Prostate Cancer

 

Welcome to PT 635 Pathophysiology of Complex Patient Problems This is a wiki created by and for the students in the School of Physical Therapy at Bellarmine University in Louisville KY. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!

Original Editors - Students from Bellarmine University's Pathophysiology of Complex Patient Problems project.

Top Contributors - Taylor Carta, Devin Conway, Shaimaa Eldib, Lucinda hampton, Kim Jackson, Nicole Sandhu, Tony Lowe, Evan Thomas, Vidya Acharya, Mandy Roscher, Jess Bell, Kirenga Bamurange Liliane, Elaine Lonnemann, 127.0.0.1, Rosie Swift, Tarina van der Stockt, Venugopal Pawar and WikiSysop  

Definition/Description

Prostate cancer is the most common noncutaneous cancer in males and is the second leading cause of death from cancer in males. It is a slow growing cancer that causes microscopic changes in the prostate affecting one third of all males by the age of 50. Variations in the rate of prostate cancer progression and spreading suggests genetic involvement along with familial predisposition and diet. Prostate cancer is a metastatic cancer that spreads primarily to bone.

Prevalence

Prostate cancer is more common in African-American males compared to white or Hispanic males, and is least common in Asians and Native American men.¹ It most commonly affects men over the age of 50 with an increasing incidence with age. It is rare in men under 45.¹

Characteristics/Clinical Presentation

Clinical Signs and Symptoms^1,2:

• urinary retention or other urinary complaints
• low back pain, inner thigh or perineal pain or stiffness
• hematuria
• suprapubic or pelvic pain
• sexual dysfunction

Early prostate cancer may be asymptomataic. Most screenings of prostate cancer are being done in asymptomatic men. The listed signs and symptoms may also be present with other prostate related disease processes such as benign prostatic hyperplasia or prostatitis.²

Manifestations of Metastasized Prostate Cancer^1,2:

• Sciatica
• Bone pain and lower extremity pain
• Lymphedema of groin or lower extremities 
• Neurological changes from spinal cord compression
• Anemia
• Weight loss and loss of appetite

Associated signs and symtoms to ask the patient about include:

• Melena
• Sudden moderate to high fever
• Chills
• Changes in bowel or bladder function

Associated Co-morbidities

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Medications

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Diagnostic Tests/Lab Tests/Lab Values

Diagnostic Test:

• Prostate-Specific Antigen (PSA)- this is a blood test used to test for elevated levels of PSA which occurs with any changes in the prostate. A normal level of PSA has not been determined¹.  (not sure if this should go here)
• Prostate biopsy is indicated for individuals who have elevated PSA levels for diagnosis.

Etiology/Causes

Risk factors include advancing age, family history, ethnicity and diet(high in animal fat or meat). The risk of developing prostate cancer is higher than average if the brother or father of that individual had the disease. Other risk factors may include low levels of vitamins or selenium, multiple sex partners, viruses and occupational exposure to chemicals, cadium and other metals¹. 

Systemic Involvement

Early prostate cancer is often asymptomatic and is often diagnosed because males seek attention for medical issues regarding urinary dysfunction (i.e. retention) or low back, hip or leg pain. Prostate cancer almost exclusively metastasizes to bone of the pelvis, spine or femur via the bloodstream or lymphatic system and spreads in the early stages¹. It has also been known to spread to the bladder, rectum and distant organs such as the liver, lung and brain via the lymphatics¹. 

Medical Management (current best evidence)

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Physical Therapy Management (current best evidence)

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Differential Diagnosis

• Obstruction of lower urinary tract
• Prostatitis
• Benign Prostatic Hyperplasia

Case Reports/ Case Studies

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Resources

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Recent Related Research (from Pubmed)

see tutorial on Adding PubMed Feed

References

see adding references tutorial.