THE SCREENING OF PROSTATE CANCER

THE SCREENING OF PROSTATE CANCER

by Ricky Ocampo RN

            Many people across the globe or the world die to various diseases. In many cases, the conditions that they suffer from can be contained or treated with proper and early diagnosis (Amin, Lin, Gore, Srigley, Samaratunga, Egevad, & Berney, 2014). One of the diseases that can be controlled if detected early is cancer. Cancer is a disease involving abnormal cell growth that can spread to other body parts. In 2012, this ailment led to 14.6% of total world deaths, which translated to about 8.2 million people (Amin et Al. 2014). Various treatment methods can be used to control the disease. However, their effectiveness is determined by the stage of advancement that the illness has reached (Amin et Al. 2014). Consequently, an early diagnosis of the disease is crucial or necessary. In this case, I will identify and evaluate a screening methodology for prostate cancer, which is relevant to the National Clearinghouse Guidelines. I will proceed to apply the technique to a specific population.

            Prostate cancer is a type of cancer that affects the man’s prostate gland. This particular type of cancer may spread to other parts of the body such as lymph nodes and bones. This disease may not have any symptoms at the initial phase but in later stages, it may cause pain in the back and the pelvis while urinating, and traces of blood in the urine. The disease is most common in elderly people since many of the people suffering from it are above 45yrs old. A person who has a first-degree relative with the disease is also 2 to 3 times more likely to catch the ailment. In America, the disease is more prevalent in African Americans than persons from the other racial groups (Amin et Al. 2014).

My chosen methodology for screening a patient is the Prostate-Specific Antigen (PSA) method. This screening technique measures the level of PSA in a man’s blood.  The prostate glands produce PSA, which is protein in nature. The persons suffering from prostate cancer have a higher level of PSA than ordinary people do. The Food and Drug Agency (FDA) approved the use of the PSA test in 1986 to monitor the progress of prostate cancer in individuals who had already been diagnosed with it (Hayes & Barry, 2014). I have chosen the method of PSA screening since it helps detect prostate cancer in its embryonic stages.  

            PSA, levels of over 4.0 mg/ml are considered high and doctors recommend a prostate biopsy for patients with those levels to check the presence of prostate cancer (Hayes & Barry, 2014). There are other complications that may cause high PSA levels and they include urinary tract infection or prostatitis (Ubel, 2015). PSA screening also has limitations such as cases where early detection of prostate cancer may not reduce the chances of a patient dying of prostate cancer in a process called overdiagnosis. This happens since tumors found through the test may be harmless or may grow at a very slow rate, which cannot affect the man.  Treatment of these tumors is called overtreatment since the patient may be exposed to side effects associated with the remedy such as erectile dysfunction, urinary incontinence while being exposed to numerous infections (Hayes & Barry, 2014).

            Another limitation of the test is that it may give false-negative or false-positive results. False-positive results occur when the person has high levels of PSA yet he does not have prostate cancer while false-negative results occur when a man has low PSA levels yet he has prostate cancer. The use of the PSA method is also helpful while monitoring a treated patient. This is done where tests will confirm rising PSA levels in those patients that will mean the prostate cancer is recurring (Amin et Al. 2014). The population that this screening method can be applied to is those that are at a higher risk of prostate cancer, which are older men above 50 years. This is because the test may be harmful and administering it to people at low risks of cancer may expose them to various undesirable effects.

Various studies have been advanced to find out and to dismiss the PSA test for screening prostate cancer in men. The National Clearing House guidelines contain various directives that have an in-depth analysis of the method where they evaluate if the benefits outweigh the harm. A guideline that offers an insight into the cancer screening method is titled; The Early Detection of Prostate Cancer: AUA Guideline. The objective of the guideline is to offer recommendations for the detection of prostate cancer that are analysis-based (Hayes & Barry, 2014).

            Another objective is to provide a principle to help address prostate cancer’s early detection, which will reduce the mortality rates resulting from the ailment. The guideline recommends shared decision-making in PSA screening of men in the ages between 55 and 69. For this age group, it also recommends that screening intervals should be in two years or more against annual screening.  The guideline does not recommend PSA tests to men under the age of 40 or routine screening of men in the ages between 40 to 54 years. The guideline also does not recommend the PSA screening of men above 70 years old or the ones who have between 5 to 10years to live (Hayes & Barry, 2014).

            In conclusion, early detection of disease is essential for ensuring that the treatment is effective. Cancer is a disease where early detection can reduce the number of deaths reported. Prostate cancer is a type of cancer that affects the prostate area in a man. Screening of this type of cancer can be done by PSA tests. This is a test that is conducted to check the levels of PSA in the blood. Other diseases such as urinary tract infection or prostatitis may cause high PSA levels. There are various limitations to the PSA screening method that include overdiagnosis whereby it may give a false-negative or false-positive result. The target population for this screening strategy is men above 50 years of age.

References

Amin, M. B., Lin, D. W., Gore, J. L., Srigley, J. R., Samaratunga, H., Egevad, L., & Berney, D.                  (2014). The Critical Role of the Pathologist in Determining Eligibility for Active Surveillance as        a Management Option in Patients with Prostate Cancer. Archives of Pathology & Laboratory              Medicine, 138(10), 1387-1405. doi:10.5858/arpa.2014-0219-SA

Edelman, C., Kudzma, E., & Mandle, C. (2013). Health Promotion Throughout the Lifespan                       (8th edition ed.). Philadelphia, Pennsylvania: Elsevier.

Hayes, J. H., & Barry, M. J. (2014). Screening for Prostate Cancer with the Prostate-Specific                      Antigen Test. JAMA: Journal of the American Medical Association, 311(11), 1143-  1149.                  doi:10.1001/jama.2014.2085

Ubel, P. A. (2015). Medical Facts versus Value Judgments -- Toward Preference-Sensitive                          Guidelines. New England Journal of Medicine, 372(26), 2475-2477.                                                      doi:10.1056/NEJMp1504245