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SPONSORED FEATURE


Sarah Henderson Macmillan Urology Nurse Specialist, St George’s Healthcare NHS Trust


Mary van Zyl Macmillan Urology Nurse Specialist, St George’s Healthcare NHS Trust


The Prostate Cancer Charity is a charity registered in England and Wales (1005541) and Scotland (SC039332). Registered company 2653887.


Prostate cancer: a growing


challenge Prostate cancer is the most common cancer in men. This Prostate Cancer Awareness Month it is essential to know the facts


P Impotence. Elevated PSA.


rostate cancer is the most common malignancy in men in the United Kingdom with over 37,000 new diagnoses and over 10,000 deaths each year.1


This


means it has a considerable impact on the health of men and uses a significant amount of healthcare resource across the country. Although it is generally a disease of older men, a significant


number of men will be diagnosed in their 40s and 50s. It is important that as nurses and practice nurses, we are aware of the issues and nuances surrounding this disease and how to treat them, to ensure the best outcomes for all involved (see Table 1).


THE PROSTATE The prostate is a small chestnut-shaped gland found at the neck of the male bladder. It is very small in children but starts to increase in size at puberty, stimulated by the release of testosterone. The function of the prostate is to produce a liquefying component of semen which allows the sperm to swim freely on ejaculation. This liquid also contains a substance known as prostate-specific antigen (PSA) which is a glyco-protein important in the diagnosis of prostate cancer. There are several conditions which can affect the prostate. As


men get older, the prostate grows and can start to constrict the urethra, causing problems passing urine. This is known as benign


BOX 1. SIGNS AND SYMPTOMS OF PROSTATE CANCER


Asymptomatic. Hesitancy. Urgency.


Poor urinary stream. Frequency. Haematuria.


Haematospermia.


BOX 3. NORMAL PSA VALUES Age


40-49 50-59 60-69


70 & over


PSA ng/ml ≥ 2.5 ≥ 3.0 ≥ 4.0 > 5.0


prostatic hyperplasia (BPH). Another condition is prostatitis, which is an inflammation of the prostate that can cause pain and difficulty in passing urine. The other common condition is prostate cancer.


PROSTATE CANCER OBSTACLES Getting the message across Men have traditionally been poor at addressing their health needs and it is well documented that they seek healthcare less than women. It is a challenge for those in primary care settings to find ways to ensure that the cancer is diagnosed early enough to make a difference to long-term outcomes. Reaching men with this message is particularly important for those in the ‘at risk’ groups (see Table 2).


Unpredictable development Another difficulty with prostate cancer is that the natural history of the disease is poorly understood, meaning it is not possible to distinguish how the cancer is going to behave. Some cancers will grow very slowly and will never cause any symptoms nor shorten life. Others are much more aggressive and may progress quickly. This issue results in men and their clinicians often facing difficult decisions in terms of which course of treatment to take, as the predicted development of the disease is uncertain. For this reason it is vital that men are given the full breadth of treatment options and information at every step of their journey.


www.nursinginpractice.com


Nursing in Practice March/April 2012 37


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