NURS 330

December 2, 2013

Agenda Breast Cancer Lecture

Guest Speaker Scheduled Review 11/25/13 In-Class

Assignment Prostate & Testicular Cancers

Lecture Distribute Final Exam Study Guide In-Class Assignment

Final Exam

Mon, December 9, 2013 7:00pm – 10pm

100 Questions, each worth 2 points

Multiple Choice, T/F, Fill-in-the-blank

Study Guide will be distributed in class on Mon, 12/2/13

The following presentation on Cancer is from the

American Cancer Society. It has been authorized

for use in this class by Chrissy Kim, Manager, Healthcare/Corporate Initiatives

What is Cancer? Cancer occurs when cells in a part of the

body begin to grow out of control. Normal cells divide and grow in an orderly fashion, but cancer cells do not. They continue to grow and crowd out normal cells.

Although there are many kinds of cancer, they all have in common this out-of-control growth of cells.

Cancer (cont) Sometimes cancer cells break away from a tumor and

spread to other parts of the body through the blood or lymph system. They can settle in new places and form new tumors. When this happens, it is called metastasis. Cancer that has spread in this way is called metastatic cancer.

Even when cancer has spread to a new place in the body, it is still named after the part of the body where it started. For example, if prostate cancer spreads to the bones, it is still called prostate cancer. If breast cancer spreads to the lungs, it is still breast cancer. When cancer comes back in a person who appeared to be free of the disease after treatment, it is called a recurrence.

Survival RatesSurvival Rates

5-year localized survival rate Localized cancer is cancer that, at the

time of diagnosis, had not spread to additional sites within the body. Typically, the earlier a cancer is detected and diagnosed, the more successful the treatment, thus enhancing the survival rate.

Survival Rates

5-year overall survival rate The 5-year survival rates represent

persons who are living 5 years after diagnosis, whether disease-free, in remission, or under treatment. They do not imply that 5-year survivors have been permanently cured of cancer.

Conditions of the Scrotum

Epididymitis an inflammation or infection of the epididymis

Caused by bacterial infections Sometimes caused by gonorrhea and chlamydia

Incidence is less than 1 in 1,000 males per year

Epididymitis is primarily a disease of adults, most commonly affecting males aged 19-40 years.

Testicular Cancer

What Is Testicular Cancer?

Testicular cancer can develop in one or both testicles in men and boys.

Contained in a sac of skin called the scrotum, the testicles are the part of the male reproductive system that produces sperm and male hormones (like testosterone).

Very rare cancer but is the most common cancer found in men ages 15 - 35

The American Cancer Society’s Estimates

In the United States during 2013:

7,920 new cases of testicular cancer

Deaths per year: 370 men

Testicular cancer is not common; about 1 in 270 men will develop testicular cancer in their lifetime.

Risk FactorsThe main risk factors for testicular cancer include:

Race Family history Being born with an undescended testicle

Cryptorchidism

Because these risks cannot be avoided, it is not currently known how to prevent most cases of testicular cancer.

Risk Factors (cont)

Although testicular cancers usually occur in patients between the ages of 15 and 40, they can affect males of any age, including infants and elderly men.

The risk among White men is about five times higher than among African American men.

Men who have had cancer in one testicle are at increased risk for developing cancer in the other testicle.

What Are Other Risk Factors?

If a man’s close family members have had testicular cancer, he is at greater risk.Men who had an undescended testicle as a baby are at increased risk (3 out of every 100 male infants).Men who have had cancer in one testicle are at increased risk for developing cancer in the other testicle.

Other Risk FactorsSome jobs may put men at increased risk for testicular cancer. Examples include being one of the following:

Miner Oil or gas worker Janitor Leather worker

Recent studies found no evidence that having a vasectomy increases a man’s risk of developingthe disease.

Reducing Your Risk

The main risk factors for testicular cancer include:

Race Family history Being born with an undescended testicle

Because these risks cannot be avoided, it is not currently known how to prevent most cases of testicular cancer.

Risk Factors (cont)

Since none of these risks can be prevented, the best protection is awareness of risks and symptoms, early detection, and prompt treatment.

Men at risk may want to perform a monthly self-exam Testicular Self Exam (TSE)

American Cancer Society. 2006

Testicular Self Exam (TSE)

The best time to perform the self-exam is during or after a

bath or shower, when the skin of the scrotum is relaxed. To

perform a testicular self exam: Hold the penis out of the way and examine each

testicle separately.

