HPA Exam 3: Colorectal Cancer

Which screening test should be done for someone who has colorectal risk factors?

A colonscopy as this allows for visualization of the polyps or lesions and if polyps are identified can also simultaneously remove precancerous polyps. This type of screening should begin at 50 years (sooner if significant risk factors) and be conducted every 10 years

A 71-year-old male has been recently diagnosed with a stage III tumor of colorectal cancer, and is attempting to increase his knowledge base of his diagnosis. Which statement about colorectal cancer demonstrates a sound understanding of the disease? A) "While diet is thought to play a role in the development of colorectal cancer, the ultimate causes are largely unknown." B) "If accurate screening test for this type of cancer existed, it could likely have been caught earlier." C) "The NSAIDs and aspirin that I've been taking for many years probably contributed to my getting cancer." D) "A large majority of clients who have my type of colon cancer survive to live many more years."

A)

A client tells the nurse, "I am not having normal bowel movements." When differentiating between what are normal and abnormal bowel habits, what indicators are the most important? A) The consistency of stool and comfort when passing stool B) That the stool is formed and soft C) That the client has a bowel movement daily D) The client is able to fully evacuate with each bowel movement

A)

What is considered a high risk for prostate cancer?

African American man with a first degree relative with a diagnosis with prostate at an early age (less than 65). Should begin to be screened at 45 years

What is considered the highest risk for prostate cancer?

African American man with more than 2 relatives with a diagnosis of prostate cancer at an early age. Should begin to be screened at 40 years of age

When is radiation therapy used to treat colorectal cancer?

After surgery if tumor are large, if patient is too weak for surgery, or to palliate symptoms. For rectal cancer it can be done before or after surgery along with chemotherapy.

When is screening for colorectal cancer recommended to begin?

At age 50 (possibly earlier depending on risk factors) colonscopys should be done every 10 years

Which term refers to intestinal rumbling? A) Azotorrhea B) Tenesmus C) Borborygmus D) Diverticulitis

C)

What are some reasons surgery can be done for colorectal cancer?

Can be done as the primary treatment for colorectal cancer or for palliative reasons. Can also be done as open surgery or laprascopically (results in fewer complications). Patients may also have colostomy created as a temporary or permanent fecal diversion which allows the drainage or evacuation of colon contents to the outside of the body. Colon may be reconnected following surgery (end to end anastomosis), colostomy created (temporary or permanent), or a coloanal reservoir or J-pouch created temporarily.

How often should stool DNA tests be conducted?

Every 3 years beginning at 50

When is permanent brachytherapy indicated for prostate cancer patients? How is it adminstered?

Involves the implantation of interstitial radioactive seeds into the prostate under anesthesia. It is commonly used for early, clinically organ-confined prostate cancer. The surgeon uses ultrasound guidance to place 80 to 100 seeds under anesthesia. This can be done in 1 day and the patient can return home after the procedure. The patient should avoid close contact with pregnant women and infants for up to 2 months and strain urine for seeds and use a condom during sexual intercourse for up to 2 weeks after implantation. Is low dose so there is minimal chance of radiation exposure to others.

Where can prostate cancer metastasize to?

Lymph nodes and bone

Identify two secondary prevention strategies for prostate cancer

Screening beginning at 50 involving a digital rectal exam and labs to track serum PSA levels

What is a sigmoidoscopy? How often should this type of screening be done?

Should be done every 5 years. Allows for visualization of polyps or lesions in sigmoid area of the colon.

How are patients with stage III and stage IV colorectal cancers typically treated?

Typically treated with combination chemotherapeutic drug 5-fluorouracil, lucovorin, and oxaplatin (FOLFOX). This is administered IV in 2 week cycles over 6 months. 5-Fluoroucil (FU) can cause mucositis and hand-foot syndrome (redness, swelling, and pain on palms of hands). Oxaliplatin can cause peripheral neuropathies (typically go away after chemotherapy is completed).

How often should fecal immunochemical test (FIT) be conducted?

Yearly beginning at 50

What is a guiac-based fecal occult blood test (gFOBT)? How often should this type of screening be done?

Yearly starting at 50. Two positive stools within 3 days for occult blood indicates colorectal cancer.

What are some nursing interventions for those who have received radical prostectomy?

1) Intermittent catheter or urinary catherization (provide catheter care) and administer bladder antispasmodics as prescribed 2) Pelvic floor exercises (kegal) exercises 3) Scrotal supports to help prevent edema in scrotum

What are some non-modifiable risk factors for colorectal cancer?

