prostate cancer
TRANSCRIPT
Prostate Cancer
Prostate Cancer
Cancer that forms in
tissues of the prostate
Prostate Cancer
Etiology/Risk factors
Prostate Cancer
Genetics Gene alterations on chromosome 1, 17, and the X
chromosome Race Prostate cancer is the most common type of cancer
found in American men, other than non melanoma skin cancer.Although men of any age can get prostate cancer, it is found most often in men over age 50. In fact, more than 8 of 10 men with prostate cancer are over the age of 65.
Diet Men who are obese and eat a diet high in fat are
also at a higher risk for prostate cancer. A high-fat diet may lead to increased risks, while a diet rich in soy may be protective
Hormonal
Prostate Cancer
Clinical Signs and
Symptoms
Prostate Cancer
Symptoms of urinary obstructions Pain with ejaculation Hip and lower back pain that does
not go away over time Pain in the lower part of your pelvis Unintended weight loss and/or loss of
appetite
Prostate Cancer
PC can metastasized to bone and lymph nodes
s/s of metastases: Backache, Hip pain Perineal and rectal discomfort Anemia, nausea Weight loss, weakness Oliguria
Prostate Cancer
Normal Anatomy and Comparison
Prostate Cancer
Pathophysiology
Prostate Cancer
Predisposing and precipitating factors
Develops the rates of cell division and cell death are no longer equal, leading to uncontrolled tumor growth.
Transitional cell morphology and are thought to arise from the urothelial lining of the prostatic urethra
70% arise in the peripheral zone, 15-20% arise in the central zone, and
10-15% arise in the transitional zone.
They become multifocal, with synchronous involvement of multiple zones of the prostate, which may be due to clonal and nonclonal
tumors.
Prostate Cancer
Primary tumor, that cannot be assessed clinically tumor not palpable or viosible by imaging
Tumor incidental histologic finding in less than or equal to 5% of tissue resected
Tumor confined within prostate,nvolving less than half a lobe
Tumor involving less than or equal to 1 lobe
Tumor involving both lobes extending through the prostatic capsule; no
invasion into the prostatic apex or into, but not beyond, the prostatic capsule
Prostate Cancer
Tumor invading seminal vesicle(s)
Tumor fixed or invading adjacent structures other than seminal vesicles (eg, bladder neck, external sphincter, rectum, levator muscles, pelvic
wall)
Prostate Cancer
Stages of
Prostate Cancer
Prostate Cancer Prostate Cancer Stage I In stage I, prostate cancer is found in the prostate only.
Stage I prostate cancer is microscopic; it can’t be felt on a digital rectal exam (DRE), and it isn’t seen on imaging of the prostate.
Prostate Cancer Stage II In stage II, the tumor has grown inside the prostate but
hasn’t extended beyond it. Prostate Cancer Stage III Stage III prostate cancer has spread outside the
prostate, but only barely. Prostate cancer in stage III may involve nearby tissues, like the seminal vesicles.
Prostate Cancer Stage IV In stage IV, the cancer has spread (metastasized)
outside the prostate to other tissues. Stage IV prostate cancer commonly spreads to lymph nodes, the bones, liver, or lungs.
Prostate Cancer
Assessment and
Diagnostic Study
Abnormal finding of DRE, Serum PSA or TRUS with Biopsy
Digital Rectal Exam
Serum PSA
Prostate Cancer
Routine repeated rectal palpation of the gland
Histologic examination of tissue removed surgically by TUR
Open prostatectomy
Prostate Cancer
Transrectal Needle Biopsy
Prostate Cancer
Fine needle aspiration Radio labeled monoclonal anti
body capromab pendetide with indium 111 (ProstaScint)
Anti body that is attracted to the prostate specific membrane antigen found on prostate cancer cells.
Prostate Cancer
Possible Complications
Prostate Cancer
Sexual dysfunction (DOC PDE-5 inhibitors)
Hormonal therapy also affects the CNS mechanisms that mediate sexual desire and arousability
Prostate Cancer
Medical / Surgical
Management
Prostate Cancer
Treatment are based on stage of disease, patients age and symptoms.
Radical Prostatectomy
Laparoscopic Radical Prostatectomy
Prostate Cancer
Radiation Therapy
Prostate Cancer
Teletherapy (external beam radiation therapy)
Intensity modulated radiation therapy
Prostate Cancer
Hormonal Therapy
Prostate Cancer
Androgen Withdrawal
Prostate Cancer
Brachytherapy
Prostate Cancer
Nursing Diagnosis
and Interventions
Prostate Cancer
Urinary retention r/t urethral obstruction secondary to prostatic tumor
Improve pattern of urinary elimination Determine patients usual pattern of
urinary function Assess for s/s of urinary retention, amt
and frequency of urination, supraspubic distention, complaints of urgency and discomfort
Catheterized to determine amount of residual urine
Prostate Cancer
Deficient knowledge r/t diagnosis of cancer, urinary difficulties and treatment modalities
Initiate measures to treat retention Encourage assuming normal position for
voiding Recommend using valsalva maneuver
preoperatively Consult physician regarding intermittent or
indwelling catheterization Monitor catheter function Prepare patients for surgery if indicated
Prostate Cancer
Maintain Optimal Nutritional Status:
Assess the amt. of food eaten Routinely weight the pt. Recognize effect of medication or
radiation therapy on appetite Inform pt. that alterations in taste can
occur Use measures to control N/V Provide small frequent meals,
comfortable and pleasant environment
Prostate Cancer
Ability to Resume/ Enjoy Modified SexualFunctioning:
Inform patient of the effect of surgery and such therapy
Include partner ion developing understanding and discovering alternative, satisfying close relations with each other
Prostate Cancer
Relief of Pain:
Evaluate pt.’s pain, its location, intensity using pain rating scale
Instruct to avoid activities that aggravate or worsen pain
Because the pain is can be r/t bone metastases, ensure that pt.’s bed has a bed board on a firm mattress, also protect the pt. from falls and injuries
Provide support for affected extremities Prepare pt. for radiation therapy Administer analgesics or opiods ate regularly
scheduled intervals Initiate vowel program to prevent constipation
Prostate Cancer
Improved Physical Mobility:
Assess for factors causing immobility ( pain, hypercalcemia, limited exercise intolerance)
Provide medication for pain relief Assess nutritional status Monitor for collaborative problems
such as, hemorrhage, infection, bladder neck obstruction
Prostate Cancer
Other Therapies
Cryosurgery of the Prostate
Prostate Cancer
Chemotherapy
Using Agents:
Doxorubicin Cisplatin cyclophosphamide
Transurethral Resection of the Prostate
Prostate Cancer
Other Types of
Prostatectomy
Suprapubic Prostatectomy
Perineal Prostatectomy
“ the beginning of knowledge is in the discovery of something we don’t understand”
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