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NURS 3512 > Week 9 Prostate Cancer > Flashcards

Week 9 Prostate Cancer Flashcards

1
Q

What is prostate cancer?

A
  • A malignant tumour of the prostate gland
  • Slow Growing
  • androgen- dependent adenocarcinoma
  • Many men die with prostate cancer but not from it
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2
Q

Signs and symptoms of prostate cancer. Early and Late

A

Early: asymptotic
Late: symptoms are similar to BPH

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3
Q

Late symptoms of prostate cancer (10)

A
  • dysuria
  • hesitancy
  • dribbling
  • frequency
  • urgency
  • hematuria
  • nocturia
  • retention
  • interruption of urinary stream
  • Inability to urinate
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4
Q

Diagnostics for Prostate cancer

A
  • PSA levels - increase
  • Digital Rectum Exam - prostate will feel asymmetrical, hard and nodular
  • TRUS scan and biopsy for confirmation
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5
Q

How do we know if cancer metastasize

A
  • Pain in the lumbosacral are that radiates down to hips or legs
  • spreads through lymph system and spread through blood stream
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6
Q

Is Prostate cancer curable?

A

if its caught in an early stage it is curable

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7
Q

When is conservative treatment appropriate? (3)

A
  • When patient has a life expectancy of less than 10 years ( low risk of dying of the disease)
  • Serious coexisting medical conditions
  • low grade, low-stage tumour

–> these patients are usually followed with frequent PSA measurements, along with DRE, to monitor for progress of the disease.

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8
Q

What are the 3 surgery for prostate cancer?

A
  • Radical prostatectomy
  • Nerve- sparing procedure
  • Cryosurgery
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9
Q

what is radical prostectomy?

A
  • the entire prostate gland, seminal vesicles, and part of bladder neck are surgically removed
  • the entire prostate is removed because cancer tends to be in many different locations within the gland.
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10
Q

when is surgery not recommended?

A

not an option for advanced stage disease (except to relieved symptoms associated with obstruction) because metastasis has already occurred.

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11
Q

what are the two most common approach for radical prostatectomy?

A

retropubic and perineal resection

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12
Q

what is retropubic resection?

A
  • a low midline abdominal incision is made to access the prostate gland
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13
Q

what is perineal resection

A

an incision is made between the scrotum and the anus.

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14
Q

post op radical prostatectomy

A
  • after surgery the patient has a large in-dwelling catheter with a 30-mL balloon placed in the bladder via the urethra.
  • This catheter is typically left in place for 1-2 weeks.
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15
Q

post op care for radical prostatectomy

A
  • make sure wound is healing

- make sure perineal approach incision is clean and dry and not contaminated with stool

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16
Q

what are major complication for post op care for radical prostatectomy

A
  1. erectile dysfunction - may have cut the nerves that control erection
  2. Incontinents - have to remove neck of bladder and sow it back to the urethra
17
Q

post op education

A
  • overtime bladder adjust and most men do gain control

- Encourage kegel exercises to strengthen urinary sphincter

18
Q

What is nerve-sparing procedure

A
  • remove prostate and preserve neuromuscular

- hope to remove all prostate but hope that nerves intact to allow for an erection

19
Q

Nerve-Sparing procedure is not indicated in patients with

A

patients with cancer outside of their prostate gland

20
Q

What is Cryosurgery

A
  • a surgical technique for prostate cancer that destroys cancer cells by freezing the tissue.
  • A TRUS probe is inserted to visualize the prostate gland. The prob contains liquid nitrogen which delivers freezing temperature destroying the tissues
  • Does not involve any incisions
  • requires general or spinal anaesthesia
21
Q

Cryosurgery complications

A
  • damage to the urethra
  • opening between urethra and the skin (rare)
  • opening between urethra and rectum (rare)
22
Q

Radiation therapy

A

a common treatments option for prostate cancer, especially for men older than 70, patients who are poor surgical risk, or those who with to avoid surgery

23
Q

Radiation: External beam Irradiation

A
  • this therapy can be used to treat patients with prostate cancer confined to the prostate ;or surrounding tissue.
  • Patients are treated on an outpatient basis 5 days a week for 4 to 8 weeks.
24
Q

Radiation: Brachytherapy

A
  • involves the implantation of the radioactive seeds into the prostate gland, allowing higher radiation doses directly in the tissue while sparing the surrounding tissue.
  • The radioactive seeds is placed in the prostate gland with a needle through a grid template guided by TRUS.
25
Q

Radiation: Brachytherapy is best suited for?

A
  • Patients with early stage of prostate cancer
26
Q

What meds are offered for prostate cancer?

A
  1. Androgen deprivation therapy - reduce level of androgen to diminish tumour growth
  2. Androgen synthesis inhibitors - decrease testosterone level
  3. Androgen receptors blocker - decrease androgen
  4. Orchiectomy - surgical removal of testes to decrease tumour growth
  5. Chemotherapy

NURS 3512 (10 decks)

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