 Prostate-specific antigen (PSA) blood
BENIGN PROSTATIC HYPERPLASIA (BPH)
 Benign prostatic hyperplasia (BPH) is a
non-cancerous enlargement of the prostate
gland, which is situated beneath the
bladder surrounding the urethra. This
enlargement can lead to urinary symptoms
due to the compression of the urethra.
ETIOLOGIC FACTORS:
 Age: BPH is more common in older
men, with prevalence increasing with
age.
 Hormonal changes: An imbalance in sex
hormones, particularly an increase in
dihydrotestosterone (DHT), is thought to
play a role.
 Family history: There may be a genetic
predisposition to developing BPH.
 Lifestyle factors: Obesity, lack of
physical activity, and certain dietary
factors may contribute.
 Medical conditions: Conditions like
diabetes and heart disease may
increase the risk.
PATOPHYSIOLOGY
Etiologic Factors
↓ improve bladder emptying and reduce
Enlargement of the Prostate
↓ 5. Medication Administration: Ensure
Compression of the Urethra
SIGNS AND SYMPTOMS:
 Urinary frequency
 Urgency
 Nocturia
 Weak urine stream
 Difficulty initiating urination
 Incomplete emptying of the bladder
 Urinary retention
 Hematuria (blood in urine)
 Urinary tract infections (UTIs)
 Bladder stones
DIAGNOSTICS:
 Digital rectal examination (DRE) to
assess prostate size and consistency.
test to rule out prostate cancer.
 Transrectal ultrasound (TRUS) to
visualize the prostate.
 Urinalysis to detect infection or
hematuria.
 Uroflowmetry to assess urinary flow
rate.
NURSING DIAGNOSES:
1. Urinary Retention related to prostatic
enlargement - evidenced by decreased
urinary output, hesitancy, and
incomplete bladder emptying.
2. Risk for Urinary Tract Infection related to
urinary stasis - evidenced by dysuria,
frequency, urgency, and hematuria.
ESSENTIAL NURSING MANAGEMENT:
1. Patient Education: Provide information
about BPH, its management, and the
importance of adherence to treatment.
2. Monitoring: Regular assessment of
urinary symptoms, fluid intake, and
urinary output.
3. Promotion of Fluid Intake: Encourage
adequate hydration to maintain urinary
flow and prevent urinary stasis.
4. Bladder Training: Teach techniques to
urinary frequency and urgency.
timely administration of prescribed
medications and monitor for side effects.
SURGICAL MANAGEMENT:
1. Transurethral Resection of the Prostate
(TURP): Removal of excess prostate
tissue using a resectoscope inserted
through the urethra.
2. Transurethral Incision of the Prostate
(TUIP): Incisions made in the prostate
gland to relieve pressure on the urethra.
3. Open Prostatectomy: Surgical removal
of the enlarged portion of the prostate
gland through an abdominal incision.
PHARMACOLOGIC MANAGEMENT
1. Alpha-Blockers
 Generic Name: Tamsulosin
  Brand Name: Flomax
 Mode of Action: Relaxes smooth
muscle in the prostate and
bladder neck, improving urinary
flow.
2. 5-Alpha Reductase Inhibitors
 Generic Name: Finasteride
 Brand Name: Proscar
 Mode of Action: Inhibits the
conversion of testosterone to
dihydrotestosterone (DHT),
reducing prostate size.
3. Phosphodiesterase-5 Inhibitors
 Generic Name: Tadalafil
 Brand Name: Cialis
 Mode of Action: Relaxes smooth
muscle in the prostate and
bladder, improving urinary
symptoms.
CANCER
 Cancer refers to a group of diseases
characterized by uncontrolled growth
and spread of abnormal cells. These
cells can invade nearby tissues and
organs, as well as metastasize to other
parts of the body.
ETIOLOGIC FACTORS:
 Genetic factors: Inherited mutations can
predispose individuals to certain types of
cancer.
 Environmental factors: Exposure to
carcinogens such as tobacco smoke,
ultraviolet (UV) radiation, and certain
chemicals increases the risk.
 Lifestyle factors: Poor diet, lack of
physical activity, obesity, and excessive
alcohol consumption are associated with
higher cancer risk.
