Question

A person who has undergone a radical prostatectomy for advanced cancer is receiving diethylstilbestrol (DES). The nurse would expect to see which effect of this drug? ? A. Increased facial hair ? B. Testicular atrophy ? C. Deepening voice ? D. Weight loss

Short answer

Answer: B. Testicular atrophy

Step-by-step solution

Understand Diethylstilbestrol (DES)

Diethylstilbestrol is a synthetic estrogen (female hormone) that has been used in the past to treat prostate cancer. Its primary function is to decrease the production of testosterone (male hormone) in the body to slow down the growth of cancer cells.

Analyze the given options

Let's look at the effects of each given option and see if they match with the effects of DES: A. Increased facial hair - This would be an effect of increased testosterone levels, which is the opposite of what we expect from DES. Therefore, this option is incorrect. B. Testicular atrophy - Since DES decreases testosterone production, this reduction can lead to testicular atrophy or shrinkage. So, this option seems to be the correct one. C. Deepening voice - This is also related to increased testosterone levels. Our purpose with DES is precisely the opposite, so this option is incorrect. D. Weight loss - Though some weight loss can occur, it is not a direct result of DES use, so this option is not necessarily expected.

Identify the correct answer

Based on the analysis of the given options and effects of diethylstilbestrol (DES), we can conclude that the correct answer is: ? B. Testicular atrophy - This is the expected effect of receiving DES after a radical prostatectomy for advanced cancer.

Key concepts

Understanding Diethylstilbestrol (DES)

Diethylstilbestrol (DES) is a synthetic version of the hormone estrogen, which was historically used to treat various medical conditions, including advanced prostate cancer. Although not commonly used today due to the discovery of potential adverse effects, it is important to understand this drug when reviewing historical treatments.

DES functions by reducing levels of testosterone, the male hormone, in the body. Testosterone can promote the growth of prostate cancer cells, so decreasing its concentration can be beneficial in managing the disease. With reduced testosterone, effects such as testicular atrophy can occur; this is because the testes, which produce testosterone, may shrink when not active. Meanwhile, increases in female characteristics, such as softer skin or breast growth (gynecomastia), may also be observed. It's pertinent to note that understanding DES allows for a more comprehensive grasp of the early hormone treatments in prostate cancer, even though current medical practice favors other treatments.

Advanced Prostate Cancer Treatment

Advanced prostate cancer requires a multifaceted approach to treatment, which typically includes medication, surgery, radiation therapy, and sometimes lifestyle changes. The primary goal is to control cancer growth and manage symptoms.

Medications could be hormonal therapies that aim to reduce testosterone levels, thus slowing the growth of cancerous cells. These therapies are akin to the rationale behind using DES, but newer drugs with fewer side effects are now preferred. Additionally, chemotherapeutic agents may be used to attack rapidly dividing cells, and newer targeted therapies focus on specific aspects of cancer cells to halt their progression.

Radical prostatectomy, the surgical removal of the prostate gland and some surrounding tissues, is another treatment option that can be considered for localized or locally advanced prostate cancer. Sometimes radiation therapy could be an alternative or an adjunct treatment to surgery. It’s imperative for any student studying prostate cancer treatment to be aware of the advancements in therapy, as well as the reasons why historical treatments like DES are now largely obsolete.

The Role of Radical Prostatectomy

Radical prostatectomy is a surgical procedure for removing the prostate gland and some of the tissue around it, including the seminal vesicles and sometimes nearby lymph nodes. It is primarily utilized in cases where the prostate cancer is thought to be confined to the prostate gland or has just extended beyond it.

Post-surgery, patients may experience various side effects including urinary incontinence and erectile dysfunction. The procedure aims to remove the cancerous tissue in the hopes of achieving cancer-free margins, which would ideally result in a cure or significant prolongation of disease-free survival. It’s critical for healthcare professionals and students to understand the benefits and potential complications of radical prostatectomy, as these aspects are paramount in patient education and postoperative care.

Furthermore, the decision for a radical prostatectomy involves detailed discussions about the patient’s overall health, cancer staging, and treatment goals. While radical prostatectomy can be a key intervention for prostate cancer treatment, it is just one component of a broader therapeutic strategy, which may also include medication or radiation.