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Prostate Cancer Overview and Management

Prostate cancer forms in the prostate gland and can range from early stage cancers contained within the prostate to later stages that have metastasized. Risk factors include genetics, race, diet, and hormones. Early stage prostate cancers may be asymptomatic, while later stages can cause urinary issues, pelvic pain, and symptoms from metastases. Diagnosis involves a digital rectal exam, PSA blood test, and prostate biopsy. Staging evaluates extent of spread. Treatment options include surgery, radiation therapy, hormone therapy, and watchful waiting depending on stage and risk level. Nursing care focuses on managing urinary issues, pain, nutrition, and sexual functioning.

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Jasmin Jacob
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731 views59 pages

Prostate Cancer Overview and Management

Prostate cancer forms in the prostate gland and can range from early stage cancers contained within the prostate to later stages that have metastasized. Risk factors include genetics, race, diet, and hormones. Early stage prostate cancers may be asymptomatic, while later stages can cause urinary issues, pelvic pain, and symptoms from metastases. Diagnosis involves a digital rectal exam, PSA blood test, and prostate biopsy. Staging evaluates extent of spread. Treatment options include surgery, radiation therapy, hormone therapy, and watchful waiting depending on stage and risk level. Nursing care focuses on managing urinary issues, pain, nutrition, and sexual functioning.

Uploaded by

Jasmin Jacob
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
  • Introduction
  • Etiology and Risk Factors
  • Clinical Signs and Symptoms
  • Normal Anatomy and Comparison
  • Pathophysiology
  • Stages of Prostate Cancer
  • Assessment and Diagnostic Study
  • Possible Complications
  • Medical and Surgical Management
  • Radiation Therapy
  • Hormonal Therapy
  • Brachytherapy
  • Nursing Diagnosis and Interventions
  • Other Therapies

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 [Link] 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

Pathophysiolog
y
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

Brachythera
py
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
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


Sexual
Functioning:

 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”

_thank you for


listening_

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 mo
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 o
Prostate Cancer PC can metastasized to bone and lymph nodes s/s of metastases: Backache, Hip pain Perineal and rectal d
Prostate Cancer Normal Anatomy and Comparison

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