Enfermería medioambientalhoja verde del cáncer de próstata

  1. Gomez Carrillo, Judit
Supervised by:
  1. Pedro López Cubillana Director
  2. J. A. Ortega García Director

Defence university: Universidad de Murcia

Fecha de defensa: 25 October 2018

Committee:
  1. Josep Ferrís Tortajada Chair
  2. Antonio Prieto González Secretary
  3. María Isabel Orts Cortés Committee member

Type: Thesis

Abstract

Introduction: Prostate cancer (PCa) is a chronic disease resulting from the interaction of two determinants. These determinants are internal or constitutional and external or environmental. The World Health Organization promotes the development of the green leaf (HV) as an instrument for the registration and screening of Environmental Health in the clinical practice of environmental factors related to diseases such as cancer aimed at improving clinical etiological judgment, the quality of care and promote healthy environments and lifestyles in cancer survivors. Objectives: To describe and study the frequency of environmental and constitutional risk factors in men aged < or = 60 years through HV in PCa. Methods: This is a descritipive study with VH. It uses face-to-face interviews and review of medical records of 93 patients with PCa (from I-2012 to XII-2015). Patients are < or = 60 years of diagnosis at the Virgen de la Arrixaca University Clinical Hospital of the Region of Murcia. Results: Median age at diagnosis is 57 years. 97.8% Caucasians 50.5% have a PSA between > 5 < or = 10 ng/d and 66.3% a prostatic volume between > or = 20 <40 ml hey are diagnosed with a T1c at 68.2% and with a Gleason of ?6 to 49.45%. The treatment of choice, with 67.05%, was laparoscopic or retropubic radical prostatectomy. After radical prostatectomy, 69.9% of subjects presented with erectile dysfunction. 72.52% of patients live in suburban-rural areas and most work in the agricultural- livestock sector (60.44%) and 1 of each table refers to habitual exposure to pesticides in their work. Poverty and the low level of education (none or primary) was present in 12% and 62.7% respectively. Geographic differences were observed with a higher incidence in the health area of Alhama. A total of 70.4% of the subjects part of this were overweight at the time of diagnosis and 69.23% had a chronic disease (40.7% hypertension, and 18.7% Type II diabetes mellitus, 35.2% dyslipidemia). 27.5% of the patients have a history of previous vasectomy. 36.3% were exposed prior to diagnosis to at least one computerized axial 87% of the participants have a sedentary or inactive lifestyle. Food consumption (rations / week): 31.2, 20.7, 7.7, 5.1 and 4.8 of red meat, dairy, fish, fresh fruit and vegetables respectively. At diagnosis, 39.56% are ex-smokers, 32.97% are smokers. The year prior to diagnosis, 6.6% are abstainers, average consumption of 38.27 grams / day of alcohol. 41% are risk drinkers. 58.9% have a previous history of cancer in the first and / or second degree, the most frequent among relatives is the prostate, followed by breast cancer. 13.1% have at least one person affected under 50 years of age at diagnosis. A hereditary PCa and a Li-Fraumeni Like syndrome were diagnosed. Patients identify constitutional factors and globalizing lifestyles as the main etiological risk factors. Conclusions: HV in PCa is a clinical tool that could contribute to improve the risk assessment in the survivor of PCa. Among the most frequent risk factors in patients, there are some chronic, hereditary and other diseases such as suburban-rural residence, spatial grouping of cases, agricultural work with occupational exposure to pesticides and asbestos, and globalizing lifestyles (alcoholism, sedentary lifestyle, obesity and a diet rich in proteins of animal origin). Nursing occupy a strategic place for the performance and implementation of PCa survivor programs that include HV helping to improve knowledge of the causes, quality of life and contribute to improve long-term morbidity and mortality outcomes.