cancer teaching demo

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