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Nursing Guide to Prostate Cancer: Nursing Diagnosis, Interventions, & Care Plans

Updated On 5 Minute Read

Prostate Cancer  Etiology and Epidemiology

Adenocarcinoma of the prostate gland ranks second among cancers found in men globally and is the most common cancer found in U.S. males (DynaMed, n.d.). Prostate cancer is primarily a slow progressing condition. It may also be referred to as prostatic cancer or prostatic carcinoma. 

Prostate Cancer ICD-10 Code: C61

Prostate cancer affects:

  • Men 65 years and older with a median age of 66
  • 39% of men 65 to 74 years of age in U.S. (DynaMed, n.d.)
  • Men throughout:
    • North America
    • Western and Northern Europe
    • Australia
    • New Zealand
  • Men of African and Caribbean descent

In 2020, prostate cancer was found to be the most common cancer in men after skin carcinoma. It has an age adjusted incidence of 109.9 cases per 100,000 men with an 11.6% lifetime risk of its development in the U.S. male population (DynaMed, n.d). 

Risk factors for prostate cancer:

  • Increasing age
  • African or Caribbean descent
  • Familial history
  • Genetics
  • Metabolic syndrome and obesity
  • Smoking
  • Dietary factors:
    • Dairy consumption
    • High calcium intake
    • Eating processed food
    • Heavy alcohol intake
  • Environmental and occupational exposure
    • Agent orange exposure
    • Rescue and recovery work at World Trade Center site
  • History of:
    • Human papillomavirus
  • Gonorrhea
  • Fathering children using in vitro fertilization and intra-cytoplasmic sperm injection

Diagnosing Prostate Cancer

Prostate cancer may be asymptomatic in many men. Individuals should be reviewed for symptoms, such as:

  • Nocturia
  • Voiding hesitancy
  • Urinary retention
  • Urinary frequency and urgency
  • Hematuria
  • Hematospermia
  • Erectile dysfunction
  • Bone and nerve pain if metastatic disease
  • Elevated prostate specific antigen
  • Bowel or bladder dysfunction
  • Back pain
  • Weight loss

History reviewed for:

  • Metabolic syndrome and obesity
  • Recurrent infections, especially human papillomavirus
  • Malignancies
  • Hereditary syndromes
  • Prior germ line genetic testing results
  • Familial history of cancers
  • Social history of:
    • Smoking
    • Alcohol consumption
    • Environmental and occupational exposures

The physical exam should include a direct digital exam for palpable lymphadenopathy. Laboratory tests for prostate cancer include:

  • Prostate specific antigen
    • Prostate health index
  • Acid phosphatase
  • Urinalysis
    • Gene expression
  • Histopathologic analysis of biopsies

Imaging for prostate cancer may include:

  • Multi-parametric magnetic resonance imaging
  • Bone scan
  • Transrectal ultrasound
  • PET and CT scans

Managing Prostate Cancer

Management of prostate cancer considers:

  • Individual disease risk level
  • Life expectancy
  • Grade of disease progression and grading system used
  • Whether disease is initial or a relapse

The Gleason scoring system is used commonly to grade the cancer of the prostate. Laboratory pathologists examine the arrangement of cancer cells in the prostate tissue. Scoring ranges from 3 to 5 and derives from two separate tissue locations. Lower scores indicate cells appear closer to a healthy appearance.

Treatment and therapy options used individually, in combination, or through clinical trials:

  • Surveillance
  • Trans urethral prostatectomy:
    • Radical
    • Retropubic
    • Perineal
    • Suprapubic
  • Orchiectomy
  • External beam radiation
  • Brachytherapy
  • Cryotherapy
  • Chemotherapy
    • When refractory to hormone therapy
  • Hormone therapy
    • Androgen deprivation
  • Lymph node dissection
  • High intensity focused ultrasound
  • Indwelling urinary catheter
  • Dietary modification

Potential complications of treatments:

  • Erectile dysfunction
  • Urethral stricture
  • Fistula or rectal injury
  • Urinary incontinence
  • Surgical anesthetic risks
  • Cystitis
  • Diarrhea
  • Proctitis
  • Rectal ulceration
  • Bowel obstruction

Prostate Cancer Nursing Care Plan

Nursing Considerations

Use the nursing process to develop a plan of care for individuals. The nursing assessment (with common findings listed), diagnoses, interventions, expected outcomes, and education for prostate cancer are listed below.

