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PROSTATE CANCER
RATHEESH R L
• Prostate cancer is cancer that occurs in a
man's prostate — a small walnut-shaped
gland that produces the seminal fluid that
nourishes and transports sperm.
• Prostate cancer is one of the most common
types of cancer in men. Prostate cancer
usually grows slowly and initially remains
confined to the prostate gland, where it may
not cause serious harm.
• While some types of prostate cancer grow
slowly and may need minimal or no
treatment, other types are aggressive and can
spread quickly.
• Prostate cancer that is detected early — when
it's still confined to the prostate gland — has a
better chance of successful treatment.
CAUSES AND RISK FACTORS
It's not clear what causes prostate cancer.
• Older age. Your risk of prostate cancer
increases as you age.
• Being black. Black men have a greater risk of
prostate cancer than do men of other races. In
black men, prostate cancer is also more likely
to be aggressive or advanced. It's not clear
why this is.
• Family history of prostate or breast cancer. If
men in your family have had prostate cancer,
your risk may be increased. Also, if you have a
family history of genes that increase the risk of
breast cancer (BRCA1 or BRCA2) or a very strong
family history of breast cancer, your risk of
prostate cancer may be higher.
• Obesity. Obese men diagnosed with prostate
cancer may be more likely to have advanced
disease that's more difficult to treat.
Whitmore-Jewett staging
classification
• Stage A : clinically
unrecognized
• A1 : <5% of prostatic tissue
neoplastic
• A2 : >5% of prostatic tissue
neoplastic, all high grade tumors
8
9
Whitmore-Jewett staging
classification
• Stage B : clinically
intracapsular
• B1 : nodule <2cm & sorrounded by
palpably normal tissue
• B2 : nodule >2cm or multiple
nodules
10
11
Whitmore-Jewett staging
classification
• Stage C : clinically extracapsular
• C1 : minimal extracapsular extension
• C2 : large tumors involving seminal
vesicles adjacent structures or both
12
13
Whitmore-Jewett staging
classification
• Stage D : metastatic disease
• D1 : pelvic lymph node metastasis
• D2 : Distant metatstsis to bone,
viscera, or other soft tissue
structures
14
15
SIGNS AND SYMPTOMS
Prostate cancer may cause no signs or symptoms in
its early stages.
• Prostate cancer that is more advanced may cause
signs and symptoms such as:
– Trouble urinating
– Decreased force in the stream of urine
– Blood in the semen
– Discomfort in the pelvic area
– Bone pain
– Erectile dysfunction
DIAGNOSIS
• Whether to test healthy men with no
symptoms for prostate cancer is controversial.
Medical organizations don't agree on the issue
of screening and whether it has benefits.
• Some medical organizations recommend men
consider prostate cancer screening in their
50s, or sooner for men who have risk factors
for prostate cancer.
• Digital rectal exam (DRE). During a DRE, your
doctor inserts a gloved, lubricated finger into
your rectum to examine your prostate, which
is adjacent to the rectum. If your doctor finds
any abnormalities in the texture, shape or size
of your gland, you may need more tests.
• Prostate-specific antigen (PSA) test. A blood
sample is drawn from a vein in your arm and
analyzed for PSA, a substance that's naturally
produced by your prostate gland. It's normal
for a small amount of PSA to be in your
bloodstream. However, if a higher than
normal level is found, it may be an indication
of prostate infection, inflammation,
enlargement or cancer.
• Ultrasound. If other tests raise concerns, your
doctor may use transrectal ultrasound to
further evaluate your prostate. A small probe,
about the size and shape of a cigar, is inserted
into your rectum. The probe uses sound waves
to make a picture of your prostate gland.
• Collecting a sample of prostate tissue. If
initial test results suggest prostate cancer,
your doctor may recommend a procedure to
collect a sample of cells from your prostate
(prostate biopsy). Prostate biopsy is often
done using a thin needle that's inserted into
the prostate to collect tissue. The tissue
sample is analyzed in a lab to determine
whether cancer cells are present.
TREATMENT
• For men diagnosed with very early-stage prostate
cancer, treatment may not be necessary right
away. Some men may never need treatment.
Instead, doctors sometimes recommend active
surveillance.
• In active surveillance, regular follow-up blood
tests, rectal exams and possibly biopsies may be
performed to monitor progression of your cancer.
