The Royal Marsden Manual of Cancer Nursing Procedures

Sara Lister, Lisa Dougherty, Lisa Dougherty, Sara Lister, Lisa Dougherty

• Publisher: Wiley-Blackwell
• Year: 2018
• Print ISBN: 9781119245186
• eBook ISBN: 9781119245209
• Edition: 1
• Topic: Medicine
• Subtopic: Nursing

The Royal Marsden is the world's first hospital dedicated to cancer diagnosis, treatment, research and education – a centre of excellence with an international reputation for ground-breaking research and pioneering the very latest in cancer treatments and technologies, as well as specialising in cancer diagnosis and education.

This companion volume to the internationally successful The Royal Marsden Manual of Clinical Nursing Procedures is designed to support practitioners who work specifically with oncology patients by providing detailed evidence-based procedures and rationale, and problem-solving guidance on all aspects of oncology nursing.

The Royal Marsden Manual of Cancer Nursing Procedures:

• Is organized and structured to represent the needs of the patient along their care pathway
• Provides the latest evidence underpinning all procedures
• Includes information on haematological procedures; pain assessment and management; wound care; oncological emergencies; and end-of-life care
• Gives detailed guidelines on supporting patients living with cancer with practical information on such things as benefits, exercise and nutrition.

The Royal Marsden Manual of Cancer Nursing Procedures is an invaluable, definitive resource for all those involved in the provision of cancer care and support to patients and their families.

CHAPTER 1
Diagnostic investigations

Procedure guidelines

1.1 Cervical uterine smear using liquid-based cytology

1.2 Unsealed radioactive sources for diagnostic investigations

1.3 Transrectal ultrasound (TRUS) prostate biopsy

1.4 Flexible cystoscopy

1.5 Flexible cystoscopy with stent removal

1.6 Flexible cystoscopy with bladder biopsy

1.7 Flexible cystoscopy with argon plasma coagulation (APC)/cystodiathermy

1.8 Clinical breast examination

1.9 Core breast biopsy

1.10 Breast fine-needle aspiration (FNA)

1.11 Breast punch biopsy

1.12 Nipple discharge smear

Overview

In clinical practice, cancer nurses or other nurses are required to instigate, participate or assist in diagnostic tests and the collection of body fluids and/or specimens for varying diagnostic purposes. This chapter will discuss various diagnostic tests encountered in clinical practice that are used during the diagnostic process, to support ongoing treatment decisions and surveillance of cancer. These include:

• tumour markers
• cervical smears
• diagnostic radioisotope procedures (nuclear medicine)
• transrectal prostate biopsy
• flexible cystoscopy
• breast diagnostics
• genetic testing.

Diagnostic tests and investigations

Definition

A diagnostic test is a procedure that is used to aid in the detection and/or diagnosis of disease (Chernecky and Berger 2013, Higgins 2013).

Related theory

Diagnostic tests and investigations are undertaken to aid in diagnosis and treatment of various conditions. The investigations are used to identify diseases from their characteristics, signs and symptoms and to identify changes or abnormalities. Diagnostic tests include the collection of blood, tissue or body fluids.

Evidence-based approaches

Rationale

Diagnostic tests and investigations are essential in cancer care, however their selection and use must be considered carefully. The overuse of diagnostic tests is a contributor to needless healthcare costs. This leads to poor quality services and continuing financial pressure on departments and organizations (Korenstein et al. 2012), hence it is essential that healthcare providers and professionals ensure that the tests used are of adequate benefit to the patient's health (Qaseem et al. 2012).

Indications

Conducting a diagnostic test or collecting a specimen is often the first crucial step in determining diagnosis and subsequent mode of treatment for patients with suspected infections or to aid in the diagnosis of specific conditions. In other aspects the collection or test may help determine variation from normal values such as blood sampling or endoscopic findings (Box 1.1).

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Box 1.1 Good practice in specimen collection

• Appropriate to the patient's clinical presentation.
• Collected at the right time.
• Collected in a way that minimizes the risk of contamination.
• Collected in a manner that minimizes the health and safety risk to all staff handling the sample.
• Collected using the correct technique, with the correct equipment and in the correct container.
• Documented clearly, informatively and accurately on the request forms.
• Stored/transported appropriately.

Source: Adapted from NHS Pathology (2014), WHO (2015).

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Principles of care

Cancer nurses and nursing staff play a key role within the diagnostic testing process because they often identify the need for diagnostic investigations, initiate the collection of specimens and assume responsibility for timely and safe transportation to the laboratory (Higgins 2013). Nurses are vital in the screening and surveillance of disease progression and may undertake ongoing surveillance p...

Table of contents

• Cover
• Title Page
• Copyright
• Foreword
• Acknowledgements
• List of contributors
• List of abbreviations
• Quick reference to the procedure guidelines
• How to use your manual
• Introduction
• CHAPTER 1 Diagnostic investigations
• CHAPTER 2 Haematological procedures
• CHAPTER 3 Cancer pain assessment and management
• CHAPTER 4 Administration of systemic anticancer therapies
• CHAPTER 5 Radionuclide therapy
• CHAPTER 6 Wound management
• CHAPTER 7 Acute oncology
• CHAPTER 8 Living with and 
beyond cancer
• CHAPTER 9 End of life care
• Index
• EULA