APPROACH TO CARE OF PROSTATE CANCER
Approachto Care of Prostate Cancer
Approachto Care of Prostate Cancer
According to Wallace et al. (2014), prostatecancer is the most usual non-skin disease diagnosed and thesubsequent foremost source of all cancer death rate in the UnitedStates. Not less than one in seven men will be named with prostatecancer in their lifespan in the U.S. In light of these facts,monitoring treatment response is the only available healthintervention option when it comes to combating the prevalence ofdisease. The importance of diagnosing and treating cancer should notbe exaggerated concerning the influence it has on the healthcareorganization. Before the advent of the prostate-specific agent, thetreatment of cancer was judged based on the lack of clinicalprogression or lack of technological advances in medical equipmentand methods. With the new arrival of the prostate-specific agent, newchanges and recommendations on the approaches have been developedtowards monitoring and treating of cancer. Also, the development ofadvanced care planning has become an essential element of end-of-lifecare policies towards the management of cancer. This paper,therefore, investigates the approaches to care of cancer,particularly prostate cancer.
Prostate-Specific Agent remains the averageexercise in nursing the state of prostrate in the post interventioncare of prostate cancer. Together with the development of an imagingtechniques, more efficient treating and monitoring methods ofprostate disease from anatomical and functional indicators havebecome potential (Wallace et al. 2014). King etal. (2015), assert that mendiagnosed with prostate cancer are probably to have elongatedsickness track and thus a burden to the healthcare system. Theeffective way to manage this situation is the provision of goodsupportive care for this group through helping their family to dealwith monitoring and treatment of cancer. This will assist the patientby increasing the quality of health benefits of treatment and toincrease their lifespan. Supportive care towards prostate cancerinvolves powerful elements of self-care, advocating for independencein managing the symptoms and side effects of the disease (King etal., 2015).
Looking at the approaches to the care ofprostate cancer, one of the most important aspects is the need foremotional care or psychological support that should commence at thebeginning of the diagnosis and continue throughout the treatmentperiod. It has become an issue that there is a scarcity of properunderstanding among healthcare specialists in secondary and primarycare concerning the psychological effects of prostate cancerspecifically in the long-term (King et al. 2015). Therefore, factorsthat should be considered when offering supportive care for prostatecancer patients include delivery of information to cancer patientswith the aim of empowering them to feel more confident and optimisticabout their condition.
Currently, standard approaches to monitoringthe treatment of prostate cancer exist, which is important because oftheir role in allowing patients to identify the local recurrence ofdisease after definitive diagnosis and treatment for prostate cancer.Separately, the foundation of the carry-out in supervising thetreatment reaction of prostate cancer is the prostate-specific agentas noted by Wallace et al. (2014).
Being highly prevalent, prostate cancer has arelatively slow rate of advancement in the body about other types ofcancer. This is in the contention that it also takes longer than anyother malignancies to progress to the advanced early stage. Duringdiagnosis, early or low-grade prostate cancer presents no signs orsymptoms. According to the Prostate Cancer Taskforce (2013), symptomsof the non-cancerous condition are similar to those of prostatecancer. These include reduced force of urine stream, passing urinewith difficulties accompanied by the delay in starting and dribblingat the end of the urine flow, and sometimes the passage of bloodyurine. Similarly, men with advanced prostate cancer present weightloss, pain in the bones, and lethargy.
Epithelial cells of prostate produceprostate-specific antigen and level of this antigen predict whetheran individual has cancer or otherwise. In this case, the higher thelevel of the substance, the likely a person is to be diagnosed withprostate cancer. PSA is secreted by prostatic epithelium andperiurethral glands, and its production amount determines thepresence of disease (Borley and Feneley, 2009). Conversely, mostcases of prostate cancer are situated in the peripheral area of theprostate, and this can be identified by digital rectal examination(Prostate Cancer Taskforce, 2013). Borley and Feneley (2009) assertthat digital rectal examination remains the foundational clinicalassessment of the prostate because it detects non-prostate specificantigen released in the tumors.