Prostate Cancer Assessment

Assess health history:

  • Risk factors
  • Urinary elimination patterns
  • Hematuria
  • Pain

The physical assessment should include:

  • Digital rectal exam (advanced nursing)
  • Integumentary
  • Lymph nodes
  • Psychosocial/palliative (Harju et al., 2018):
    • Emotional state
    • Energy levels
    • Pain
    • Social functioning
    • Role functioning
    • Physical functioning
    • Grief levels

Nursing Diagnosis/Risk For

  • Risk for infection related to decreased secondary defenses and immunosuppression as evidenced by:
    • Fever
    • Malaise
    • Abnormal lab values
    • Need for antibiotic therapy
  • Risk for altered sexual patterns related to treatment protocols, fear, and anxiety as evidenced by diminished:
    • Libido
    • Sexual activity
    • Sexual desire
  • Anticipatory grieving related to loss of physiological wellbeing as evidenced by changes in:
    • Eating habits
    • Sleep patterns
    • Activity level
    • Libido
    • Communication patterns
  • Anxiety related to the condition as evidenced by:
    • Elevated vital signs
    • Activity level
    • Tone of voice
    • Nervousness
    • Diaphoresis
    • Muscle tension
  • Nutrition imbalance related to hypermetabolic state, treatment consequences, and emotional distress as evidenced by:
    • Inadequate food intake
    • Altered tastes or interest in food
    • Weight loss
    • Diarrhea
    • Constipation
    • Cramping
  • Knowledge deficit of symptom prevention and condition management as evidenced by:
    • Request for information
    • Verbalization of problems
    • Presence of preventable complications

Interventions

  • Manage care of indwelling urethral catheter, if indicated
  • Monitor dietary intake
  • Measure height and weight regularly
  • Assess skin and mucous membranes
  • Encourage individual with related self-care tasks
  • Encourage open and honest communications
  • Promote relaxation techniques
  • Assist or administer medication as ordered
  • Promote and teach good hygiene practices
  • Assess all systems for signs of infection
  • Monitor temperature regularly
  • Assess for depression and stage of grief
  • Encourage verbalization and sharing of feelings
  • Discuss side effects of treatments
  • Refer to sex therapist if needed

Expected Outcomes

  • Reports adequate pain control
  • Demonstrates stable weight and dietary intake
  • Verbalizes understanding of disease process and treatment regimes
  • Remains afebrile and free from infection
  • Expresses feelings openly and honestly
  • Continues normal life activities
  • Verbalizes understanding of side effects and measures to correct
  • Maintains normal sexual activity levels

Individual/Caregiver Education

  • Diagnosis and treatments
  • Signs of potential complications
  • Post-surgical monitoring and care
  • Post radiation treatment care and concerns
  • Managing urinary incontinence
  • Support groups available
  • Catheter care if indicated
  • Nutrition and diet
  • Lifestyle changes
  • Call the provider if:
    • Pain or symptoms worsen
  • Medications they are prescribed
  • Encourage the individual to follow-up with healthcare provider as recommended

Read More About Our Clinical Guides

View Our Clinical Guides

Understanding Prostate Cancer

The goal of this course is to update nurses on prostate cancer screening guidelines and the management of the disease.

View course

Additional Information

Content Release Date 

4/1/2022

Content Expiration

12/31/2027

Course Contributor

The content for this course was created by Edward Bartels, RN, BSN, MICN. Ed has over 30 years of clinical and teaching experience, and his areas of expertise are emergency and critical care, skilled nursing, behavioral health, occupational health, and safety, and home care. Ed served in several senior nursing leadership roles including: Emergency Services Director, Physician Practices Director, and Administrative Director of Nursing at the executive level. Ed is certified in LEAN efficiency fundamentals and tactics, which he has successfully deployed over the years in multiple settings resulting in cost savings, improved quality, and patient safety. Ed is a certified clinical nursing instructor in North Carolina. He earned his Diploma in Nursing from St. Vincent's School of Nursing in Staten Island, New York, in 1990 and Bachelor of Science in Nursing from the University of North Carolina, Greensboro in 2006. Ed is retired from the U.S. Coast Guard with 34 years.

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Edward Bartels, RN, BSN, MICN

Ed has over 30 years of clinical and teaching experience, and his areas of expertise are emergency and critical care, skilled nursing, behavioral health, occupational health, and safety, and home care. Ed served in several senior nursing leadership roles including: Emergency Services Director, Physician Practices Director, and Administrative Director of Nursing at the executive level. Ed is certified in LEAN efficiency fundamentals and tactics, which he has successfully deployed over the years in multiple settings resulting in cost savings, improved quality, and patient safety. Ed is a certified clinical nursing instructor in North Carolina. He earned his Diploma in Nursing from St. Vincent's School of Nursing in Staten Island, New York, in 1990 and Bachelor of Science in Nursing from the University of North Carolina, Greensboro in 2006. Ed is retired from the U.S. Coast Guard with 34 years.