 Infectious agents: Some viruses (e.g.,
human papillomavirus, hepatitis B and C
viruses) and bacteria (e.g., Helicobacter
pylori) can cause cancer.
 Hormonal factors: Hormonal
imbalances, such as those seen in
hormone-dependent cancers like breast
and prostate cancer, can contribute to
cancer development.
Pathophysiology:
Cancer arises from genetic mutations that
disrupt the normal regulation of cell growth and
division.
↓
These mutations can occur spontaneously or be
induced by carcinogens.
↓
Cancer cells exhibit characteristics such as
uncontrolled proliferation, evasion of apoptosis
(programmed cell death), sustained
angiogenesis (formation of new blood vessels),
and ability to invade and metastasize to distant
sites.
SIGNS AND SYMPTOMS:
 Lump or mass
 Unexplained weight loss
 Fatigue
 Persistent pain
 Changes in bowel or bladder habits
 Persistent cough or hoarseness
 Changes in moles or skin lesions
 Difficulty swallowing
 Persistent indigestion or discomfort after
eating
 Changes in menstrual cycle
DIAGNOSTICS:
 Biopsy: Removal and examination of
tissue sample for cancerous cells.
 Imaging tests: X-rays, CT scans, MRI
scans, PET scans, and ultrasound to
visualize internal organs and detect
tumors.
 Blood tests: Elevated levels of certain
biomarkers may indicate the presence of
cancer.
 Endoscopy: Visual examination of
internal organs using a flexible tube with
a camera.
 Genetic testing: Identification of genetic
mutations associated with increased
cancer risk.
SURGICAL MANAGEMENT:
 Surgery: Removal of cancerous tissue,
lymph nodes, or organs affected by
cancer.
  Tumor debulking: Surgical reduction of
tumor size to alleviate symptoms or
improve response to other treatments.
 Reconstructive surgery: Restoration of
appearance or function following cancer
surgery, such as breast reconstruction
after mastectomy.
PHARMACOLOGIC MANAGEMENT:
1. Chemotherapy
 Generic Name: Doxorubicin
 Brand Name: Adriamycin
 Mode of Action: Inhibits DNA
replication and kills rapidly dividing
cancer cells.
 Targeted Therapy
2. Generic Name: Trastuzumab
 Brand Name: Herceptin
 Mode of Action: Targets specific
molecular alterations in cancer cells,
such as HER2 overexpression in
breast cancer.
3. Immunotherapy
 Generic Name: Pembrolizumab
 Brand Name: Keytruda
 Mode of Action: Enhances the
immune system's ability to
recognize and attack cancer cells.
NURSING DIAGNOSES:
 Risk for Infection related to
immunosuppression from cancer
treatments - evidenced by neutropenia,
fever, and presence of invasive devices
(e.g., central venous catheters).
 Anxiety related to cancer diagnosis,
treatment uncertainties, and prognosis -
evidenced by restlessness, fear, and
verbal expressions of worry.
ESSENTIAL NURSING MANAGEMENT:
1. Patient Education: Provide information
about cancer, treatment options, and
self-care strategies.
2. Symptom Management: Assess and
manage cancer-related symptoms such
as pain, nausea, and fatigue.
3. Psychosocial Support: Offer emotional
support, counseling, and referrals to
support groups or mental health
professionals.
4. Nutritional Support: Monitor nutritional
status and provide dietary guidance to
maintain adequate nutrition during
treatment.
5. Palliative Care: Coordinate with
interdisciplinary team members to
provide holistic care focusing on
symptom management, quality of life,
and end-of-life care for patients with
advanced cancer.
BREAST CANCER
 Is a malignancy that originates from
breast tissue, primarily the ducts or
lobules. It is the most common cancer in
women worldwide and can also affect
men.
TYPES:
1. Ductal Carcinoma in Situ (DCIS):
Cancer cells are confined within the milk
ducts and have not invaded surrounding
tissue.
2. Invasive Ductal Carcinoma (IDC):
Cancer cells break through the ductal
walls and invade surrounding breast
tissue.
