with answers
Preventing Metastasis
-Active Surveillance (AS) ✅✅-Prostate cancer is slow growing with a late metastasis
-Older men may be asymptomatic and have other illnesses may choose to have
observation with any immediate active treatment, especially in an early stage
-*Factors to consider when choosing AS:* Urinary incontinence, ED, estimated life
expectancy, risk for morbidity d/t not seeking active treatment
-If obstruction occurs, TURP may be done
Surgical Management:
-Radical prostatectomy ✅✅-Complete prostate removal
-Can be done transperineal and retropubic area (nerve sparing)
-Will have catheter in place for 7-10 days (Will need catheter maintenance teaching)
-May take anti-spastic medications to help with bladder spasms
-*Potential long-term complication of open radical surgery ED*
-Urge incontinence may occur d/t internal + external sphincters can be damaged
-Teach Kegel exercises to help regain sphincter control
Surgical Management:
-Laparoscopic radical prostatectomy ✅✅-Most common
-Done with robotic assistance
-Patients must have a PSA <10ng/mL and had no previous hormone therapy or
abdominal surgeries
-*Advantages:*
-Decreased hospital stay
-Minimal bleeding
-Smaller or no incisions so less scarring
-Less post-op discomfort
-Decreased time for catheter placement
-Fewer complications
-Faster recovery
-Nerve sparing advantages
Non-Surgical Management:
-Radiation therapy ✅✅-Can be done internally or externally as treatment of prostate
cancer or as a salvage treatment when cancer recurs
-Can also be used for palliation
-Commonly lasts 4-6 weeks
-External radiation causes ED in many men
*Acute Radiation Cystitis:* Complication of external therapy that causes persistent pain
and hematuria