Another common diagnostic modality of prostatecancer is the use of trans rectal ultrasonography and biopsies. Thismethod provides the imaging of the prostate and seminal vesicles.However, Borley and Feneley (2009) argue that this approach is notencouraged when detecting early-stage prostate cancer. Aside fromthat, Wallace et al. (2014), suggest that treatment plan and optionsunder clinical evaluation are appropriate for prostate cancer. Intheir assertion, Cryotherapy is one of the recommended techniquesthrough which, under ultrasound guidance, individual metal rods areintroduced into the prostate. In this procedure, highly sanctifiedargon gas is employed to freeze tissue surrounding the prostate, andbecause of this, it can kill cancer cells. Equally, the use ofHigh-Intensity Focused Ultrasounds to raise the temperature of thetarget tissue will kill cancer-infected tissue through coagulationnecrosis. Another treatment method recommended by Wallace et al.(2014), is the use of focal therapy. This technique is currently usedto reduce the morbidity seen within radical treatment options whenpreserving cancer control. Additionally, this option attempts tolessen the impairment to the healthy tissue, particularly the complexbody part that significant working determinants.
Staging of this type of cancer as noted byBorley and Feneley (2009), is based on the lymph nodes (N), primarytumor (T), and metastasis (M) class. T group is grounded on imaging,clinical examination, biopsy, and biochemical text, while N-typewhich is established on imaging, and finally, M is based skeletalstudies, imaging, clinical examination, biochemical tests. Table 1summarizes the staging of prostate cancer.
Table1: Stages of Prostate Cancer.
Primary Tumor (T)
The main tumor is not assessed.
Tumor is not available.
Imaging cannot detect the tumor.
Tumor as subsidiary histological finding at transurethral resection.
More than 5 percent secretion of prostate in the tissue.
The tumor is bounded with prostate.
Tumor is associated with one or half of the lobe.
Tumor is associated with more than one-half of the one lobe.
Tumor exist in both lobes.
Tumor widens through prostatic capsule.
Incursion of formative vesicle.
Tumor attempts to invade adjacent structures such as bladder neck, pelvic walls, and rectum.
Lymph Nodes (N)
Lymph node are not able to be assessed.
No lymph nodes metastasis.
Lymph nodes metastasis available either lateral of bilateral.
Distant metastasis cannot be assessed.
Nor regional lymph nodes metastasis.
Metastasis to bone.
Other places of metastasis.
Source:Borleyand Feneley, 2009.
Describe threecomplications of cancer, the side effects of treatment, and methodsto lessen physical and psychological effects.
Diagnosisof prostate cancer has some complications that vary in differentstages. In the first stage, primary treatment includes radiationtherapy, radical prostatectomy, and active surveillance that mayresult in dysfunctional urinary, sexual, bowel functioning over time.Sountoulides and Rountos (2013) suggest that other complicationsinclude bleeding in the urine and blockage of the bladder through theurethral obstruction. Treatment-related complications originatingfrom radiation include erectile dysfunction, bowel problems, diseaserecurrence, osteoporosis (that is, a condition characterized bynarrowing of bones), cardiovascular disease, and difficulty inconcentration.
In dealing with the side effects andcomplications arising from the managing and treatment of prostatecancer, Roth et al. (2009), posit that treatment options such assildenafil, tadalafil, or vardenafil may be used to enhance erectileperformance. Separately, dealing with psychological and relationshipimplications is another significant aspect that should be consideredfor individuals undergoing treatment for prostate cancer. The problemof erectile disfunction may lead to relationship breakdowns that areassociated with distress or depression. To cope up with thissituation supportive psychotherapy and cognitive behavioral therapycan help men to deal with such circumstances. Similarly, dealing withpain is yet another aspect that should be highly considered. Painfrom bone metastasis is often intense thus support and pain relievingmedication should be recommended to improve quality a patient’slife.
Borley, N., and Feneley, M. (2009), ProstateCancer: Diagnosis and Staging. Asian Journal of Andrology (2009) 11:74–80
King et al. (2015). Prostate Cancer andSupportive Care: A Systematic Review and Qualitative Synthesis ofMen’s Experience and Unmet Needs.European Journal of Cancer Care 24, p.618-634.
Prostate Cancer Taskforce. (2013). Diagnosisand Management of Prostate Cancer in New Zealand Men: Recommendationsfrom the Prostate Cancer Taskforce. Wellington: Ministry of Health.
Roth et al. (2009). Prostate Cancer: Quality ofLife, Psychosocial Implications, and Treatment Choices. FutureOncology 4(4): 561–568.doi:10.2217/147966184.108.40.2061
Sountoulides, P., and Rountos, T. (2013). TheAdverse Effect of Androgen Deprivation Therapy for Prostate Cancer:Prevention and Management. ReviewArticle Volume 2013, Article ID 240108, 8 pageshttp://dx.doi.org/10.1155/2013/240108
Wallace et al. (2014). Current Approaches,Challenges, and Future Directions for Monitoring Treatment Responsein Prostate Cancer. Journal ofCancer 2014 5(1): 3-24. doi:10.7150/jca.7709