Hold the testicle between the thumbs and fingers with both hands and roll it gently between the fingers.

Look and feel for any hard lumps or nodules (smooth rounded masses) or any change in the size, shape, or consistency of the testes.

SymptomsLump or swelling in either testicle

90% of cases Often painless or slightly uncomfortable

Enlargement of a testicleFeeling of heaviness in the scrotumDull ache in the lower abdomen or groinSudden collection of fluid in the scrotumEnlargement or tenderness of the breasts

Detection Methods

In 90% of cases, men have a lump or swelling in a testicle. Any swelling or aching in the testicles should be examined by a doctor without delay.Men at risk may want to perform a monthly self-exam.

Diagnosis

Medical History and Physical Exam Ultrasound Blood Tests

TreatmentTreatment

Testicular cancer is highly treatable, usually curable, and relatively rare.Treatment is most successful when cancer is detected early.Often two or more treatment methods are used. Patients should thoroughly discuss treatment options with their doctors.

Treatment Options

There are three main treatment options: Surgery

An operation to remove cancer cells. Radiation therapy

Uses high-energy rays to shrink or kill cancer cells.

Chemotherapy Uses anticancer drugs that attack cancer

cells and normal cells. The drugs are usually given by injection or by mouth.

Survival Rates

5-year localized survival rate is 99%

5-year overall survival rate is 95%

Survival rates drop to 76% when cancerhas spread to distant organs, which underlines the need for early action.

Prostate Cancer

What Is Prostate Cancer?

In American men, prostate cancer is the most common cancer and the second leading cause of cancer death.

The prostate gland is walnut-sized and is located in front of the rectum, behind the penis, and under the bladder.

Most prostate cancers grow very slowly, but when they spread, they can do so quickly.

The American Cancer Society’s Estimates

In the United States during 2013:

238,590 new cases of prostate cancer

Deaths per year: 29,720

The Prostate Gland

Prostate Gland

Urinary Bladder

Three Greatest Risk Factors Three Greatest Risk Factors

Being a man Only men develop prostate cancer, typically those

ages 50 and older.

Age More than 70% of prostate cancers are diagnosed in

men over 65.

Race: African American men have the highest prostate cancer incidence rates in the world. The rates of prostate cancer death for African American men are more than twice the rates for White men.

Other Risk Factors

About 5 to 10% of prostate cancers may be inherited.

Eating a high-fat diet especially a diet high in saturated fat, found primarily in animal sources, such as red meat and dairy products—may play a part in

causing prostate cancer.

SymptomsMost early cases of prostate cancer cause no symptoms, but some early signs may be:

Frequent urination, especially at night.

Difficulty starting urinationor inability to urinate.

Weak or painful urination.

Diagnosis Prostate-Specific Antigen (PSA)

blood test

Digital Rectal Exam (DRE) rectal exam

All men 50 years of age and older should ask their physicians about having the PSA test and a DRE every year. At a younger age if at high risk

TreatmentTreatment

Treatment is most successful when prostate cancer is detected early.

Often two or more treatment methods are used.

Patients should thoroughly discuss treatment options with their doctors.

TreatmentIf prostate cancer is detected early, is slow growing, and is not causing symptoms, “watchful waiting” may be chosen initially, especially for older men.

Active treatment is started if the cancer begins to grow more quickly or symptoms appear.

Treatment (active) Options

Surgery Removal of the prostate, called prostatectomy, is

the most commonly chosen surgical treatment.

Radiation therapy Uses high-energy rays to shrink or kill cancer cells.

Treatment Options (cont)

Chemotherapy Uses anticancer drugs that attack cancer

cells and normal cells. The drugs are usually given by injection or by mouth.

Hormone therapy Treatment with hormones or drugs that

interfere with hormone production or action, or the surgical removal of hormone producing glands.

Survival Rates

5-year localized survival rate is 100%

5-year overall survival rate is 99%

PreventionAll men 50 and older should talk to their doctors about having annual DRE and PSA tests to help find prostate cancer early.

Men who are at high risk for prostate cancer (African Americans or men with a first-degree relative diagnosed with prostate cancer at a young age) should begin testing at age 45.

Prostate cancer is less likely to be curable once it has spread; however, with annual screening, prostate cancer can be detected before this occurs.