Saturday, January 14, 2006

cancer, prostate

Cancer of the prostate is a major health problem in the geriatric male. It is the second most common cause of cancer deaths in men. As life expectancy increases, more and more men live to an age when the incidence of this disease is highest. Initially, there are no symptoms. However, when the tumor grows large enough, it will obstruct urinary flow. Thus, when a patient complains of urinary symptoms, such as retention, painful urination, or blood in the urine, the disease is already in a more advanced stage.
Radiation therapy is the usual method of treatment and is at least as effective as surgical removal in controlling the disease. The advantage of this method of treatment is a lower incidence of incontinence and impotence. However, if urinary obstruction occurs, surgical treatment may be necessary.
The disadvantages of this treatment are that it virtually guarantees impotence and may result in serious urinary control problems.
If the cancer spreads, it is by way of the blood stream and lymphatics to the pelvic lymph glands and bones, particularly the lumbar vertebrae, pelvis, and hips. The first symptoms may be back pain or sciatica due to metastases to the nerve sheaths. Systemic hormonal therapy is the method of treatment when metastases develop.
After surgery, some dietary control may be indicated if the patient experiences bladder or bowel incontinence. Perineal exercises to improve muscle tone may also be helpful.
See also PROSTATE HYPERTROPHY, BENIGN.
Scherer, J. C. Introductory Medical-Surgical Nursing. 3rd ed. Philadelphia: J. B. Lippincott Co., 1982.
Steinberg, F. U. Care of the Geriatric Patient. 6th ed. St. Louis: C. V. Mosby Co., 1983.

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