3. Lobular Carcinoma in Situ (LCIS):
Abnormal cells are confined within the
lobules.
4. Invasive Lobular Carcinoma (ILC):
Cancer cells invade surrounding breast
tissue from the lobules.
ETIOLOGIC FACTORS:
 Genetic mutations: BRCA1 and BRCA2
mutations increase the risk of
developing breast cancer.
 Family history: Having a first-degree
relative with breast cancer increases the
risk.
 Hormonal factors: Prolonged exposure
to estrogen, early menarche, late
menopause, and hormone replacement
therapy increase the risk.
 Lifestyle factors: Obesity, excessive
alcohol consumption, and lack of
physical activity are associated with
higher risk.
  Age: Risk increases with age, with most
breast cancers diagnosed in women
over 50.
PATHOPHYSIOLOGY:
Breast cancer arises from genetic mutations that
disrupt the normal regulation of cell growth and
division.
↓  Generic Name: Tamoxifen
Uncontrolled proliferation of breast cells and the
formation of tumors
↓ effects of estrogen on breast
Invades surrounding tissue, enter the
bloodstream or lymphatic system
↓ positive breast cancer.
Metastasize to distant organs.
SIGNS AND SYMPTOMS:
 Lump or mass in the breast or underarm
area
 Changes in breast size or shape
 Nipple discharge (other than breast milk)
 Nipple inversion or retraction
 Skin changes on the breast, such as
redness, dimpling, or puckering
 Breast pain or tenderness
 Enlarged lymph nodes in the armpit
DIAGNOSTICS:
1. Mammography: X-ray imaging of the
breast to detect abnormalities.
2. Breast ultrasound: Sound waves used to
produce images of the breast tissue,
particularly for evaluating lumps.
3. Breast MRI: Magnetic resonance
imaging used for further evaluation of
breast abnormalities.
4. Biopsy: Removal and examination of
tissue sample to confirm cancer
diagnosis and determine tumor
characteristics.
Genetic testing: Identification of inherited
mutations associated with increased breast
cancer risk.
Surgical Management:
Lumpectomy: Surgical removal of the tumor and
surrounding margin of normal tissue.
Mastectomy: Surgical removal of the entire
breast tissue, which may include removal of one
or both breasts.
5. Sentinel lymph node biopsy: Removal
and examination of the lymph nodes to
determine if cancer has spread.
PHARMACOLOGIC MANAGEMENT:
1. Hormone Therapy
 Brand Name: Nolvadex
 Mode of Action: Blocks the
tissue, reducing the risk of
recurrence in hormone receptor-
2. Targeted Therapy
 Generic Name: Trastuzumab
 Brand Name: Herceptin
 Mode of Action: Targets HER2-
positive breast cancer cells,
inhibiting their growth and
proliferation.
3. Chemotherapy
 Generic Name: Doxorubicin and
Cyclophosphamide
 Brand Name: Adriamycin and
Cytoxan
 Mode of Action: Kills rapidly
dividing cancer cells by
damaging DNA and interfering
with cell division.
NURSING DIAGNOSES:
1. Anxiety related to breast cancer
diagnosis, treatment uncertainties, and
prognosis - evidenced by restlessness,
fear, and verbal expressions of worry.
2. Impaired Body Image related to changes
in breast appearance due to surgery or
treatment - evidenced by expressions of
dissatisfaction with body image and
social withdrawal.
ESSENTIAL NURSING MANAGEMENT:
1. Patient Education: Provide information
about breast cancer, treatment options,
and self-care strategies.
2. Symptom Management: Assess and
manage cancer-related symptoms such
as pain, nausea, and fatigue.
 3. Emotional Support: Offer emotional
support, counseling, and referrals to
support groups or mental health
professionals.
4. Wound Care: Monitor surgical incisions
for signs of infection and provide wound
care as needed.
5. Lymphedema Prevention: Educate
patients about measures to prevent
lymphedema, such as avoiding limb
constriction and performing gentle
exercises.
6. Pain Management: Administer
analgesics as prescribed and assess
effectiveness of pain relief measures.
7. Nutritional Support: Monitor nutritional
status and provide dietary guidance to
maintain adequate nutrition during
treatment.
