Uterine, Prostate, GU Cancers Tutor Session

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Go back to Fundamentals of patient care
Always do least invasive
Priority is to take care of what will kill patient fastest
Bladder Cancer Patient : blood in urune, freuency ur!ency, edematous, flank pain, Ct
scan show mass, cytoscopy will show mass, biopsy will tedt positive fo r mali!nant cells,
uro!raphy will show mass or obstruction, "Ct, GG #BC decreased,,,urinalysis will show
blood
$ranfusion of packed rBC%%% transfusion%%done over & hrs, stay with patient '( mins after,
not too fast
#adiation therapy%%skin care
mi!ht have sur!ery dependin! on sta!e of cancer%%the later sta!e less chance of sur!ery
pt will be sedated, anal!esics
$rans)rethral #esection%%%for early sta!e and tumor that hasnt infected muscle yet
*ay !et intravesical chemotherpy %%for superficial tumors and tumors in mutliple spots
#adical - whole bladder
*onitor renal status %%lookin! for blood, smell, infection, output, cloudy, sediment,
*aintain continuous bladder irri!ation
standard post op care, cou!h, deep breath, pain man!aement, ambulation when
possible
some !o home with ostomy%%%provide teachin! for care
Put patient in contact with support !roups
$each skin care after radiation
CervicalCancer - +rd most common in women%%contributin! factors%%multiple se,
partner, se, at youn! a!e, "P-, .$/s%%%no symptoms early
once invasive they may have abnormal dischar!e%%if it metastisi0e to rectum there will be
fecal leaka!e,, to bladder - urine leaka!e, flank pain, irre!ular bleedin!
Colposcopy %%%after abnormal PAPs%%% no anesthesia%%% camera that ma!nifies cervi, on tv
screen%%%they will !o in with twee0er and and brush and snip pieces for testin!%%brush
biopsy%%%1othin! in va!ina for a while, bleed a few days, crampin!, sore%%wait for results
may be cause for an,iety
2f it comes back positive they may do cryosur!ery%% after done colposcopy or PAP will be
repeated%%then every 3 months
*ay !et internal radiation implant%%maybe e,ternal, maybe both
if very invasive then radical hysterectomy performed
Chemo is usually ineffective but may be used in combo with radiation
4motionally support patient
Assess for compliccations: e,cessive pain or bleedin!
teach pt about treatment plan and med re!imen, after care, reportin! si!ns of infection,
must have follow up pap smears and pelvic e,aminations
5-A#2A1 CA1C4#:
*ost common cause of cancer death in A*erican 65men
/epends on type and sta!e of disease and pro!nosis%%% very few si!ns early on%%usually
not dia!nosed until late%%reason while there is only a &78 survival rate
C5ntributin! factors%%celibacy, menopause a!e, chemical e,posure, family "9 or breast
and uterine , fertility dru! use, infertility:nuliparity;, poor diet,
*ay have mild abdominal discomfort, mild G2 upset, Pelvic discomfort, mass, urinary
freuency, wei!ht loss
6ill have ultrasound, C$ scan
2f bad G2 symptoms they may have barium enema to see if tumor is obstructin! anythin!
<ymph nodes will be tested
*ammo!ram to see if there is a primary Breast Cancer condition:other tests will be done
to rule out metastasis;
2f very youn! /r may try to do resection to keep an ovary to still be able to have
children:most conservative approach;
Peritoneal wash will be done and fluid will be sent out to be tested
2f too much spread oophorectomy and radical hysterectomy%%%appendi, may also need to
be taken
all nodes in the area will be checked
2f premenopausal%%e,plain that they may have symptoms of menopause once ovaries
are removed:insomnia, depression, hot flashes;
*ay have flulike symptoms when havin! immunotherapy:bacille calmette !uerin vaccine
=BCG>%%may !et symptoms of $B--is the tb vaccine; %%administer antipyretics, !ive blanket
All post op procedures%%-?. , fluid 2?5, Pain mana!ement, abdominal support, sur!ical
site assessment, reposition, cou!h, deep breath, encoura!e ambulation, monitor for
abdominal distension, deal with chemo symptoms, emotional support:!roups, chaplain,
social worker;, teach med re!imen, infection symptoms etc
P#5.$A$4
$umor on prostate !land - constrict urethra%%commonly metastisis to bone lymph brain
and lun!%
C5ntributin! factors: a!e, race, family h,, vasectomy, increased dietary fat
may notice decrease in urine and stream%%may have urine retention, may feel firm
nodules on /#4, may have blood in urine
P.A, PAP, C4A:marker for all cancers; may be elevated
Biopsy, $ransurethral ultrasound
#adiation implant - :implant precautions fo others;
need hi!h protein diet but restrict caffeine and spicy food
#adical Prostatectomy - prostate taken out if locali0ed w?o metasaisi%%%if metastasis
$)#P wil be done
Anal!esics, antiemetics, antineoplastics, corticosteroids, hormonal therapy,
:estro!en,<",Cytoto,in;, 1.A2/.
*onitor renal and fluid status, lab values,
*onitor for infeciton
assess pain level
keep hydrated
mainatain patency of urinary catheter
Can cause se,ual dysfunction - emotionally support patient , may have body issues
Avoid prolon!ed sittin!, standin!, walkin!
$each ways to mana!e se,ual dyfunction : with radical may lose function all
to!ether%%to!ether may retain function;
avoid strainin! and liftin! :stool softners to reduce strainin!;
*ay have urinary freuency after
teach catheter care
2nform doctor of blood in urine, loss of bladder control, freuency, burnin!
$esticular Cancer
Check testes in shower or after shower in warn room
#5ll testes between both hands
usually can be cured unless late and metastis0es throu!h lymph
)sually between @7 and &7
6ill have firm painless testicular masses varyin! in si0e%%testes may feel heavy
*ay have urethral obstruction, may have abdominal mass, wei!ht loss,lethar!y,
pallor
C$ to detect metastasis, scrotal ultrasound to distin!uish between cyst and solid
mass%%biopsy
*ay receive radiation, testicle removed - but not scrotum%%
<ymph removed if lymph involvemnet%%will be at risk for lymphadema
"i!h calorie diet%%small freuent feedin!s, 2- therapy
Antineoplastic, anal!eiscs, antiemetics, hormone replacement, diuretics
$each pt that they wont be impudent Aust because testical remove %%they wont be
sterile unless both are removed :C"4CB 6"5 62<< B4 .$4#2<4 A1/ 6"5
651$;
2C4 pack on scrotom day after sur!ery%%adminsiter anal!esics, monitor bleedin!, oo0in!,
infeciton
Athletic support for scrotum especially durin! ambulation
keep hydrated,
monitor for myelosuppression si!ns