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NURS 330
March 10, 2014
Agenda





Breast Cancer Lecture
Review 3/3/14 In-Class Assignment
Prostate & Testicular Cancers Lecture
Distribute Final Exam Study Guide
In-Class Assignment
Final Exam

Mon, March 17, 2014
7:30pm – 10pm

100 Questions, each worth 2 points

Multiple Choice, T/F, Fill-in-the-blank

Study Guide will be distributed in class on Mon,
3/10/14 and also posted on the course website.

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 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 Factors
The 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 Factors
Some 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 developing
the 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)
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.
American Cancer Society. 2006
Symptoms

Lump or swelling in either testicle
90% of cases
 Often painless or slightly uncomfortable

Enlargement of a testicle
Feeling of heaviness in the scrotum
Dull ache in the lower abdomen or groin
Sudden collection of fluid in the scrotum
Enlargement 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
Treatment
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


Radiation therapy


An operation to remove cancer cells.
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 cancer
has 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
Urinary Bladder
Prostate Gland
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.
Symptoms
Most early cases of prostate cancer cause no
symptoms, but some early signs may be:




Frequent urination, especially at night.
Difficulty starting urination
or inability to urinate.
Weak or painful urination.
Diagnosis

Prostate-Specific Antigen (PSA)


Digital Rectal Exam (DRE)


blood test
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
Treatment
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.

Treatment
If 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%
Prevention
All 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.