8. Medication Management: Educate
patients about prescribed medications,
including potential side effects and
adherence.
9. Continuity of Care: Coordinate care with
interdisciplinary team members and
ensure continuity of care across different
healthcare settings.
10. Follow-Up Care: Schedule regular
follow-up appointments for monitoring
and surveillance, including imaging tests
and clinical examinations.
KAPOSI'S SARCOMA (KS)
 is a rare type of cancer that develops
from the cells lining blood vessels or
lymphatic vessels. It is characterized by
abnormal growth of blood vessels,
resulting in red or purple skin lesions.
ETIOLOGIC FACTORS:
 Human Herpesvirus 8 (HHV-8) infection:
KS is strongly associated with HHV-8
infection, which is transmitted through
sexual contact, organ transplantation, or
blood transfusion.
 Immunocompromised state: HIV/AIDS,
organ transplantation, and certain
medications that suppress the immune
system increase the risk of developing
KS.
 Genetic predisposition: Certain genetic
factors may influence susceptibility to
HHV-8 infection and development of KS.
PATHOPHYSIOLOGY:
HHV-8 infection
↓
The virus infects endothelial cells lining blood
vessels
↓
Abnormal proliferation
↓
Formation of characteristic vascular lesions,
which can occur in the skin, mucous
membranes, and internal organs.
SIGNS AND SYMPTOMS:
 Red or purple skin lesions: These may
be flat, raised, or nodular and can vary
in size.
 Lesions may be painless or may cause
discomfort, itching, or bleeding,
especially if they ulcerate.
 In advanced cases, KS may involve
internal organs, leading to symptoms
such as difficulty breathing, abdominal
pain, or gastrointestinal bleeding.
DIAGNOSTICS:
 Clinical examination: Identification of
characteristic skin lesions.
 Skin biopsy: Removal and examination
of tissue sample to confirm diagnosis
and determine the type of KS.
 Imaging tests: CT scans, MRI scans, or
PET scans may be performed to assess
the extent of disease involvement,
especially in cases of internal organ
involvement.
SURGICAL MANAGEMENT:
Surgical excision or biopsy may be performed to
remove isolated lesions or obtain tissue samples
for diagnosis. However, surgical management is
generally limited, and other treatment modalities
are often used due to the multifocal nature of
KS.

PHARMACOLOGIC MANAGEMENT:
1. Antiretroviral Therapy (ART)
 Generic Name: Various
combinations (e.g.,
tenofovir/emtricitabine + integrase
inhibitors)
 Brand Name: Varies
 Mode of Action: Suppresses HIV
replication, reducing immune
suppression and controlling HHV-8-
associated KS in HIV/AIDS patients.
2. Chemotherapy
 Generic Name: Liposomal
doxorubicin
 Brand Name: Doxil
 Mode of Action: Kills rapidly dividing
cancer cells by damaging DNA and
interfering with cell division.
3. Immunotherapy
 Generic Name: Interferon alfa
 Brand Name: Intron A
 Mode of Action: Stimulates the
immune system to recognize and
attack cancer cells, particularly in
cases of refractory or advanced KS.
NURSING DIAGNOSES:
1. Impaired Skin Integrity related to
presence of Kaposi's sarcoma lesions -
evidenced by skin lesions, ulceration, or
bleeding.
2. Risk for Infection related to
ETIOLOGIC FACTORS:
immunosuppression from HIV/AIDS or
immunosuppressive therapy - evidenced
by presence of HIV/AIDS, low CD4
count, or use of immunosuppressive
medications.
ESSENTIAL NURSING MANAGEMENT:
1. Skin Care: Provide gentle skin care to
prevent trauma to lesions and minimize
risk of infection.
2. Pain Management: Assess and manage
pain associated with KS lesions using
pharmacologic and non-pharmacologic
interventions.
3. Emotional Support: Offer emotional
support, counseling, and referrals to
support groups for patients coping with
the psychological impact of KS.
4. Education: Provide information about
KS, its treatment options, and self-care
strategies to promote adherence to
treatment and improve outcomes.
5. Infection Control: Implement standard
precautions to prevent transmission of
infections, especially in
immunocompromised patients.
