Transcript Breast Conditions

Prostate Cancer (1495)
Most common cancer in men 2nd to skin
cancer and 2nd leading cause of death from
cancer to lung cancer. ¾ are over 65 y.o.
Over 30,000 die each year
Twice as common in African Americans
Risk factors include age >50, family hx
(father or brother), red meat ingestion (high
fat diet)
Manifestations of Prostate
Cancer
 Asymptomatic at 1st
 Obstructive symptoms
 Hematuria, oliguria
 Painful ejaculation
 Back and hip pain
 Perineal or rectal discomfort
 Anemia
 Nausea, wt loss
Diagnostics
 DRE
 PSA>4
 CBC for hematuria
 Elevated alkaline phosphatase indicates
malignancy
 Transrectal US
 CAT scan for kidney involvement
 Needle bx
Medical Management of
Prostate Cancer
Pharmacologic: androgen suppressors
(Lupron), androgen blockers (Eulexin), or
DES (less popular r/t CV SE)
Nonsurgical: external or internal radiation
Surgical Management
Surgical tx includes radical prostatectomy
(lymphs are removed) by one of three
methods: suprapubic, retropubic,
perineal—see p. 1424, Figure 55-4
Orchiectomy may also be done if tumor is
testosterone dependent
Postop Nursing Management
Monitor for return of sensation from spinal
anesthesia and protect from injury
Monitor 3-way Foley and CBI (also for
laser)
Keep CBI running at rate that keeps urine
pink without clots
Watch for hemorrhage
FF, keep strict I&O (subtract CBI)
Monitor surgical incision
Postop Nursing Care cont’d
After CBI is d/c, urine will be cranberry
Make sure there are no clots—if so call
MD for irrigation order
After Foley is d/c, urine is racked (serial
urines, 3-cup rotation)
Push fluids! Clots must be prevented
Expect bladder spasms and discomfort
with first voiding which will be small
Give analgesics and antispasmodics if
ordered, stool softeners
Patient/Family Education
• Kegel exercises
• Wearing pad up to one year
• No Valsalva, lifting, long trips, strenuous
activity
• Caffeine restriction, FF, urine will be
cloudy
• Watch for bright red bleeding, infection,
decreased UOP, incision, calf tenderness
• Management of ED