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Scholarly Assignment Experiencing A Health Challenge: The Effects On Clients

Movie: 50/50
Ruwangi Wadugodapitiya
Janet Jeffrey


The movie 50/50 portrays the story of Adam, a timid, introverted man who gets
diagnosed with shwannoma neurofibrosarcoma, which is a malignant tumor in his spine. Adam
lives a mundane life, which is hindered by his severe back pain. Once he finally seeks medical
attention for this, he learns of his cancer. After doing Internet research on his diagnosis he finds
that his odds for survival is 50/50. Along with him, his mother and girlfriend have difficulty
coping with his diagnosis. His mother becomes very over bearing and anxious, insisting on
moving in to take care of him. His girlfriend Rachel becomes very uncomfortable with the fact
that his illness is possibly terminal and becomes unfaithful to Adam. Initially, Adam undergoes
chemotherapy to treat his cancer. However, it had no effect in curing him. The last option for
Adam was to resort to an invasive, high-risk surgery that Adam decided to take. The surgery was
successful and Adam was on the road to recovery.
Cancer is a major health problem and has multiple physical effects related to the
uncontrolled and unregulated growth of cells (Lewis, 2014, p. 347). Adams back pain was so
severe that it was affecting his daily life. He constantly complained of pain while sitting at his
desk at work, walking for too long, riding his bicycle and his pain also hindered his sexual
performance. According to Lewis (2014), Compression or infiltration of tumor involving nerves
causes pain (p. 369). Considering that Adams tumor is located on his spine which is a highly
concentrated with nerves, this is a plausible cause of pain. Another cause of pain according to
Lewis (2014) could be the inflammation, ulceration or necrosis of tissues caused by cancer cells
(p. 369). The other physical effects that Adam experiences in the movie are side effects of his
chemotherapy treatments. The Canadian Cancer Society describes chemotherapy as drugs that
destroy cancer cells (2014). However, these types of drugs can also damage healthy cells, which
can cause multiple side effects (Canadian Cancer Society, 2014). Throughout the movie after


undergoing chemotherapy treatments, Adam was very lethargic. He would appear pale with bags
underneath his eyes and spoke slowly as if he was on the verge of falling asleep. When
constantly asked to party with his out-going friend Kyle, Adam always refused as he was too
tired and wanted to go to sleep. According to Lewis (2014), fatigue is a commonly reported
adverse effect of cancer therapy, affecting 70% to 100% of patients with cancer (p. 367). In the
movie, Adam is constantly vomiting or feeling nauseated. Cellular breakdown caused by
chemotherapy stimulates the vomiting center of the brain (Lewis, 2014, p.366). The drugs taken
to treat cancer and the destruction of the gastrointestinal lining can also cause vomiting (Lewis,
2014, p.367) His friends who he had made during chemotherapy treatments suggested smoking
marijuana to help alleviate this symptom. Studies conducted have shown that cannabis is highly
effective in relieving nausea (Tramer et al., 2001). These three physical effects are very evident
in the movie, but are only few of the effects that cancer can have on a patient.
Along with the physical effects, Adam as well as his loved ones also bears the
psychosocial effects of this health challenge. Firstly, in the movie it is witnessed when his mother
discovers the news of his diagnosis. She is seen to have a mental breakdown and goes into a fit
of crying, yelling, and even hitting. Since Adam was previously estranged from his mother, she is
further distressed at the thought of possibly losing her son. The diagnosis of cancer in ones
child marks the beginning of social and psychological devastation for the whole family,
especially the mother (Ghufran et al., 2014). Adams girlfriend Rachel at first was very
supportive. She drove him to his chemotherapy sessions, provided him with support, comfort and
care when he was first diagnosed. However, the idea of him being terminally ill troubled her. She
only dropped him off at his cancer related appointments, but didnt accompany him, as she didnt
feel comfortable in the hospital environment. Eventually the pressure of having to take care of


