Nursing Diagnosis:
Definition:
1. Impaired Urinary elimination related to functional
changes in lower urinary system.
2. AnxietyPrelated to diagnosis
3. Acute pain related metastasis of prostatic cancer
to bone.
Nursing interventions:
1. Encourage patient to express his fears and concerns
including those about changes in his sexual identity
2. Administer ordered analgesics and provide comfort
measures to reduce pain.
3. Catheterize the patient. Prepare patient for
orchiectomy or prostatectomy as indicated.
4. Encourage patient undergoing radiation to drink at
least 8-oz glasses of fluid daily.
Drugs:
Antineoplastic drugs
Flutamide (eulexin)- antiandrogen
Opioid/non-opioid (prednisone and
Mitoxantrone)
Laboratory and Diagnostic Tests:
1. Digital Rectal Examination (DRE)- recommended yearly
for males older than 40
2. Blood tests- show elevated levels of prostate-specific
antigen (PSA)
3. Transrectal prostatic ultrasonography- used for patients
with abnormal PSA test findings.
4. Bone scan and excretory urographymay determine the
diseases extent.
5. MRI and CT- can help define tumors extent.
Risk factors:
Prostate cancer is cancer that occurs
in the prostate- a small walnut-shaped
gland in men that produces the
seminal fluid that nourishes and
transports sperm.
Prostate Cancer
Medical Management:
Orchiectomy (removal of testes) to reduce
androgen production
Radical Prostatectomy- effective for localized
lesions without metastasis
Transurethral resection of the prostate- to
relieve obstruction in metastatic disease
Radiation therapy- cures locally invasive
lesions in early disease and may relive bone
pain from metastatic skeletal involvement.
Cryosurgery- for patients who cannot tolerate
surgery. This is to ablate the tumor.
Chemotherapy- (combinations of
cyclophosphamide, doxorubicin, fluoroucil,
cisplatin and etoposide)
Race: African American Men
Age: 50
Family history (Having a father or brother with
prostate cancer more than doubles a mans risk of
developing this disease)
Gene Changes: mutations in BRCA1 and BRCA2
Lynch Syndrome also known as hereditary non-
polyposis colorectal cancer
Diet- men who consume lots of red meat and high-fat
dairy products. Men who consume less fruits and
vegetables. Ment who consume too much calcium.
Smoking
Chemical Exposures e.g. exposure to Agent Orange
used in the Vietnam war.
Note: Those highlighted have less clear effect on
prostate cancer risk
Signs and Symptoms:
Usually asymptomatic in early stage
Nodule felt within the substance of the gland or
extensive hardening in the posterior lobe.
Advanced stage:
Lesion is stony hard and fixed
Symptoms of obstruction: Difficulty and frequency of
urination, urinary retention and decreased size and
force of urinary stream.
Blood in urine or semen; painful ejaculation
Symptoms of metastases: backache, hip pain,
perineal and rectal discomfort, anemia, weight loss,
weakness, nausea, and oliguria; hematuria may
result from urethral or bladder invasion.
Sexual Dysfuntion