Focus on Prostate Cancer - Lecture Slides |, Study notes of Nursing

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Focus on

Prostate Cancer

“Nursing Management: Male Reproductive Problems”

Significance

 Malignant tumor of the prostate  Estimated 232,000 new cases diagnosed and 30,350 deaths annually  1 in every 5 men will develop it in their lifetime

Etiology and

Pathophysiology

 Androgen-dependent adenocarcinoma  Majority of tumors occur in outer aspect of the gland  Usually slow growing

Etiology and Pathophysiology (Cont’d)  Spreads by three routes

Direct extension

Through lymph system

Through bloodstream

 Veins from the prostate seem to be mode of spread to Pelvic bones Head of femur Lower lumbar spine Liver Lungs Etiology and Pathophysiology (Cont’d)

 Age, ethnicity, and family history are nonmodifiable risk factors  Incidence rises more than 80% after 50 years of age Etiology and Pathophysiology (Cont’d)

 High-fat diet associated with increased risk  Exposure to certain chemicals may be associated with higher risk  History of BPH is NOT a risk factor Etiology and Pathophysiology (Cont’d)

Clinical Manifestations

 Usually asymptomatic in early stages  Eventually may experience symptoms similar to BPH Dysuria Hesitancy Dribbling Frequency

Clinical Manifestations

(Cont’d)

 Pain in lumbosacral area that radiates to hips or legs, when coupled with urinary symptoms, could indicate metastasis  Once cancer has spread to distant sites, pain management becomes major problem

Diagnostic Studies

 Two primary screening tools PSA (prostate-specific antigen) blood test

• Elevated levels indicate prostatic pathology—not necessarily cancer
• Marker of tumor volume when cancer exists
• Also used to monitor success of treatment

Diagnostic Studies

(Cont’d)

Elevated levels of PAP

(prostatic acid phosphatase) also indicate prostate cancer

Diagnostic Studies

(Cont’d)

 Neither a PSA or DRE is a definitive diagnostic test  Biopsy of prostate tissue is necessary to confirm diagnosis Done using Trans-Rectal UltraSound visualize and pinpoint abnormalities

Collaborative Care

Staging  Whitmore-Jewett  (TNM) system used to stage prostate cancer Tumor, Node, Metastasis Based on size (volume) and spread

Collaborative Care

(Cont’d)

 Conservative therapy Watchful waiting when

• Life expectancy is less than 10 years
• Presence of significant comorbid disease
• Presence of low-grade, low-stage tumor