1) Most significant risk factor is older age (50+) 2) Family history of colon cancer (specific form of hereditary colorectal cancer known as Lynch syndrome) or polyps (familial adenomatous polyposis) 3) History of inflammatory bowel disease 4) History of ovarian or breast cancer 5) Colorectal polyps 6) Gastrectomy (partial removal of stomach) 7) Ashkenazi Jewish heritage 8) African American

What are some different types of treatment for prostate cancer?

1) Nonsurgical watchful waiting for those who have a life expectancy of less than 5 years or have low-risk cancers 2) Surgery (radical prostatectomy is first-line treatment) 3) Radiation (internal/brachytherapy or external beam) 4) Chemotherapy (those with advanced cancer) 5) Vaccine (Sipuleucel-T) which destroys existing cells and prevents further cancer development 6) Hormone therapy

What are some interventions for radiation proctitis?

1) Antidiarrheals and adequate hydration 2) Low residue diet 3) Topical medications for proctitis 4) Keep skin clean and dry 5) Use sitz baths (tepid water in which person sits in up to the hips) and barrier creams

What are some risk factors for prostate cancer?

1) Being greater than 65 years of age 2) African-American 3) High-fat or red meat diet 4) Genetic predisposition (having HPC1, BRCA1, or BRCA 2 gene) 5) High consumption of calcium

What are some modifiable risk factors for colorectal cancer?

1) Cigarette smoking 2) High consumption of alcohol (greater than 2 drinks daily in men, greater than 1 drink daily in women) 3) High-fat, high-protein diet, low fiber diet 4) Type 2 diabetes 5) Overweight or obesity 6) Limited physical activity

Identify two examples of secondary prevention for colorectal cancer

1) Fecal occult blood tests (should be done annually at age 50) 2) Colonscopy 3) Sigmoidscopy

Identify two examples of primary prevention for colorectal cancer

1) Improved nutrition 2) Increased intensity and frequency of exercise 3) Smoking cessation 4) Taking aspirin starting at the age of 50

What are some post-op interventions which should be done with a patient who has received surgery for colorectal cancer?

1) Nurse should assess the abdomen for returning peristalsis and assess initial stool characteristics 2) Should also help patients out of bed the first postoperative day to prevent atelectasis, VTE, and accelerate the return of peristalsis 3) Assess stoma (should be reddish, pink, moist, small amount of blood postoperatively) and report ischemia, necrosis or frank bleeding 4) Coughing, deep breathing, use of incentive spirometer 5) Wound care and frequently assessing abdominal dressing especially during the first 24 hours to detect signs of hemorrhage 6) Monitor vital signs for signs of infection 7) Provide ostomy teaching if applicable 8) Teach patient on how to use PCA pump 9) Ostomy care possible referral to ostomy care nurse 10) Emotional support and providing any information about ostomy support groups

Name three risk factors for colorectal cancer

1) Obesity 2) Sedentary lifestyle 3) Type II diabetes 4) Family history (lynch syndrome or polyps) 5) African american or ashkenzi jewish heritage 6) Being over the age of 50

Name three non-modifiable risk factors for prostate cancer

1) Older age (over the age of 65) 2) African-American descent 3) Genetic predisposition (HCA1 gene, BRCA1, BRCA2)

What are some interventions to treat side effects of radiation used to treat colorectal cancer?

1) Skin care: avoid sunlight, hot water, hydrophilic non-scented lotions 2) Perinuem care 3) Anti-emetics 4) Anti-diarrheals 5) Pain management 6) Exercise program 7) Emotional support 8) Nutrition assessment

Describe three nursing management strategies for patients with colorectal cancer receiving radiation therapy

1) Skin care: avoid the sun, hot water, use non-scented hydrophilic creams, do not disturb blisters 2) Administering anitmetics and antidiarrheals before and after chemo to help with nausea and diarrhea 3) Perinuem care

What are some side effects of radiation used to treat colorectal cancer?

1) Skin irritation 2) Radiation enteritis which causes nausea, diarrhea, rectal irritation, and bowel incontinence 3) GU symptoms such as urinary frequency and dysuria 4) Sexual problems 5) Fatigue

What are some nursing interventions for hormone therapy used to treat prostate cancer?

