cancer at an early age should start testing at age 40 Cant change family

Cancer at an early age should start testing at age 40

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cancer at an early age should start testing at age 40 Can’t change family history but can reduce risk factors Alter nutritional habits Increase Omega-3 fatty acids Hi-fiber foods Reduce environmental exposure
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Assessment - History Assessment of: Family history Nutritional habits Problems voiding? This is first symptom - bladder outlet obstruction Difficulty starting stream, frequency, hematuria, nocturia Obtain detailed sexual history Pain with intercourse when ejaculating Change in sexual desire or function Current or previous STDs Any other pain (bone pain is sx of advanced cancer) Medications to rule out side effects
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Physical Assessment - Clinical Manifestations Men with early-stage prostate cancer are often asymptomatic Urinary manifestations depend on size and location of tumor and on stage of malignancy Gross hematuria – late sign If pain in pelvis, spine, hips, legs, ribs do through assessment – late sign Palpate for enlarged lymph nodes in groin - late sign Check for wt. loss & fatigue Prepare for digital rectal examination (DRE) If prostate hard with palpable irregularities or induration, highly likely to be malignant
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Psychosocial Assessment
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Laboratory Assessment PSA (Prostate-specific antigen ) blood analysis is used as a screening tool for prostate CA; it is NOT specifically diagnostic for cancer EPCA-2 serum marker for prostate CA is specific Prostate- specific antigen PSA should be drawn before DRE Normal level in men younger than 50 yrs - _______ng/ml Can increase as high as 6.5 ng/ml in men > than 70 yrs AA men have slightly higher normal levels (? Reason unknown) Serum acid phosphatase – elevated in advanced cases Serum alkaline phosphatase – elevated c bone mets
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Diagnostic Tests TRANSRECTAL ULTRASOUND (TRU) A small probe is inserted in the rectum giving off sound waves that make a picture of the prostate on a video screen. PROSTATE BIOPSY Guided by this picture, the physician inserts a narrow needle through the rectal wall into the prostate gland, and the needle removes a sample of tissue for examination. Bone scan, MRI, or CT may be performed to determine the presence of tumor metastasis
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Client Education R/T Prostate Biopsy Must perform cleansing enema prior to exam May or may not receives local anesthesia Multiple aspirations done through rectum to the prostate to obtain satisfactory specimens Complications: (rare) sepsis, hematuria with clots, s/s infection, perineal pain Teach client & caregiver to: Report s/s infection (fever, chills), bloody urine, difficulty voiding Avoid strenuous activity and drink plenty fluids in first 24 hrs. Small amt. bleeding, turning urine pink, is expected Stool softeners
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Surgical Options – Prostatectomy & Orchiectomy
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