6. Monitoring: Regularly assess skin
lesions, monitor for signs of infection or
disease progression, and report any
changes to the healthcare team.
7. Nutritional Support: Monitor nutritional
status and provide dietary guidance to
maintain adequate nutrition, especially
in patients with advanced disease or
undergoing chemotherapy.
8. Medication Management: Educate
patients about prescribed medications,
including potential side effects and
adherence to ART or chemotherapy
regimens.
LYMPHOMA
 A type of cancer that originates in the
lymphatic system, which is part of the
body's immune system. It involves the
abnormal proliferation of lymphocytes, a
type of white blood cell, leading to the
formation of tumors in lymph nodes or
other lymphoid tissues.
 Genetic predisposition: Certain genetic
mutations may increase the risk of
developing lymphoma.
 Immunosuppression: Conditions or
treatments that suppress the immune
system, such as HIV/AIDS or organ
transplantation, increase the risk.
 Infections: Certain viruses, such as
Epstein-Barr virus (EBV) or human T-
cell lymphotropic virus (HTLV-1), are
associated with an increased risk of
lymphoma.
 Environmental exposures: Exposure to
certain chemicals, pesticides, or
radiation may increase the risk.
PATHOPHYSIOLOGY: PHARMACOLOGIC MANAGEMENT:
Lymphoma can arise from either B lymphocytes 1. Chemotherapy
(B-cell lymphomas) or T lymphocytes (T-cell  Generic Name: Rituximab
lymphomas). The exact cause of lymphoma is  Brand Name: Rituxan
often unknown, but it involves genetic mutations  Mode of Action: Targets and
that disrupt the normal regulation of lymphocyte destroys B lymphocytes
proliferation and survival. These abnormal expressing CD20, leading to cell
lymphocytes accumulate in lymph nodes and death.
other lymphoid tissues, forming tumors and 2. Immunotherapy
interfering with normal immune function.  Generic Name: Pembrolizumab
 Brand Name: Keytruda
SIGNS AND SYMPTOMS:  Mode of Action: Enhances the
 Enlarged lymph nodes, which may be immune system's ability to
painless or tender to the touch. recognize and attack cancer
 Fever, night sweats, and unexplained cells, particularly in Hodgkin
weight loss (B symptoms). lymphoma.
 Fatigue and weakness. 3. Targeted Therapy
 Itchy skin (pruritus).  Generic Name: Brentuximab
 Swelling in the abdomen, groin, or neck. vedotin
 Persistent cough or shortness of breath  Brand Name: Adcetris
if lymphoma involves the chest.  Mode of Action: Targets CD30-
expressing lymphoma cells,
DIAGNOSTICS: delivering a cytotoxic agent
1. Physical examination: Assessment of directly to the cancer cells.
lymph nodes, spleen, and liver for
enlargement or tenderness. NURSING DIAGNOSES:
2. Imaging tests: CT scans, MRI scans, or 1. Risk for Infection related to
PET scans to visualize lymph nodes and immunosuppression from lymphoma or
other organs for signs of lymphoma. its treatment - evidenced by
3. Biopsy: Removal and examination of neutropenia, fever, and presence of
lymph node or tissue sample to confirm invasive devices (e.g., central venous
diagnosis and determine the type of catheters).
lymphoma. 2. Fatigue related to lymphoma or its
4. Blood tests: Complete blood count treatment - evidenced by decreased
(CBC) and blood chemistry tests to energy levels, weakness, and difficulty
assess overall health and detect performing usual activities.
abnormalities.
5. Bone marrow biopsy: Removal and ESSENTIAL NURSING MANAGEMENT:
examination of bone marrow tissue to  Infection Control: Implement strict
assess for involvement by lymphoma infection control measures to prevent
cells. healthcare-associated infections,
particularly in immunocompromised
SURGICAL MANAGEMENT: patients.
Surgery is not typically a primary treatment for  Fatigue Management: Assess and
lymphoma. However, surgical procedures such manage fatigue through energy
as lymph node biopsy or removal may be conservation techniques, activity pacing,
performed for diagnostic purposes or to relieve and appropriate rest periods.
symptoms in certain cases.  Pain Management: Assess and
manage pain associated with lymphoma
or its treatment using pharmacologic
and non-pharmacologic interventions.