1) Treatment for erectile dysfunction 2) Anti-depressants to treat hot flashes, avoid triggers (such as caffeine, alcohol) 3) Exercise program to combat weight gain and loss of muscle mass 4) Sexuality counselor 5) Healthy diet to treat increased cholesterol levels 6) Support groups

What are some complications of radical prostectemy?

1) Urinary incontinence 2) Erectile dysfunction 3) Production of a dry orgasm 4) Loss of fertility 5) Possible lymphedema (if lymph nodes were also removed)

What is the most common types of colorectal cancer?

95% are adenocarcinomas, arise from a gland in the epithelial lining of the colon. Begins as a benign polyp which may become malignant, invade and destroy normal tissues, and extend into surrounding structures.

Which characteristic is a risk factor for colorectal cancer? A) Familial polyposis B) Low-fat, low-protein, high-fiber diet C) Age younger than 40 years D) History of skin cancer

A)

A client is diagnosed with colon cancer, located in the lower third of the rectum. What does the nurse understand will be the surgical treatment option for this client? A) Abdominoperineal resection B) Colectomy C) A low colectomy D) Segmental resection

A) Explanation: A cancerous mass in the lower third of the rectum will result in an abdominoperineal resection with a wide excision of the rectum and the creation of a sigmoid colostomy. An encapsulated colorectal tumor may be removed without taking away surrounding healthy tissue. This type of tumor, however, may call for partial or complete surgical removal of the colon (colectomy). Occasionally, the tumor causes a partial or complete bowel obstruction. If the tumor is in the colon and upper third of the rectum, a segmental resectionis performed. In this procedure, the surgeon removes the cancerous portion of the colon and rejoins the remaining portions of the GI tract to restore normal intestinal continuity.

The nurse is caring for a 67-year-old woman in the reproductive health clinic. Which question should the nurse be sure to include during health screening and counseling with this client? A) "When was your last colonoscopy completed?" B) "Which contraceptive medications are you currently taking?" C) "Do you experience hot flashes and night sweats?" D) "Have you been tested for gonorrhea recently?"

A) Explanation: For women older than the age of 65 years, the nurse should ask about diagnostic testing for colorectal cancer during the health screening and counseling visit. The risk for this health problem increases with age and regular screening is required after age 40. Although all women should be assessed for high risk sexual behaviors, screening for sexually transmitted infections is generally a standard part of the health screening visit for women aged 19 to 39 years. The risk of pelvic inflammatory disease, ectopic pregnancy and infertility is of greatest concern in this age group and can occur as a result of untreated sexually transmitted infections. Hot flashes and night sweats are typical symptoms of perimenopause, for which the average age of onset is 47.5 years. A woman older than 65 years of age would not be prescribed contraceptive medication. The risk of pregnancy is very low at this age.

The risk for developing colorectal cancer during one's lifetime is 1 in 19. Nurses play an integral role in the promotion of colorectal cancer screening. What are risk factors for colorectal cancer? Select all that apply. A) age 50 and older B) a history of inflammatory bowel disease C) a diet high in fruits, vegetables, and whole grains. D) a positive family history

A), B), D)

A client is being screened for colorectal cancer with the fecal occult test. The nurse instructs the client to avoid ingesting which items 3 to 7 days prior to the test? Select all that apply. A) Citrus fruits B) Red meats C) Green leafy vegetables D) Milk E) Aspirin

A), B), E)

The public health nurse is facilitating a cancer screening in-service for colorectal cancer. Which clients present the fewest risk factors for colon cancer? Select all that apply. A) 80-year-old male with a history of prostatitis B) 45-year-old female with a 25-year history of ulcerative colitis C) 72-year-old female with a history of breast cancer D) 60-year-old female who follows a diet low in fat and high in fiber E) 50-year-old male whose father died of colon cancer

A), D)

When should all men begin to be screened for prostate cancer?

