PROSTATE CANCER Presented by: Franklin Que, BSN-RN
PROSTATE CANCER
Presented by: Franklin Que, BSN-RN
Learning Objectives:After the discussion, the students will be able to:
Identify the characteristics of cancer cells & the different causes of prostate cancer
Identify the signs & symptoms of prostate cancer
State the diagnostic procedure for prostate cancer
Describe the TNM classification of prostate cancer
Differentiate the different grade and staging of prostate cancer
Discuss the different treatments for prostate cancer
Apply the nursing interventions in caring for prostate cancer patient.
CancerIs an umbrella for a group of disorders in which certain cells grow and multiply uncontrollably, eventually forming tissue masses called tumors.
in cancer development, disorders of cell proliferation and differentiation exist
Proliferation
Refers to the process of cell renewal or replacement
Proliferative Patterns
Hyperplasia
Metaplasia
Dysplasia
Anaplasia
Neoplasia
Differentiation
Refers to the process by which cells diversify, acquire specific structural and functional characteristics, and mature.
Characteristics of Cancer Cells
Cells and tumors may be benign or malignant
Uncontrolled proliferation
Poor differentiation
Capacity to metastasize
Causes of CancerGenetic Factors
Hormonal Factors
Chemical carcinogens
Viruses
Radiation
Immune system alterations
Tumors are classified according to grade and stage
Grading
Involves categorizing tumors according to the cell differentiation and the relationship to the tissue of origin.
TNM Clinical Classification
Primary Tumor (T)
Regional Lymph Nodes (N)
Distant Metastasis (M)
Primary TumorTX - primary tumor can’t be
assessed
T0 – no evidence of primary tumor
Tis – Carcinoma in situ
T1, T2, T3, T4 – increasing size and/or local extent of the primary tumor
Regional Lymph Nodes
NX – regional lymph nodes cannot be assessed
N0 – no regional lymph node metastasis
N1, N2, N3 – increasing involvement of regional lymph nodes
Distant Metastasis
MX – presence of distant metastasis can’t be assessed
M0 – No distant metastasis
M1 – distant metastasis
Staging
Involves categorizing the disease progression, including the presence or absence of organ involvement.
Staging GroupingStage I – localized involvement
or single lymph node region.
Stage II – two or more lymph node region involvement
Stage III – involvement of nearby tissues.
Stage IV - Disseminated
7 Warning Signs of Cancer1. Change in bowel or bladder habits
2. A sore that doesn’t heal
3. Unusual bleeding or discharge
4. Thickening or lumps in breast or elsewhere
5. Indigestion or difficulty swallowing
6. Obvious change in wart or mole
7. Nagging cough or hoarseness
PROSTATE CANCER
ProstateIs a gland in the male reproductive system that produces the majority of fluid that makes up the semen, the thick fluid that carries the sperm.
Its function is regulated by testosterone.
Prostate Cancer
It is the most commonly occurring male cancer
It generally affects men over age 50.
Etiology
The exact cause is unknown.
Risk Factors associated includes: Age, Race, Genetic predisposition, Hormonal factors, Hx of STD, Exposure to chemical carcinogens, High fat diet.
Signs & Symptoms:
No warning s/sx of early prostate cancer.
It appears only in advanced disease stages.
Advanced disease stages:Difficulty in urination
Urinary dribbling
Urine retention
Unexplained cystitis
Hematuria- a rare sign
Back or pelvic pain
DRE may reveal a hard nodule, w/c may be felt before other s/sx develop
Pathophysiology
Prostate cancer grows slowly. When primary lesions spread beyond the prostate, they invade the prostatic capsule and spread along the ejaculatory ducts in the space between the seminal vesicles.
Diagnostic tests
DRE – may reveal a hard, fixed nodule.
Serum tumor markers – PSA
Transrectal prostatic ultrasonography
Biopsy
Serum acid phosphatase
Alkaline phosphatase
Bone scan
MRI & CT Scan
TNM Staging System of Prostate Cancer
Primary TumorTx – cannot be assessd
T0 – no evidence of primary tumor
Tis – carcinoma in situ
T1a – carcinoma in 5% or less of tissue resected; normal DRE
T1b – carcinoma in more than 5% of tissue resected; normal DRE
T1c – detected from elevated PSA alone; normal DRE
T2a – tumor in one lobe
T2b – tumor in both lobes
T3a – extracapsular extension
T3b – seminal vesicle involvement
T4 – adjacent organ involvement
Regional Lymph Nodes
Nx – cannot be assessed
N0 – no regional lymph node metastasis
N1 – metastasis in one or more regional lymph nodes
Distant Metastasis
Mx – cannot be assessed
M0 – no distant metastasis
M1 – distant metastasis present
Prostate Cancer StagingStage I – the tumor is found in the
prostate only.
Stage II – the tumor is grown inside the prostate but hasn’t extended beyond it.
Stage III – the cancer has spread outside the prostate but only barely.
Stage IV – the cancer has metastasized outside the prostate to other tissues.
Prostate Cancer Grading
Grading takes place after a biopsy
Grade refers to the cancer’s appearance and indicates how quickly a cancer is growing.
Grade 1 – the cancerous tissue looks very much like normal prostate cells.
Grade 2 to 4 – some cells do look like normal prostate cells, others do not.
Grade 5 – the cells don’t look like normal prostate cells.
Treatments:Radiation
Prostatectomy
Orchiectomy
Cryoablation
Hormone therapy with synthetic estrogen or leuprolide and flutamide
Chemotherapy
May be tried, if hormone or radiation therapy and surgery can’t be done or prove ineffective.
Common combinations include cyclophosphamide, vincristine. Doxorubicin, bleomycin, cisplatin, and vindesine
Nursing Interventions:Advise men over age 40 to have
DRE annually to aid early detection of prostate cancer.
Prepare patient for treatment
Provide supportive care if patient is scheduled for prostactectomy, along with good postoperative care and symptomatic treatment of radiation and post surgical complications.
If the patient has received radiation or hormonal therapy, watch for N&V, dry skin, and alopecia. Watch out for thrombophlebitis ( such as pain, tenderness, swelling, warmth, and redness in calf.
Teach and encourage him to begin perineal exercises within 24 to 48 hrs after surgery.
THANK YOU