From the Guidelines
The plan of nursing care for a patient with prostate cancer should prioritize symptom management, treatment support, and addressing physical and emotional needs, with a focus on individualized care based on disease stage, treatment approach, and patient preferences, as recommended by the AUA/ASTRO guideline 1.
Symptoms:
- Pain
- Urinary symptoms (retention, incontinence, obstruction)
- Fatigue
- Nausea or appetite changes
- Anxiety, depression, and body image concerns
- Hot flashes and bone density loss (associated with androgen deprivation therapy)
Look for and CALL the RN on-call if any of the following are observed:
- Increased pain or discomfort
- Urinary retention or incontinence
- Fatigue that interferes with daily activities
- Nausea or vomiting that persists despite interventions
- Anxiety or depression that affects daily life
- Signs of bone metastases or spinal cord compression (e.g., back pain, weakness, numbness)
Call 911 and notify the RN on-call if any of the following are observed:
- Severe pain or discomfort that is unrelieved by medication
- Sudden onset of urinary retention or incontinence
- Severe fatigue that interferes with breathing or circulation
- Vomiting blood or black tarry stools
- Severe anxiety or depression that poses a risk to self or others
- Signs of spinal cord compression (e.g., sudden weakness, numbness, or loss of bladder/bowel function)
Actions to take:
- Monitor patient's symptoms, treatment side effects, and psychological state regularly, using standardized/validated instruments to assess urinary, bowel, and sexual function, as recommended by the AUA/ASTRO guideline 1
- Provide education about treatment options, side effects, and self-care strategies
- Encourage patient to engage with professional or community-based resources for support, such as social work services, local virtual and in-person prostate cancer support groups, and national patient advocacy organizations, as recommended by the AUA/ASTRO guideline 1
- Refer patient to dietary and nutrition services, physical therapists, pelvic floor rehabilitation specialists, and psychosexual therapists as needed
- Support patient in developing a plan for managing symptoms, treatment side effects, and emotional needs, with a focus on individualized care based on disease stage, treatment approach, and patient preferences, as recommended by the AUA/ASTRO guideline 1
From the Research
Symptoms:
- Back pain
- Weakness or numbness in the legs
- Loss of bladder or bowel control
- Difficulty walking
Look for and CALL the RN on-call if any of the following are observed:
- Sudden increase in back pain
- Sudden weakness or numbness in the legs
- Loss of bladder or bowel control
- Difficulty walking
- Fever or chills
- Confusion or disorientation 2, 3, 4, 5
Call 911 and notify the RN on-call if any of the following are observed:
- Severe back pain that does not respond to medication
- Sudden loss of bladder or bowel control
- Sudden difficulty walking
- Severe weakness or numbness in the legs
- Confusion or disorientation that worsens over time 2, 3, 4, 5
Actions to take:
- Monitor patient's pain level and adjust medication as needed 6
- Encourage patient to report any changes in symptoms or pain level
- Provide emotional support and education to patient and family
- Collaborate with multidisciplinary team to develop a comprehensive pain management plan 6
- Consider referral to palliative care for patients with advanced prostate cancer and significant pain or other symptoms 6