At the age of 50. Should also have PSA levels checked yearly

The hospital nurse is caring for a group of adult clients. For which client should the nurse most likely administer prophylactic anti-infectives? A) A client who has hyperkalemia and who is receiving sodium polystyrene B) A client who is undergoing cardiac rehabilitation following a myocardial infarction C) A client with colorectal cancer who is preoperative for a bowel resection D) A client with diabetic nephropathy who has recently begun dialysis

C)

The nurse is conducting a community education program using the American Cancer Society's colorectal screening and prevention guidelines. The nurse determines that the participants understand the teaching when they identify that people over the age of 50 should have which screening test every 10 years? A) Fecal occult blood test B) Papanicolaou (Pap) C) Colonoscopy D) Prostate-specific antigen (PSA)

C)

A client suspected of having colorectal cancer requires which diagnostic study to confirm the diagnosis? A) carcinoembryonic antigen (CEA) B) sigmoidoscopy C) stool Hematest D) abdominal computed tomography (CT) scan

B)

A client with colorectal cancer reports constipation. Which signs or symptoms accompany constipation? A) increased bowel movement B) pain on defecation C) feeling of abdominal emptiness D) inability to pass urine

B)

A client with colorectal carcinoma is devastated after learning that the cancer has spread to the liver and lungs and the client has only a 5% chance of surviving for 5 years. Which comment by the nurse would best help the client cope with this news? A) "I've seen clients in your situation who have lived almost 20 years." B) "It must be hard to hear that prognosis. Would it help you to talk to me or the chaplain?" C) "This might be a good time to think about an advance directive in case you run into problems while you're here." D) "Those are just numbers. You have to live each day fully and not worry about dying."

B)

One of the greatest causes of death in the United States and Canada is colon cancer. The nurse instructs the community on which of the following factors? A) Administration of a stool softener daily B) Annual screening after the age of 50 C) Endoscopic exam every year after 30 D) <20 g of fiber intake per day

B)

Select the client at greatest risk for developing colorectal cancer. A) A 40-year-old male with a history of peptic ulcer disease B) A 64-year-old female whose mother had colorectal cancer C) A 26-year-old male with a history of irritable bowel syndrome D) A 45-year-old female who takes four to six aspirin per week for arthritis

B)

The nurse is conducting a community education program on colorectal cancer. Which statement should the nurse include in the program? A) Colorectal cancer has no hereditary component. B) It is the third most common cancer in the United States. C) The lifetime risk of developing colorectal cancer is 1 in 10. D) The incidence of colorectal cancer decreases with age.

B)

The nurse is teaching a client with rectal bleeding about fecal occult blood test (FOBT) testing supplies. What teaching will the nurse provide? A) "This test will show if you have colorectal cancer." B) "This test detects heme, a type of iron compound in blood in the stool." C) "This test will show if you have an infection in the bowel." D) "This test will determine whether foods are contributing to rectal bleeding."

B)

A 53-year-old client undergoes colonoscopy for colorectal cancer screening. A polyp was removed during the procedure. Which nursing interventions are necessary when caring for the client immediately after colonoscopy? Select all that apply. A) Instruct the client to follow a clear liquid diet after recovery from sedation. B) Inform the client that there may be blood in the stool and to report excessive blood immediately. C) Observe the client closely for signs and symptoms of bowel perforation. D) Tell the client to report excessive flatus. E) Monitor vital signs frequently until they are stable.

B), C), E) Explanation: After colonoscopy, the nurse should observe the client closely for signs and symptoms of bowel perforation (malaise, rectal bleeding, abdominal pain and distention, fever, and mucopurulent drainage). The nurse should monitor vital signs frequently, until they become stable. Because a polyp was removed during the procedure, the nurse should inform the client that there may be some blood in the stool and to report excessive bleeding immediately. The nurse should caution that the client might pass large amounts of flatus resulting from air insufflated to distend the colon, but it is not necessary to report it. The client may resume a usual diet after recovery from sedation; a clear liquid diet is not necessary.

The nurse is talking with a group of clients who are older than age 50 years about the recognition of colon cancer to access early intervention. What should the nurse inform the clients to report immediately to their primary care provider? A) Daily bowel movements B) Abdominal cramping when having a bowel movement C) Change in bowel habits D) Excess gas

C)

Which client requires immediate nursing intervention? The client who: A) complains of epigastric pain after eating. B) complains of anorexia and periumbilical pain. C) presents with a rigid, board-like abdomen. D) presents with ribbonlike stools.

C)

A client is undergoing treatment for metastatic colorectal cancer. The client's chemotherapeutic regimen includes oxaliplatin IV. The nurse is preparing to administer a scheduled dose, and should: a) establish a new peripheral intravenous site. b) administer benzodiazepines as prescribed to prevent anxiety during chemotherapy. C) administer antiemetics and dexamethasone as prescribed. D) assess the client's baseline paint level to provide a comparison post-administration.