If tests show your cancer is progressing, you may
opt for a prostate cancer treatment such as
surgery or radiation.
Radiation therapy
Radiation therapy uses high-powered energy to kill
cancer cells. Prostate cancer radiation therapy can
be delivered in two ways:
• Radiation that comes from outside of your body
(external beam radiation). During external beam
radiation therapy, you lie on a table while a
machine moves around your body, directing high-
powered energy beams, such as X-rays or
protons, to your prostate cancer. You typically
undergo external beam radiation treatments five
days a week for several weeks.
• Radiation placed inside your body
(brachytherapy).
Brachytherapy involves placing many
rice-sized radioactive seeds in your prostate
tissue. The radioactive seeds deliver a low dose
of radiation over a long period of time. Your
doctor implants the radioactive seeds in your
prostate using a needle guided by ultrasound
images. The implanted seeds eventually stop
giving off radiation and don't need to be
removed.
SURGERY
• Radical prostatectomy
it is surgery to remove the
entire prostate gland and surrounding lymph
nodes.
• Laparoscopic prostatectomy. During a
laparoscopic radical prostatectomy, the doctor
performs surgery through small incisions in
the abdomen with the assistance of a tiny
camera (laparoscope).
• Surgery to remove the testicles
(orchiectomy).
Removing your testicles reduces
testosterone levels in your body.
Chemotherapy
• Chemotherapy uses drugs to kill rapidly
growing cells, including cancer cells.
Chemotherapy can be administered through a
vein in your arm, in pill form or both.
Biological therapy
• Biological therapy (immunotherapy) uses your
body's immune system to fight cancer cells.
One type of biological therapy called
sipuleucel-T (Provenge) has been developed
to treat advanced, recurrent prostate cancer.
COMPLICATIONS
• Cancer that spreads (metastasizes). Prostate
cancer can spread to nearby organs, such as
your bladder, or travel through your
bloodstream or lymphatic system to your
bones or other organs. Prostate cancer that
spreads to the bones can cause pain and
broken bones. Once prostate cancer has
spread to other areas of the body, it may still
respond to treatment and may be controlled,
but it's unlikely to be cured.
• Incontinence. Both prostate cancer and its
treatment can cause urinary incontinence.
Treatment for incontinence depends on the
type you have, how severe it is and the
likelihood it will improve over time. Treatment
options may include medications, catheters
and surgery.
• Erectile dysfunction. Erectile dysfunction can
be a result of prostate cancer or its treatment,
including surgery, radiation or hormone
treatments. Medications, vacuum devices that
assist in achieving erection and surgery are
available to treat erectile dysfunction.
PREVENTION
• Choose a healthy diet full of fruits and
vegetables. Avoid high-fat foods and instead
focus on choosing a variety of fruits, vegetables
and whole grains.
• Exercise most days of the week. Exercise
improves your overall health, helps you maintain
your weight and improves your mood. There is
some evidence that men who don't exercise have
higher PSA levels, while men who exercise may
have a lower risk of prostate cancer.
• Maintain a healthy weight. If your current
weight is healthy, work to maintain it by
exercising most days of the week. If you need
to lose weight, add more exercise and reduce
the number of calories you eat each day.
NURSING DIAGNOSIS WITH
MANAGEMENT
1. Impaired Urinary Elimination related to an enlarged
prostate, and bladder distension.
Intervention:
Encourage the patient to urinate every 2-4 hours and
when it suddenly felt.
– Observation of the flow of urine, note the size and
strength.
– Percussion / palpation of the suprapubic area.
– Encourage fluid intake to 3000 ml per day.
– Monitor vital signs closely
– Collaboration in the provision of drugs.
2. ResKkfor Infection related to invasive procedures
(tools during surgery)
Intervention:
Maintain a sterile catheter system, provide catheter care
and give regular antibiotic ointment around the catheter.
– Perform ambulation with dependent drainage bag.
– Observation of wound drainage around suprapubic
catheter.
– Replace dressings with frequent (supra incision /
retropubic and perineal), cleaning and drying of the
skin over time.
– Collaboration in the provision of antibiotics.
• 3. Imbalanced Nutrition, Less Than Body
Requirements related to the nausea and weight
loss
Intervention:
Assess the patient's nutritional status.
• Encourage the patient to eat small amounts
frequently.
• Collaborate with a nutritionist.
