Pathophysiology

�Describe available preventive services that providers might recommend for patients at
risk of the type of cancer you selected.
�Explain how the factors you selected might impact decisions related to preventive
services.
�Describe drug treatment options for patients diagnosed with the type of cancer you
selected. Explain the short-term and long-term implications of these treatments.

Pathophysiology
Introduction

Research indicates that 2 million of men in the US are prostate cancer survivors. It is the most
common cancer among the male, followed by skin cancer. According to the American Cancer
Society, there are about 220,800 cases of prostate cancer annually, which claims about 27,540
lives every year. According to statistics, it is estimated that every one male in every seven will be
diagnosed with prostate cancer in his lifetime. Prostate cancer is the cancer of the prostate gland,
which is found in males. The gland is located below the urinary bladder. The size of the gland
changes with age, and has been found to grow rapidly in puberty. This rapid growth in puberty is
fueled by increased concentration on male hormones (androgens). The medical terminology of

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cancer in the prostate gland is referred to adenocarcinoma. Other types of prostate gland include
sarcomas, cell carcinomas, transitional cell carcinomas, and neuroendocrine tumors. Some of the
cancer spread rapidly whereas others grow slowly (Burdelski et al., 2015).
Preventive services
The early prostate cancer is usually asymptomatic and is known to have no symptoms. However,
at an advanced stage, prostate cancers have symptoms such as difficulties when passing urine
due to a weakened urine system. The patient tends to have frequent urination especially during
the night. In some cases, blood traces are present in urine. Additionally, the male individual
could suffer from erectile dysfunction, chronic pain in the hips, spine, and chest. The patient may
also have weakness and numbness in the feet and legs, loss of bowel or bladder control due to
the altered nervous system, especially the spinal cord (Ingersoll et al., 2015).
Early screening is one of the preventive measures applied in management of prostate cancer.
Early detection is important because it facilitates a quick application of intervention to protect
the patient from further complications. Prostate cancer screening is usually done by measuring
the prostrate-specific antigen (PSA) in the patient’s concentration. Digital rectal Exam has also
been widely used where the physician inserts their finger into the rectum to evaluate the size and
texture of the prostate gland. Some medications proposed to reduce risk for prostate cancer
including, 5-alpha reductase inhibitors that inhibits the conversion of the enzyme testosterone to
dihydrotestosterone (DHT) enzymes that induces prostate cancer. Recent studies have identified
an effective prostate cancer vaccine known as Sipuleucel-T. The vaccine works by boosting the
immune system, which fights prostate cancer cells (Thalgott et al., 2015).
The current evidence based risk factors include embracing a healthy lifestyle. This implies that
the individual should feed on a low fat diet by avoiding high intake of meat, oils, dairy products,

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and nuts. This is because high intake of fats is associated with high risk of prostate cancer.
Elderly males should be advised to consume more plant meals than animal meals. More fruits,
vitamin, mineral supplements, and seafood should be included in the diet. Physical activeness
must be encouraged among the individuals. Studies indicate that active people have low risk of
prostate cancer. This is because exercising help in keeping the body in good shape (Gupta et al.,
2015).
Risk factors influence of preventive services
There are risk factors that affect prostate cancer. Risk factor includes factors that aggravate
chances of developing the healthcare complication. The different types of cancer have varying
risk factors with a few having unknown risk factors. One of the main risk factors for prostate
cancer includes age, geographical location, ethnic background, sexually transmitted diseases,
genetic factors, vasectomy, and exposures in the work place, lifestyles, and family history. This
paper evaluates the two main risk factors that affect the decisions for preventive care (Tomioka
et al., 2015).
Age is one of the main risk factors of prostate cancer, which is more common in men above 65
years of age, but very rare in the young male of below 40 years. This age group often lack
adequate knowledge and information. This acts as barrier to the adoption of preventive services
such as early screening, life style modification and medication adherence. Prostate cancer has
also been found to be common in African-American men than in other ethnic groups. Prostate
cancer is less common in the Latino’s and Hispanics. Cultural values and beliefs are key
hindrances to the adoption and integration of the aforementioned preventive services (Nakazawa
et al., 2015).

