Med-Surg Immune System, part 14: Prostate, Colorectal, & Lung Cancer

by Cathy Parkes 1 Comment

In this video

Prostate Cancer

  • Screening for prostate cancer
  • Risk factors for prostate cancer
  • Signs and symptoms of prostate cancer
  • Lab values and diagnosis of prostate cancer
  • Treatment of prostate cancer

Colorectal Cancer

  • Screening for colorectal cancer
  • Risk factors for colorectal cancer
  • Signs and symptoms of colorectal cancer
  • Lab values and diagnosis of colorectal cancer
  • Treatment of colorectal cancer

Lung Cancer

  • Screening for lung cancer
  • Risk factors for lung cancer
  • Signs and symptoms of lung cancer
  • Lab values and diagnosis of lung cancer
  • Treatment of lung cancer

Full Transcript

Alright. In this video, we are going to continue our coverage of the most common types of cancer. If you are following along with your Medical-Surgical Nursing Edition 2.0 cards, I am on card 32 in the immune system. In this video, we will be talking about prostate cancer, colorectal cancer, and lung cancer.

Let's first talk about prostate cancer.

So the way we screen for prostate cancer is by taking the patient's PSA level, so that's prostate-specific antigen level, as well as doing a digital rectal exam, or a DRE.

We do these things starting at age 50, unless the patient's at higher risk. Then we can start them earlier.

It's important to remember that we need to first take the patient's blood to check for their PSA level before we do a digital rectal exam, and that's because if we did the digital rectal exam first, that actually causes an increased level of PSA. So if we did the DRE and then the PSA, we can end up with an artificially high level of PSA. So again, take the blood first for the PSA, then the DRE.

In terms of risk factors of prostate cancer, old age is one, as well as a high-fat diet. Race also plays a role. So African Americans are at higher risk for prostate cancer. And then genetics is another risk factor.

In terms of signs and symptoms, the urethra runs right in the middle of that prostate gland, so if there's a tumor and enlargement of that prostate gland, it can really put pressure on that urethra and cause urinary-type symptoms, so you'll have symptoms such as urinary retention, hesitancy, and frequency. The patient may have frequent bladder infections, as well as hematuria, so that's like blood in the urine, and nocturia, so that means a lot of peeing at night. So the patient may have to get up several times a night to go to the bathroom.

In terms of the labs and diagnosis of this condition, if the patient's PSA level comes back over 4, then that is suspect for prostate cancer. However, PSA levels may also be elevated if the patient has BPH, so, definitely, further investigation will be needed to be able to differentiate whether the patient has cancer or BPH.

Other diagnostic tools include using a transrectal ultrasound. And then, in terms of getting a definitive diagnosis, we would need to obtain a biopsy.

In terms of treatment, hormone therapy can be used, such as leuprolide. We can also use chemotherapy and radiation.

The patient may require surgery, such as a prostatectomy, so that is removal of a portion or all of the prostate gland.

They may also require an orchiectomy, which is removal of the testicles, and that would be done in order to stop production of testosterone, which really fuels the growth of the prostate cancer.

Alright. Now let's talk about colorectal cancer.

Screening tools used for this cancer include an FOBT, which is a fecal occult blood test. This where we're testing for the presence of blood in a stool sample. A colonoscopy starting at age 50 is probably the best screening tool for colorectal cancer. These are done every 10 years if nothing shows up in the colonoscopy. If the patient ends up having a polyp removed during a colonoscopy, chances are they're going to want to do another colonoscopy sooner than every 10 years.

The patient may also choose to do a sigmoidoscopy every 5 years instead. However, a sigmoidoscopy really examines only the lower part of the colon, as opposed to a colonoscopy, which examines the whole large intestine. So really, a colonoscopy is more highly recommended as a good screening tool for colorectal cancer.

In terms of risk factors associated with this type of cancer, older age is one, as well as a high-fat diet, especially a diet that's high in red meat. Genetics, smoking, obesity, alcohol, and physical inactivity are other risk factors.

Signs and symptoms of colorectal cancer can include rectal bleeding, as well as a change in the bowel color, shape, or consistency. So if you have a patient who suddenly has a big change in their bowel movements, they should definitely bring that to the attention of their provider.

In terms of labs and diagnosis, a colonoscopy with a biopsy is really the gold standard for diagnosing colorectal cancer. In addition, a positive FOBT would be suspect for colorectal cancer. We could also do imaging, such as a CT or an MRI.

As far as treatment, chemotherapy is an option, as well as radiation.

We may need to do surgery, so a colon resection or colectomy with the creation of a colostomy or ileostomy. This is where we reroute part of the intestine through the abdominal wall and the patient has a bag. So there's definitely some important things regarding nursing care and patient teaching when it comes to ostomies, so I definitely recommend that you watch my video on that topic in our gastrointestinal playlist.

Alright. Lastly, let's talk about lung cancer.

So we don't screen everybody for lung cancer. However, if there are at-risk individuals, like people who smoke, we can do an annual low-dose CT scan to screen them for lung cancer. So my mom's boyfriend, he's very sweet. He smokes, though, so he actually goes and gets these low-dose CT scans every year to screen for lung cancer.

In terms of risk factors associated with lung cancer, you probably can guess what they are. So smoking is the big one, in addition to secondhand smoke, pollution, exposure to asbestos, and being of a male gender also places an individual at higher risk.

In terms of the signs and symptoms of lung cancer, the patient may have a cough, blood-tinged sputum, chest pain, shortness of breath, weight loss, fatigue, and a dull chest percussion. So when you percuss the chest, you are expecting resonance. If you're not getting resonance and you're getting that dull sound, then that is suspect for a lung tumor.

In terms of the labs and diagnosis, a CT scan can be helpful. In addition we can do a bronchoscopy with a needle biopsy to definitively diagnose the lung cancer.

And then in terms of treatment, chemotherapy is an option, as well as targeted therapy. So targeted therapy helps to prevent damage to healthy cells, as opposed to chemotherapy. Radiation is also an option, as well as photodynamic therapy. We may need to do a lobectomy, so that is a surgical removal of a lobe of the lung, or we may need to do a pneumonectomy, which is removal of the entire lung.

So that is it for lung cancer, and that is it for this playlist. So if you have found value in these videos, if this has been a good review for you, be sure to like this video, and leave us a comment, and definitely subscribe to our channel. So take care and good luck studying!

[BLOOPERS]

Alright. So let's first talk about prostate cancer, and discuss screening. Screening for prostate cancer is done through obtaining a-- so if a patient really has changes in their bowel movements, they should definitely notify the provider because that may be a.


1 Response

Vishia

October 27, 2020

Thank you, Cathy. The review was clear and concise.

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