C)

A nurse is interviewing a client about past medical history. Which preexisting condition may lead the nurse to suspect that a client has colorectal cancer? A) Hemorrhoids B) Duodenal ulcers C) Polyps D) Weight gain

C)

A nurse is providing teaching about colon cancer to a group of females 45 to 65 years of age. Which of the following assessments should the nurse include in the teaching? A) Coloscopies for individuals with no family history of cancer should begin at 40 B) A sigmoidoscopy is recommended every 5 years beginning at age 60 C) Fecal occult blood tests should be done annually beginning at age 50 D) An MRI provides a definitive diagnosis of colon cancer

C)

A nursing assessment of a client with peritonitis reveals hypotension, tachycardia, and signs and symptoms of dehydration. What else would the nurse expect to find? A) rectal bleeding and a change in bowel habits B) tenderness and pain in the right upper abdominal quadrant C) severe abdominal pain with direct palpation or rebound tenderness D) jaundice and vomiting

C) Explanation: Peritonitis decreases intestinal motility and causes intestinal distention. A classic sign of peritonitis is a sudden, diffuse, severe abdominal pain that intensifies in the area of the underlying causative disorder (i.e., appendicitis, diverticulitis, ulcerative colitis, a strangulated obstruction). The client may also have rebound tenderness. Tenderness and pain in the right upper abdominal quadrant suggest cholecystitis. Jaundice and vomiting are signs of cirrhosis of the liver. Rectal bleeding or a change in bowel habits may indicate colorectal cancer.

What are colorectal cancers?

Cancer of the rectum or colon. Is the third leading cause of cancer death in men or women and the third leading cause of cancer death among all adults in the US

What is a radical prostatectomy? When is it indicated?

Considered a first-line treatment for prostate cancer and is used with patients whose tumor is confined to the prostate. It is the complete surgical removal of the prostate, seminal vesicles, tips of the vas deferens, and often the surrounding fat, nerves, and blood vessels. It can be done laprascopically or through open surgery. Sexual impotence can be a common side effect and dry climax can occur. It can also produce urinary incontinence

A client is admitted to the hospital for diagnostic testing to rule out colorectal cancer. Which intervention should the nurse include on the plan of care? A) Administer morphine (Duramorph PF) routinely, as ordered. B) Prepare the client for a gastrostomy tube placement. C) Administer topical ointment to the rectal area to decrease bleeding. D) Test all stools for occult blood.

D)

A client's colorectal cancer has necessitated a hemicolectomy with the creation of a colostomy. In the 4 days since the surgery, the client has been unwilling to look at the ostomy or participate in any aspects of ostomy care. What is the nurse's most appropriate response to this observation? A) Arrange for the client to be seen by a social worker or spiritual advisor. B) Reassure the client that many people are fearful after the creation of an ostomy. C) Ensure that the client knows that he or she will be responsible for care after discharge. D) Acknowledge the client's reluctance and initiate discussion of the factors underlying it.

D)

Which is the most common presenting symptom of colon cancer? A) Anorexia B) Weight loss C) Fatigue D) Change in bowel habits

D)

The American Cancer Society recommends routine screening to detect colorectal cancer. Which screening test for colorectal cancer should a nurse recommend? A) Proctosigmoidoscopy after age 30 B) Carcinoembryonic antigen (CEA) test after age 50 C) Barium enema after age 20 D) Annual digital examination after age 40

D) Explanation: The American Cancer Society recommends an annual digital examination after age 40 for the purpose of detecting colorectal cancer. The CEA test is performed on clients who have already been treated for colorectal cancer. It helps monitor a client's response to treatment as well as detect metastasis or recurrence. Proctosigmoidoscopy is recommended every 3 to 5 years for people older than age 50. Barium enema isn't a screening test.

What are the diagnostic procedures for prostate cancer?

Detection is more likely with the use of combined therapies. Biopsy will be performed and confirmed diagnosis if any of these procedures show suspicion of malignancy: 1) Digital rectal exam (if positive will feel hard prostate with palpable irregularities) 2) PSA levels (elevation indicates possible malignancy)

What is the diagnostic criteria for prostate cancer?

Diagnostic evaluation involves digital rectal exam and PSA. PSA will show elevated levels above 4 and abnormal DRE (hard, palpable mass). A prostate biopsy (can be done through fine-needle biopsy) will then be taken in order to definitively determine malignancy. Bone scan, MRI, CT, and x-ray may also be done in order to see if there is any metastasis.

When is a transurethral resection of the prostate done?

Done for symptom management after a radical prostatectomy

What in temporary internal brachytherapy radiation?