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In some community, such as African American, it is actually a taboo to discuss genitalia matters
in public, and especially so if the physician is of the opposite sex and of younger age than the
service user. This implies that the disease is detected late, and interventions are given when the
disease has reached its unmanageable stage. Other barriers associated with these two risk
factors are time constraints and low staff levels, which results to an unanimous theme during
counseling on current evidence, based practices of preventive services (Burdelski et al., 2015).
Drug treatment for prostate cancer
If the prostate cancer is diagnosed and staged effectively, it is important for the patient to
empower to make informed decisions. Several drug treatment options are associated treatments
with prostate cancer. These include active surveillance or watchful waiting where prostate cancer
growth is monitored closely with DREs and PSA. This is because some prostate cancers are
benign and may not need to treat the condition. Radiation therapy involves the use of high
energy to destroy the cancerous cells. Cryosurgery is used to treat the first prostate cancer stage
and involves the freezing of the cancerous cells (Gupta et al., 2015).
Chemotherapy is often used as anti-cancer drugs, which are often injected in the vein in the
blood circulatory system. This therapy is important if the cancer has spread throughout the other
body organs. Hormone therapy involves the use of hormone blockers or suppression therapy to
suppress the conversion of testosterone to cancer inducing enzyme. Bone directed therapy and
vaccine therapy have been successful in treating prostate cancer. The decision of treatment
should be based on the patient’s general health condition, age, stage of cancer, preferences and
the expected side effects.
Short term and long-term implication of prostate cancer

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Short-term effects include fatigue and extreme tiredness. In some cases, fecal inconsistencies
may occur due to the inflammation if the rectum. This often results in urgency to urinate,
diarrhea, cramps, and blood in the patients stool. Other short term effects include the
possibilities of blood transfusion and pulmonary embolism In some cases, the issue of erectile
dysfunction can occur, low libido and infertility and urinary leakage (Burdelski et al., 2015).
The long-term side effects include erectile dysfunction, narrowing of the joint between the
urethra and the urinary bladder, which causes the frequent urge of urination. Men under
hormonal therapies are at risk of muscle and mineral loss (osteoporosis) which makes the patient
become more vulnerable to fractures. The most common long-term effect is emotional
instability, which is associated with loss of fertility and erectile dysfunction. Most men
diagnosed with erectile dysfunction tend to be angry, anxious and in denial. Their self-esteem is
usually reduced especially if the illness affects their sex life and finances (Gupta et al., 2015).

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References
Burdelski, C., Menan, D., Tsourlakis, M., Kluth, M., Hube-Magg, C., & Melling, N. et al.
(2015). The prognostic value of SUMO1/Sentrin specific peptidase 1 (SENP1) in prostate
cancer is limited to ERG-fusion positive tumors lacking PTEN deletion. BMC Cancer,
15(1).
Gupta, D., Trukova, K., Popiel, B., Lammersfeld, C., & Vashi, P. (2015). The Association
between Pre-Treatment Serum 25-Hydroxyvitamin D and Survival in Newly Diagnosed
Stage IV Prostate Cancer. PLOS ONE, 10(3), e0119690.
Ingersoll, M., Lyons, A., Muniyan, S., D’Cunha, N., Robinson, T., & Hoelting, K. et al.
(2015). Novel Imidazopyridine Derivatives Possess Anti-Tumor Effect on Human
Castration-Resistant Prostate Cancer Cells. PLOS ONE, 10(6), e0131811.
doi:10.1371/journal.pone.0131811
Nakazawa, T., Tateoka, K., Saito, Y., Abe, T., Yano, M., & Yaegashi, Y. et al. (2015). Analysis
of Prostate Deformation during a Course of Radiation Therapy for Prostate Cancer. PLOS
ONE, 10(6), e0131822.
Thalgott, M., Rack, B., Eiber, M., Souvatzoglou, M., Heck, M., & Kronester, C. et al. (2015).
Categorical versus continuous circulating tumor cell enumeration as early surrogate marker
for therapy response and prognosis during docetaxel therapy in metastatic prostate cancer
patients. BMC Cancer, 15(1).
Tomioka, A., Tanaka, N., Yoshikawa, M., Miyake, M., Anai, S., & Chihara, Y. et al. (2015).
Risk factors of PSA progression and overall survival in patients with localized and locally
advanced prostate cancer treated with primary androgen deprivation therapy. BMC Cancer,
15(1).

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