Prostate Cancer

Running head: Prostate Cancer

PROSTATE CANCER

Ernite Hyman

Kaveta Ramkishun

Bruce Jackson

Medgar Evers College

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Every mans fear is to be diagnosed with any type of cancer. One of the most common cancers in men is prostate cancer. Study has shown that about 1 man in 6 will be diagnosed with prostate cancer sometime in his life. Prostate cancer is the second leading cause of cancer death in American men. About 1 in 36 will die of prostate cancer. However, this type of cancer is rare in men younger than 40. (American Cancer Society, 2011) Though there is no cure, a respectable treatment plan is put into place by the physician to make patients lives a little bit easier to cope with. Nurses also play a role in the treatment process by assessing, educating, and assisting the patient to choose and comply with medical regimens. The males prostate is part of the reproductive system, which is the size of a walnut. It is found in front of the rectum and below the bladder. This gland wraps around the urethra that carries urine to the bladder through the penis. It also produces semen that carries the sperm. As men get older they have a greater risk of developing an enlarged prostate that can cause prostate cancer. Men can be evaluated for prostate cancer with a blood test called a prostate-specific antigen (PSA) test or a digital rectal exam by a physician. Prostate cancer is more prevalent in African American men, than in any other race. African American men are more often diagnosed with prostate cancer when it is in advanced stages. They are over 2 times more likely to die from prostate cancer than white men. Hispanic/Latino and Asian-American men are less likely to develop prostate cancer. Family history is a strong risk factor. Men who have a father or

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a brother who has had prostate cancer have twice the risk of developing prostate cancer than a man without a family history of the disease. One in ten men who get prostate cancer has hereditary prostate cancer- cancer that is caused by genes inherited from their parents. (American Society, 2011) Environmental factors play a crucial role in the development of prostate cancer. Such examples are: geographical location, high-caloric/ high fat diet, and lack of exercise. Research has shown that Sweden and Canada has the highest death rate than those who live in the United States. It is also shown that men who consume high levels of saturated fat, red meat and sugar seem to be at a higher risk of developing prostate cancer.

In the early stages of prostate cancer most men may not develop any symptoms. However, men entering the late stages may experience problems such as; trouble urinating, blood in the urine and semen, swelling of legs, pelvic discomfort, and bone pain. In many cases, the tumor in the prostate can enlarge the prostate, in turn, causing it to press on the urethra. The pressing on the urethra can cause the passing of urine more difficult or more frequent. As a man gets older, the prostate may become enlarged and block the urethra or bladder. This is a common condition called benign prostatic hyperplasia (BPH). BPH is not cancer, but the symptoms of BPH are similar to the symptoms of prostate cancer. So, testing is needed to confirm a diagnosis.

Common nursing diagnosis found on Nursing Care Plans for Prostate Cancer Acute pain, Anxiety, Fear, Impaired urinary elimination, Ineffective coping, Risk for infection, Sexual dysfunction.

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The treatment options offered to men include periodic observation, radical prostatectomy, radiation therapy, hormonal therapy, and combination therapy. Each option offers challenges for the nurses who care for patients. Nurses must address issues with patients that impact quality of life and physical functioning (e.g., sexual dysfunction, incontinence, problems associated with radiation and surgery, recurrence of disease, and living with advanced metastatic disease). Nursing care is critical in the management of prostate cancer patients throughout the disease continuum. Patient education, as well as emotional support to the patient and spouse, is vital from screening to diagnosis, from treatment to cure, or from palliative care to hospice care. The challenge to oncology nursing is to assist men in making appropriate decisions regarding treatment options. Watch for signs of urethral stricture (dysuria decreased force and caliber of urine stream and straining to urinate). Also observe for abdominal distention (a result of urethral stricture or catheter blockage by a blood clot). Irrigate the catheter as ordered. Assess urine output and catheter/drainage system, especially during bladder irrigation. Record the time and amount of color of void.

Watch for the common adverse effects of radiation to the prostate. These include proctitis, diarrhea, bladder spasms, and urinary frequency. Internal radiation of the prostate almost often results in cystitis in the first 2 to 3 weeks of therapy. Encourage the patient to drink at least 2000 ml of fluid daily. Administer analgesics and antispasmodics to increase comfort. Maintain patency of catheter and drainage system. Keep tubing free of kinks and clots.

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When a patient receives hormonal therapy with diethylstilbestrol, watch for adverse effects (gynecomastia fluid retention nausea and vomiting). Be alert for thrombophlebitis (pain tenderness swelling warmth and redness in calf).

Assess pain, noting location, intensity (0-10 scale). Provide comfort measures; example: position changes/back rub, therapeutic touch, and dimensional activities. Encourage use of relaxation techniques, including deep breathing exercises, visualization, and guided imagery.

Provide openings for client to talk about concerns of incontinences and sexual functioning. Give accurate information about expectation of return of sexual function. Discuss retrograde ejaculation if transurethral/suprapubic approach is used. Refer to sexual counselor as indicated.

Teach the patient the following points: Show him how to care for his skin, including perianal skin, and to monitor skin integrity. Explain how to use skin moisturizers and protectants. Suggest that he wear loose cotton undergarments and nonirritating outer clothing. Encourage a low-residue diet to help manage diarrhea. He can also use prescribed or over-the-counter antidiarrheal medication. Remind him to drink plenty of fluids and to replace lost electrolytes. Advise him to avoid alcohol, caffeine, spices, and tobacco, which irritate the bladder mucosa and can aggravate urinary tract symptoms.

Teach him to recognize signs and symptoms of infection and ways to prevent infection.

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Assess him for other social issues, such as sexual dysfunction (he may need treatment for erectile dysfunction or a referral for counseling), fatigue (teach energy conservation techniques), and bone marrow depression (he'll have a CBC count weekly and as needed). Teach the patient that hematuria typically lasts up to 3 days after seed placement. He also may notice that his semen is discolored red, brown, or black from blood. The patient should wash his perineum daily with soap and water and use cold packs, sitz baths, and mild oral analgesics for perineal discomfort for the first day post-procedure. Tell him to call his health care provider immediately if he can't void and to repo-t rectal bleeding, rectal irritation, gassy bowel movements, or diarrhea. In conclusion, although prostate cancer may be fatal, treatment is readily available. However, educating men on how to minimize their chances of receiving prostate cancer can be vital for their health. They can be informed about maintaining a low-caloric/fat diet, exercising, and a regular visit to their physician.

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Cited Work

American Cancer Society. Cancer Facts and Figures 2011. Atlanta, Ga: American Cancer Society; 2011. American Joint Committee on Cancer. Prostate. In: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer.

Barton-Burke, Margaret, AJN, American Journal of Nursing. 106():72-77, March 2006.

Pain and Neuropathy in Cancer Survivors: Surgery, radiation, and chemotherapy can cause pain; research could improve its detection and treatment , Polomano, Rosemary C.; Farrar, John T. AJN, American Journal of Nursing. 106():39-47, March 2006.