her partner took a toll on the relationship as Rachel became unfaithful. According to Goodfellow,
the psychological and physiological disturbances of cancer patients can cause high levels of
stress in their spouses (2014). Fear, lack of knowledge about treatment and having to adjust daily
activities are factors that make spouses unsure about the future (Goodfellow, 2014); therefore,
could have lead to Rachels infidelity. When Adam received his diagnosis of his cancer he was
initially confused. He felt this way as he leads a very healthy and precautious lifestyle. He tries
to prevent death to the best of his abilities, including not getting his drivers license because he
thought driving was dangerous. When his doctor disclosed his diagnosis he responded by saying
This cant be true, I dont even smoke. The initial shock, denial and disbelief are common
among people who have their diagnosis confirmed (Trill, 2012). As his cancer progresses Adam
feels helpless. He tried his whole life to avoid unfortunate circumstances; however, as he cannot
control his cancer, he feels tired and wants it to be over. He tries to crash his friends car to try
and end his own life. Recurrent thoughts of suicide, and attempting suicide are common amongst
cancer patients who face major depression (Trill, 2012).
When providing holistic nursing care for Adam, the priority would be to relieve his pain.
Pain is defined as an unpleasant, subjective sensory and emotional experience associated with
actual or potential tissue damage (Potter et al., 2014, p.1017). Addressing Adams pain will
improve his physical and psychological well being. When treating pain, studies have suggested
that a multidisciplinary approach should be taken when relieving chronic back pain rather than
individualistic treatments for example resorting only to drug therapy, or physiotherapy. The
results presented the benefits of multidisciplinary treatments to not only improve pain, but also
mood as well as behavior in patients (Flor et al., 1992). Alleviating pain is a holistic priority
because it causes suffering and reduces the quality of life (Lewis, 2014, p. 154). Pain is the


initial reason why Adam sought after care. According to Potter et al. (2014), pain is the most
common reason for people to seek care (p. 1017). Relieving Adams chronic back pain will
help him adjust better to daily life. In the movie his pain was mainly what hindered his day-today routine as well as his relationships.
To address Adams priority concern of pain, the nurse has many responsibilities when
providing care. The first intervention would be for the nurse to administer the clients pain
medications. Because of the severity and invasiveness of the drug therapy, the nurse should be
very precautious before and after administration of medications. A thorough head to toe
assessment, vital signs and a pain assessment should be done in order to monitor how the
patient is tolerating his treatments as well as gaining a better understanding of the pain.
According to Jarvis et al. (2014), the ability to measure pain is an important component of a
comprehensive assessment (p. 186). Ultimately, understanding the patients pain will enhance
the nurses ability to provide care. Vital signs such as increased blood pressure, pulse and
respirations could indicate pain. The use of analgesic medication, especially narcotics will
depress these vital signs along with the central nervous system (Lilley, 2014, p.204). Thus,
when administering medication for pain it is also important to constantly monitor the clients
neurological status along with the vital signs and pain assessments. The second nursing
intervention is to alleviate the back pain by reducing the pressure on the area affected by the
tumor. Using special pillows such as donut cushions could help alleviate pressure on the
coccyx area. Laying the patient on their side could help take the pressure off of their back.
Providing patient education is an important intervention that the nurse should implement to
reduce pain. Health promotion enables individuals to gain control over and improve their
health and well being (Potter et al., 2014, 1036). Educating the patient about pain makes it a


decision-making process for the client and family. This helps reduce anxiety and increase selfcontrol. According to Potter et al. (2014), Fear increases the perception of painful stimuli(p.
1036). Therefore, by reducing fear and anxiety, pain becomes more manageable. The nurse
could implement health teaching about relaxation methods to reduce pain. Deep breathing and
relaxation through guided imagery are non-pharmacological techniques that could help alter
perceptions of pain (Potter et al., 2014, p. 1036).
When dealing with such a life-threatening and serious illness such as cancer,
collaborative care is critical in treatment. To provide collaborative care, there has to be a team
of inter-professional members that implement strategies in the best interest of the client and to
assist in recovery. Firstly, to relieve the immediate stimuli of pain is to remove the tumor in the
spine, which is done by the surgeons. Post surgery, nurses monitor the client with frequent
assessments of vital signs and pain, administering medications and providing care ordered by
the Doctors. After removal of the tumor, it is important for the patient to be able to return to
performing daily activities. Physiotherapy plays a big role in helping increase range of
movement and walking after surgery. Spinal surgery is quite invasive and is a high-risk
procedure as it could easily paralyze a client or could even be fatal. To prepare for this,
psychologists help develop coping mechanisms as well as stress relieving exercises for clients.
Breathing and calming strategies could help distract the client from pain as well as manage
anxiety of their condition and dealing with the possibility of death. This occurred in the movie
with Adam, and his psychologist Katherine.
There are many community resources that reach out to people who have cancer. At
Wellspring there are many volunteers who have cancer as well. These volunteers provide
comfort and guidance for patients as well as their family members who are facing the


challenges of cancer. This association provides access to a wide range of expertly led programs
and services to help cope and manage the impact of cancer on patients and their families lives.
Wellsprings programs range from music therapy to healing touch to help alleviate stress and
pain. The Canadian Cancer Society is another community resource that patients could utilize.
They recommend coping with pain by talking about it. Verbalizing pain will assist others to
find an effective way to relieve it. There are multiple other support groups to help with the
battle of cancer. The best way to cope for the patients is to know that they are not alone and
that there is hope in recovery as there was for Adam in 50/50.


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