nursing care for prostate cancer

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WHAT IS PROSTATE CANCER?

Content is medically reviewed by:

Dr. Udaya Kumar Maiya (MBBS, MD, DNB(RT), DCCF (Paris), Medical Director, Portea.

The prostate gland is located just below the bladder of a human male, in front of the rectum. It plays a huge role in producing parts of the semen and is partly responsible for urine control in men. The prostate gland is also the site of the most common cancer in men, but prostate cancer remains treatable if it is diagnosed in early stages.

Around a fifth of all people affected by prostate cancer end up succumbing to the disease, but the prostate cancer treatment can be successful if it is diagnosed at an early stage. It is important to undergo regular testing so that the disease can be identified before metastasis occurs. Common prostate cancer symptoms usually include urination and a lack of control in the urge to urinate.

What are the prostate cancer symptoms?

The early stages of cancer within the body is characterised by a lack of symptoms, although they should soon appear if cancer spreads. The symptoms include frequent urge to urinate, even when the man is sleeping. The person will also find it difficult to start or stop urinating since the general control over the action is lost. The urine of the person will also be mixed with blood, sometimes in copious amounts.

Urination becomes painful, and ejaculation will also be a painful ordeal at the time. The person will start to lose his libido since it becomes hard for him to sustain an erection. If the cancer is in its advanced stage, the man might start to feel pain in his upper body and a number of bones. Bones like the ribs and femurs might start to fracture, too. In the advanced stage, cancer might start to compress the spine and affect the strength of the legs, and also result in faecal and urinary incontinence in the person.

Prostate Cancer Causes

The prostate gland is an exocrine gland, which means that the secretions of the gland have to be used outside the body. The secretions of the prostate gland are important in maintaining the health of the sperm when they embark on the journey to the ovum. The gland is also responsible for maintaining control over urination and ejaculation.

Cancer initially starts in the glandular cells, and this is called adenocarcinoma. The size and shape of the gland cells start to change, and there may not be any symptoms at this stage. This stage is also called Prostatic Intraepithelial Neoplasia (PIN). It is estimated that around half of all men over the age of 50 have PIN. The degree of PIN can vary, with high-grade PIN considered to be a precursor to prostate cancer stages.

If cancer starts to spread, the condition becomes more dangerous- it starts to spread to the bones.

Prostate Cancer Stages

The stages of the prostate cancer vary according to the size and the shape of the prostate gland cells. Stage 0 is considered to be when a tumour has not started spreading from the prostate gland. At this stage, the tumour has not affected the gland itself in a large manner. However, at stage 4, cancer will already have spread to distant organs and bones of the upper body.

PROSTATE CANCER DIAGNOSIS

The initial step for diagnosing prostate cancer in men will be a simple physical examination, and the doctor will ask you more about your physical history. Symptoms of cancer may already be present, and they will give the doctor a better idea. He may also take a sample of blood in order to check for PSA levels- if the levels are abnormally high, further examinations will be carried out.

There are many tests to check for prostate cancer. A digital rectal examination involves the doctor using his fingers to feel for any abnormalities which may have occurred in the size and shape of the prostate. Biomarker tests include using the blood, urine and body tissues of the person to check for cancerous cells.

If there have been any symptoms of cancer in the above tests, the doctor will prescribe advanced tests to confirm it. These include a PCA3 test for PCA3 genes in the urine, a transrectal ultrasound scan or even a biopsy. In order to track the spread of cancer into other areas of the body, the doctor will prescribe CAT scans or MRI scans.

Prostate Cancer Treatments

The treatment methods for the prostate cancer depend upon how far it has progressed, as they are markedly different for stage 0 and stage 4 patients.

For patients in the early stages, the treatment consists of monitoring the prostate, or radical prostatectomy. In this procedure, the prostate itself is removed using surgery. For targeted radiation therapy, radioactive seeds may also be implanted in the prostate in a procedure called Brachytherapy. Radiation therapy may be made in the shape of the prostate so that the exposure to other tissues is limited. The method of treatment is determined by the doctor and is usually different for each patient according to his condition.

For patients in their advanced stages, chemotherapy might be used to kill the cancer cells spreading across the body. Androgen Deprivation Therapy or similar hormone therapies can slow down the growth of the cancer cells in the long term, and make the cells dormant or slow to spread.

WHEN DO YOU NEED US?

Combating prostate cancer is a difficult affair, and is sure to be stressful to the patient as well as his immediate family members. For patients, providing prostate cancer care can be difficult. Since the disease usually affects the aged, nurses for prostate cancer patients are also hard to find. The nurses may have to take the patient to various prostate cancer tests, too. In such situations, Portea can provide care to patients in the early stages or those recovering from the treatment procedures at late stages.

References

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Mary Alphonsa, Bengaluru

The nurse was very compassionate with the patient taking care of her needs from time to time from feeding to giving medicines.