• Collaborate with the physician in the delivery
of antiemetic drugs.
Prostate cancer

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Prostate cancer

  • 2. • Prostate cancer is cancer that occurs in a man's prostate — a small walnut-shaped gland that produces the seminal fluid that nourishes and transports sperm.
  • 3. • Prostate cancer is one of the most common types of cancer in men. Prostate cancer usually grows slowly and initially remains confined to the prostate gland, where it may not cause serious harm.
  • 4. • While some types of prostate cancer grow slowly and may need minimal or no treatment, other types are aggressive and can spread quickly.
  • 5. • Prostate cancer that is detected early — when it's still confined to the prostate gland — has a better chance of successful treatment.
  • 6. CAUSES AND RISK FACTORS It's not clear what causes prostate cancer. • Older age. Your risk of prostate cancer increases as you age. • Being black. Black men have a greater risk of prostate cancer than do men of other races. In black men, prostate cancer is also more likely to be aggressive or advanced. It's not clear why this is.
  • 7. • Family history of prostate or breast cancer. If men in your family have had prostate cancer, your risk may be increased. Also, if you have a family history of genes that increase the risk of breast cancer (BRCA1 or BRCA2) or a very strong family history of breast cancer, your risk of prostate cancer may be higher. • Obesity. Obese men diagnosed with prostate cancer may be more likely to have advanced disease that's more difficult to treat.
  • 8. Whitmore-Jewett staging classification • Stage A : clinically unrecognized • A1 : <5% of prostatic tissue neoplastic • A2 : >5% of prostatic tissue neoplastic, all high grade tumors 8
  • 9. 9
  • 10. Whitmore-Jewett staging classification • Stage B : clinically intracapsular • B1 : nodule <2cm & sorrounded by palpably normal tissue • B2 : nodule >2cm or multiple nodules 10
  • 11. 11
  • 12. Whitmore-Jewett staging classification • Stage C : clinically extracapsular • C1 : minimal extracapsular extension • C2 : large tumors involving seminal vesicles adjacent structures or both 12
  • 13. 13
  • 14. Whitmore-Jewett staging classification • Stage D : metastatic disease • D1 : pelvic lymph node metastasis • D2 : Distant metatstsis to bone, viscera, or other soft tissue structures 14
  • 15. 15
  • 16. SIGNS AND SYMPTOMS Prostate cancer may cause no signs or symptoms in its early stages. • Prostate cancer that is more advanced may cause signs and symptoms such as: – Trouble urinating – Decreased force in the stream of urine – Blood in the semen – Discomfort in the pelvic area – Bone pain – Erectile dysfunction
  • 17. DIAGNOSIS • Whether to test healthy men with no symptoms for prostate cancer is controversial. Medical organizations don't agree on the issue of screening and whether it has benefits. • Some medical organizations recommend men consider prostate cancer screening in their 50s, or sooner for men who have risk factors for prostate cancer.
  • 18. • Digital rectal exam (DRE). During a DRE, your doctor inserts a gloved, lubricated finger into your rectum to examine your prostate, which is adjacent to the rectum. If your doctor finds any abnormalities in the texture, shape or size of your gland, you may need more tests.
  • 19. • Prostate-specific antigen (PSA) test. A blood sample is drawn from a vein in your arm and analyzed for PSA, a substance that's naturally produced by your prostate gland. It's normal for a small amount of PSA to be in your bloodstream. However, if a higher than normal level is found, it may be an indication of prostate infection, inflammation, enlargement or cancer.
  • 20. • Ultrasound. If other tests raise concerns, your doctor may use transrectal ultrasound to further evaluate your prostate. A small probe, about the size and shape of a cigar, is inserted into your rectum. The probe uses sound waves to make a picture of your prostate gland.
  • 21. • Collecting a sample of prostate tissue. If initial test results suggest prostate cancer, your doctor may recommend a procedure to collect a sample of cells from your prostate (prostate biopsy). Prostate biopsy is often done using a thin needle that's inserted into the prostate to collect tissue. The tissue sample is analyzed in a lab to determine whether cancer cells are present.
  • 22. TREATMENT • For men diagnosed with very early-stage prostate cancer, treatment may not be necessary right away. Some men may never need treatment. Instead, doctors sometimes recommend active surveillance. • In active surveillance, regular follow-up blood tests, rectal exams and possibly biopsies may be performed to monitor progression of your cancer. If tests show your cancer is progressing, you may opt for a prostate cancer treatment such as surgery or radiation.