High dose rate given under anesthesia. Involves iridum or cesium placed and removed. Requires radiation safety precautions as the patient is radioactive.

What are some adverse reactions of hormone therapy used to treat prostate cancer?

Hot flashes, loss of libido, decreased bone density, anemia, fatigue, increased fat mass, gynecomastia, osteoporosis, loss of muscle mass, weight gain, increased cholesterol levels, depression

When is external beam radiation therapy used to treat prostate cancer?

Indicated for palliative treatment or cancer that has recurred. Can cause severe fatigue and patients may experience inflammation of the rectum, bowel, and bladder because of their proximity to the prostate. Should also be doing frequent skin checks of area for radiation dermatitis and be implementing proper skin care.

When is hormone therapy indicated to treat prostate cancer?

Indicated to treat advanced cancer, cancer with a high risk of recurrance, or cancer that has reoccurred

What are clinical manifestations of colorectal cancer?

Most common manifestation is changes in bowel habits (changes in stool consistency or shape). Passage of blood in or on the stools is also a common symptom. Frank red blood indicates left sided tumors while right-sided tumors typically produce stool which is darker (black, tarry). Could also experience early satiety, abdominal pain, fatigue, unintended weight loss, narrowing stools, constipation, distention, and sensations of bowel fullness after defecation. Lab findings could also show anemia and elevated liver enzymes if cancer has metasized to the liver.

Where does colorectal cancer often metastasize?

Often metastasizes to the liver (most common site), lungs, brain, or bones

What are some early clinical manifestations of prostate cancer?

Often times will rarely produce symptoms (slow growing cancer). If it does it produces symptoms related to urinary obstruction which includes: difficulty and frequency of urination, urinary retention, decreased size and force of urinary stream. Mimics the signs of BPH.

What are some complications which can result from colorectal cancer?

Partial or complete bowel obstruction or perforation (perforation often is treated with an ostomy). Extension of the tumor and ulceration into the surrounding blood vessels can cause bleeding. Other complications are abscesses, peritonitis, and sepsis.

What is the diagnostic criteria for colorectal cancer?

Patient who has a tumor found on a screening colonscopy should have the tumor biopsied (if another screening test indicated tumor, patient should have a colonscopy done). A family history is done to screen for genetic predisposition and genetic tests (KRAS, NRAS). Lab studies should be done which include a CBC (may indicate anemia), chemistry panel (to determine baseline status), and liver function tests (to screen for possible metastasis). A baseline carcinoembryonic antigen (CEA) level is also obtained (CEA is a tumor marker for colorectal cancer). Should also have contrast CT scans of abdomen, pelvis, and chest to screen for the extent of the tumor and any metastases.

What are some primary prevention methods for colorectal cancer?

Prevent obesity and weight gain through increasing the intensity and amount of physical activity. Also instituting a healthy diet through limiting intake of red and processed meats and eating more vegetables and fruit. Also cutting out smoking and alcohol. Adults between the ages of 50 to 59 years should also take daily or alternate day-aspirin for 5 to 10 years as an effective primary prevention strategy for both cardiovascular disease and colorectal cancer.

What is the second most common type of cancer in men?

Prostate cancer

What is a major complication of radiation therapy?

Radiation proctitis (inflammation of the rectal tissue). It can cause diarrhea, rectal urgency, tenesmus (a recurral or inclination to empty the bowels), rectal leakage, blood in stool, rectal leakage.

Where is the most common location of colorectal cancer?

Rectosigmoidal region

How does hormone therapy help treat prostate cancer?

Reduces prostatic epithelium through androgen deprivation therapy (ADT). ADT suppresses androgenic stimuli to the prostate by decreasing the circulating plasma testosterone or interrupting the conversion to or binding of DHT. Uses luteninzing hormone-releasing hormone agonists (LHRH) to decrease circulating testosterone.

What are some advanced manifestations of prostate cancer?

Urinary obstruction, blood in the urine or semen, hematuria, painful ejaculation, sexual dysfunction, symptoms of metastatic disease such as backache, hip pain, bone pain, perineal, rectal discomfort, anemia, weight loss, weakness, nausea, oliguria, etc.

What is a double contrast barium enema? How often should this type of screening be conducted?

Uses two contrasts of air and barium to allow for visualization and location of tumor. Laxatives should be given afterwards in order to allow for evacuation of barium. This type of screening should be done every 5 years