2:1, smokers twice as likely, environmental carcinogens, recurrent/chronic
UTIs, bladder stones, high urinary pH, high cholesterol intake, pelvic radiation,
primary CA in prostate/colon/rectum in males or gynecological tract in females...mets
Clinical manifestations of bladder cancer
-visible painless hematuria
-UTI: dysuria, urgency, frequency (UTI sx)
-change in voiding patterns
-pelvic & back pain (could be r/t bladder/prostate cancer)
Nursing education/interventions for patients undergoing surgical resection for bladder cancer
-ileal conduit, catheterizable pouch and neobladder to divert urine from bladder to new exit (usually through a stoma in the skin); conduit only holds 10cc and leads to bag
-may also require IV chemo, radiation, adjuvant intravesical drugs after TUR for large/multiple/high grade/superficially invasive tumors (drugs put into bladder for direct contact e.g. Bacille Calmette-Guerin (BCG) for activate immunologic/inflammatory response), or photodynamic techniques for superficial cancer
-no voiding; UTI assessment per low UO (min is 30cc/hr), concentrated urine, flank pain, fever
-stoma should be bright red, wet, may have no sensation
-RN mgmt: IVF, pain, I&O, O2,
H&H, electrolytes, erterostomal tx (monitor stoma and surrounding skin), recline & ambulate, TEDs/SCDs, address sexual concerns
Risk factors for prostate cancer
-70% men>65y/o w family hx, diet high in red meat/dairy w high fat, environment
-common in men>50y/o
-mostly Af Am men
-high PSA levels (N PSA < 4.0,
intermediate 4-10, high > 10)
-dad/brother w dx doubles risk
-PSA screen @ 40y/o for high risk
(e.g. Am men w close relative dx), 50 y/o for men
w no risk
Clinical manifestations with prostate cancer
-elevated PSA
-early diseaseàfew/no sx
-late diseaseàurinary obstruction, blood in urine/semen, painful ejaculation
