus promoting regular bowel movement.
Refer the patient to the dietitian.	To provide more specialized care for the patient in terms of nutrition and diet in relation to newly diagnosed colon cancer.
Symptom control: Administer the prescribed medications for abdominal cramping and pain, such as antispasmodics. Promote bowel emptying using laxatives as prescribed.	To reduce cramping, relieve the stomach pain, and help the patient to have a better appetite. To treat persistent and/or severe constipation, which is a common symptom of colon cancer.

Related FAQs

1. How does colon cancer start?

Most colorectal cancers start as a growth on the inner lining of the colon or rectum. These growths are called polyps. Some types of polyps can change into cancer over time (usually many years), but not all polyps become cancer. The chance of a polyp turning into cancer depends on the type of polyp it is.

2. Can colon cancer be cured?

Cancer of the colon is a highly treatable and often curable disease when localized to the bowel. Surgery is the primary form of treatment and results in cure in approximately 50% of the patients.

3. What is the first stage of colon cancer?

Also known as carcinoma in situ, in this stage abnormal cells are only in the inner lining of the colon or rectum. Stage 1. The cancer has penetrated the lining, or mucosa, of the colon or rectum and may have grown into the muscle layer. It hasn’t spread to nearby lymph nodes or to other parts of the body.

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4. What are the six signs of colon cancer?

6 Early Warning Symptoms of Colon Cancer

• Bleeding. Watch out for bright red rectal bleeding or dark, tarry stools, which could indicate the presence of blood.
• Stomach pain. Look for persistent abdominal pain, discomfort, or bloating.
• Change in bowel habits.
• Tenesmus.
• Unexplained weight loss.
• Fatigue/weakness.

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