  Nutritional Support: Monitor nutritional
status and provide dietary guidance to
maintain adequate nutrition during
treatment, especially in patients
experiencing appetite changes or weight
loss.
 Medication Education: Educate
patients about prescribed medications,
including potential side effects,
administration instructions, and
adherence.
 Symptom Management: Assess and
ASSESSMENT
manage symptoms such as nausea,
vomiting, and diarrhea using appropriate
interventions and medications.
 Fluid Management: Monitor fluid intake
and output, and provide hydration as
needed, particularly in patients
experiencing fluid losses from fever or
diarrhea. DIAGNOSIS:
KIDNEY CANCER
 Kidney tumors may be benign or
malignant, bilateral or unilateral.
 Common sites of metastasis of
malignant tumors include bone, lungs,
liver, spleen, and the other kidney.
 The exact cause of renal carcinoma is
unknown.
CAUSES:
● The specific causes of kidney cancer
are not always clear, but several risk
factors are associated with its
development:
○ Smoking: Smokers have a
higher risk of kidney cancer.
○ Age: The risk increases with
age, and it is more common in
people over 40.
○ Gender: Men are more likely
than women to develop kidney
cancer.
○ Obesity: Overweight individuals
have an increased risk. MEDICATIONS:
○ High Blood Pressure:
Hypertension is a risk factor for
kidney cancer.
○ Genetic Factors: Hereditary
conditions, such as von Hippel-
Lindau (VHL) disease.
○ Family History: A family history
of kidney cancer may increase
the risk.
○ Occupational Exposure: Certain
workplace exposures to
chemicals like asbestos or
cadmium.
 Dull flank pain
 Palpable renal mass
 Painless gross hematuria
 Weight Loss
 Hematuria
● Blood Tests:
○ Creatinine and Blood Urea
Nitrogen (BUN): Elevated levels
indicate impaired kidney
function.
○ Glomerular Filtration Rate
(GFR): A measure of kidney
function.
○ Electrolyte Levels: Assessing
imbalances such as high
potassium.
○ Urinalysis: Examination of urine
for abnormalities.
● Imaging Studies:
○ Ultrasound: To visualize the
kidneys and identify structural
abnormalities.
○ CT Scan or MRI: Detailed
imaging for assessing kidney
structure.
● Kidney Biopsy: In some cases, a
sample of kidney tissue is taken for
examination.
● Tyrosine Kinase Inhibitors (TKIs):
○ Sunitinib (Sutent)
○ Pazopanib (Votrient)
○ Cabozantinib (Cabometyx)
● mTOR Inhibitors:
 ○ Everolimus (Afinitor)
○ Temsirolimus (Torisel)
● Checkpoint Inhibitors:
○ Nivolumab (Opdivo)
○ Ipilimumab (Yervoy)
○ Pembrolizumab (Keytruda

RADICAL NEPHRECTOMY
a. Surgical removal of the entire kidney,
adjacent adrenal gland, and renal artery
and vein
b. Radiation therapy and possibly
chemotherapy may follow radical
nephrectomy.
c. Before surgery, radiation may be used
to embolize (occlude) the arteries
supplying the kidney to reduce bleeding
during nephrectomy.

Postoperative interventions
a. Monitor vital signs for signs of bleeding
(hypotension and tachycardia).
b. Monitor for abdominal distention,
decreases in urinary output, and
alterations in level of consciousness as
signs of bleeding; check the bed linens
under the client for bleeding.
c. Monitor for signs of adrenal
insufficiency, which include a large
urinary output followed by hypotension
and subsequent oliguria.
d. Administer fluids and packed red blood
cells intravenously as prescribed.
e. Monitor intake and output and daily
weight.
f. Monitor for a urinary output of 30 to 50
mL/hr to ensure adequate renal function.
g. Maintain the client in a semi-Fowler’s
position.
h. If a nephrostomy tube is in place, do not
irrigate (unless specifically prescribed)
or manipulate the tube.