  • 23. Radiation therapy Radiation therapy uses high-powered energy to kill cancer cells. Prostate cancer radiation therapy can be delivered in two ways: • Radiation that comes from outside of your body (external beam radiation). During external beam radiation therapy, you lie on a table while a machine moves around your body, directing high- powered energy beams, such as X-rays or protons, to your prostate cancer. You typically undergo external beam radiation treatments five days a week for several weeks.
  • 24. • Radiation placed inside your body (brachytherapy). Brachytherapy involves placing many rice-sized radioactive seeds in your prostate tissue. The radioactive seeds deliver a low dose of radiation over a long period of time. Your doctor implants the radioactive seeds in your prostate using a needle guided by ultrasound images. The implanted seeds eventually stop giving off radiation and don't need to be removed.
  • 25. SURGERY • Radical prostatectomy it is surgery to remove the entire prostate gland and surrounding lymph nodes.
  • 26. • Laparoscopic prostatectomy. During a laparoscopic radical prostatectomy, the doctor performs surgery through small incisions in the abdomen with the assistance of a tiny camera (laparoscope).
  • 27. • Surgery to remove the testicles (orchiectomy). Removing your testicles reduces testosterone levels in your body.
  • 28. Chemotherapy • Chemotherapy uses drugs to kill rapidly growing cells, including cancer cells. Chemotherapy can be administered through a vein in your arm, in pill form or both.
  • 29. Biological therapy • Biological therapy (immunotherapy) uses your body's immune system to fight cancer cells. One type of biological therapy called sipuleucel-T (Provenge) has been developed to treat advanced, recurrent prostate cancer.
  • 30. COMPLICATIONS • Cancer that spreads (metastasizes). Prostate cancer can spread to nearby organs, such as your bladder, or travel through your bloodstream or lymphatic system to your bones or other organs. Prostate cancer that spreads to the bones can cause pain and broken bones. Once prostate cancer has spread to other areas of the body, it may still respond to treatment and may be controlled, but it's unlikely to be cured.
  • 31. • Incontinence. Both prostate cancer and its treatment can cause urinary incontinence. Treatment for incontinence depends on the type you have, how severe it is and the likelihood it will improve over time. Treatment options may include medications, catheters and surgery.
  • 32. • Erectile dysfunction. Erectile dysfunction can be a result of prostate cancer or its treatment, including surgery, radiation or hormone treatments. Medications, vacuum devices that assist in achieving erection and surgery are available to treat erectile dysfunction.
  • 33. PREVENTION • Choose a healthy diet full of fruits and vegetables. Avoid high-fat foods and instead focus on choosing a variety of fruits, vegetables and whole grains. • Exercise most days of the week. Exercise improves your overall health, helps you maintain your weight and improves your mood. There is some evidence that men who don't exercise have higher PSA levels, while men who exercise may have a lower risk of prostate cancer.
  • 34. • Maintain a healthy weight. If your current weight is healthy, work to maintain it by exercising most days of the week. If you need to lose weight, add more exercise and reduce the number of calories you eat each day.
  • 35. NURSING DIAGNOSIS WITH MANAGEMENT 1. Impaired Urinary Elimination related to an enlarged prostate, and bladder distension. Intervention: Encourage the patient to urinate every 2-4 hours and when it suddenly felt. – Observation of the flow of urine, note the size and strength. – Percussion / palpation of the suprapubic area. – Encourage fluid intake to 3000 ml per day. – Monitor vital signs closely – Collaboration in the provision of drugs.
  • 36. 2. ResKkfor Infection related to invasive procedures (tools during surgery) Intervention: Maintain a sterile catheter system, provide catheter care and give regular antibiotic ointment around the catheter. – Perform ambulation with dependent drainage bag. – Observation of wound drainage around suprapubic catheter. – Replace dressings with frequent (supra incision / retropubic and perineal), cleaning and drying of the skin over time. – Collaboration in the provision of antibiotics.
  • 37. • 3. Imbalanced Nutrition, Less Than Body Requirements related to the nausea and weight loss Intervention: Assess the patient's nutritional status. • Encourage the patient to eat small amounts frequently. • Collaborate with a nutritionist. • Collaborate with the physician in the delivery of antiemetic drugs.