You are seeing a husband and wife for routine yearly physicals. You want to discuss health promotion activities with them, including self-breast exam (SBE) and mammography for the wife and prostate self-exams for the husband. The wife states she is embarrassed to admit she has never done a breast self-exam or had a mammogram and didn't think they were useful anyway. The husband tells you he read in the magazine in your waiting room that blood tests to check for prostate cancer don't need to be done anymore.
1. Briefly describe the technique for doing a SBE.
Self-breast exam (SBE) is an at-home screening technique that examines changes or problems in the breast tissue. The best time for SBE is 3-5 days after the menstrual cycle and the steps
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1).
4. Critique the use of serum prostate-specific antigen (PSA) to diagnose prostate cancer.
The prostate-specific antigen (PSA) is “used primarily to screen for prostate cancer and measures the amount of PSA in the blood. High levels of PSA can indicate the presence of prostate cancer or enlarged or inflamed prostate”("PSA test," 2013, p. 1). If the PSA level is elevated, then the test may be repeated at a later date or a biopsy of the prostate may be advised to rule out cancer. Age, race, and family history will play a role when determining the next steps. Other PSA tests that can be used are:
- Percent-free PSA: The ratio of how much PSA circulates free compared to the total PSA level, percentage of free PSA is lower in men who have prostate cancer than in men who do not”("Tests for prostate cancer," 2014, p. 1). It can be used to determine if a biopsy is necessary.
- PSA velocity: Measures how fast the PSA rises over time.
- PSA density: Used for men with larger prostate glands; a higher density indicates a greater likelihood of cancer.
- Age-specific PSA ranges: Compares PSA results with other men of the same age, but it not a recommended
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8). There is no specific age for screening in men with showing no symptoms, but it is advised that men are educated on the benefits and risks of screenings. Men with an “initial PSA level below 2.5 ng/ml can be screened every two years, but men with higher levels should be tested annually”(Brosman, 2015, p. 8). The recommendation for this patient is to have an initial PSA level screening and DRE with this routine physical. Further testing will depend on these
Second is age- and race-specific PSA reference ranges. Age- and race-specific PSA reference ranges compare the PSA test results among men in the same group. Third is Percent-free PSA (fPSA) is the percentage of the total PSA that is unbound. Evidence suggests that fPSA is lower in men who have prostate cancer compared with men who do not. Fourth are the complexed PSA (cPSA) test measures the amount of bound PSA circulating in the blood. Fifth is the PSA density (PSAD) which is a test sometimes used by doctors in patients who have a large prostate gland. To determine PSAD, the PSA value (ng/mL) is divided by the volume (size in cubic centimeters) of the prostate. The size of the prostate gland is determined by Tran’s rectal ultrasound (TRUS), a procedure that uses sound waves to create a picture of the prostate. ( (Diagnosis))
Prostate cancer is a kind of cancer that affects the prostate gland in men. It is a common cancer that grows slowly and its treatment can be done successfully if it is detected at an early stage. Sometimes, symptoms are not visible in case of cancer limited to the prostate gland which may result into metastatic cancer. To detect the symptoms, active surveillance can be done. There are various options available
The recommendation to reduce PSA screening by the Canadian Task Force of Preventative Health Care originated from the observations that PSA screening does not decrease the relative risk for acquiring PCa, nor does it decrease the mortality rate of PCa. Since the implementation of proactive and opportunistic PSA screening in Canada the annual incidence of PCa has increased but the mortality rate has not decreased (Pron, 2015). Ontario spends approximately $119.2 million on PSA screening annually and considering PCa mortality rates decreased prior to PSA screening introduction in the late 1990s, the $119.2 million spent on PSA screening appears redundant (Ontario Health Technology Assessment, 2015).
Another method to detect this cancer is with a Prostate Specific Antigen (PSA). Protein in the blood that is produced only by prostate cells is reflected the volume of both benign and malignant prostate tissue in the PSA. The higher the PSA level is the more likely it is that Prostate Cancer present. (“Prostate
Acid Phosphatase is an enzyme found in seminal fluid. It comes from the prostate gland (Johnson 2009). Typically, the more Prostatic Acid Phosphatase found in a sample of semen is a sign of prostate cancer. This is important because the Acid Phosphatase Color Test was once used to determine of a male had prostate cancer. It was later replaced by Prostate Specific Antigen, aka PSA. Forensic scientists still use this test to identify semen, however. In 1938, Gutman and Gutman reported increased levels of acid phosphatase in patients with metastatic prostate cancer (Taira, Merrick, Wallner, and Dattoli, “Reviving the Acid Phosphatase Test for Prostate Cancer”). It was later replaced by the Prostate Specific Antigen in 1971 (Taira, Merrick, Wallner, and Dattoli, “Reviving the Acid Phosphatase Test
Qin Shi Huang calling himself the First Emperor after China’s unification, QIn is a pivotal figure in the history of china, after directing china, he and his chief advisor Li Si passed a series of Important economic and political reforms. He undertook huge projects which lasted years, These included unifying various sections of the great wall of china, which is now a famous city-sized mausoleum guarded by the mighty Terracotta Army, which also includes a immense national road system, this was all at the cost of human lives, in this tremendous stage of power was the establishment of his high status as a fearful leader that ruled China.
Benign prostate hyperplasia (BPH) and prostate cancer share a few similarities, elevated prostate-specific antigen (PSA). Along with enlargement of prostate gland that causes urinary symptoms such as, frequent urination, hesitancy, dribbling, and frequent nighttime urination. However, they are quite different which is why more tests need to be done to confirm one or the other condition. These two diseases are also similar in the fact that they both cause an enlargement of the prostate. However with BPH the central portion of the prostate is enlarged and with prostate cancer more commonly the lateral lobes or side of the prostate are enlarged, but can affect any were on the prostate. Both can even be detected by a digital rectal exam however
The first reason being the level accuracy of PSA testing is questionable. The test determines a positive for the cancer based on the levels of prostate-specific antigens in the blood of the patient, which can be abnormally high for multiple other reasons not related to prostate cancer. The major evidence supporting said claim is that individuals with more than 4.0 ng per mL (the threshold to test positive) can have false positive rates of 70% (Mulhem 2). The second reason would be the implications of testing positive for prostate cancer, including but not limited to unnecessary treatment of the disease. While the analysis does not back up unnecessary treatment with any statistical evidence, it does go to explain further tests and procedures to confirm and understand the nature of the patient’s condition. This bleeds over to the negative physical and psychological side-effects of regular prostate cancer screening cited by the analysis. Mulhem explains that after testing positive for prostate cancer, more tests are performed to determine the accuracy of the screening and if so, reveal the specificities of the cancer. The most common of these tests being the prostate biopsy, a procedure that causes a significant portion of participants to develop moderate to severe problems requiring a follow-up with their doctor (Mulhem
Today, prostate cancer is usually detected through screening, and there are two methods for early detection. The prostate-specific antigen test (PSA) is used, but there are
PSA test results are interpreted as: 0-4 ng/mL is normal. Between 4 to 10 ng/ML is 25% of developing cancer, and > 10 ng/ml is a > 50% risk of cancer. However, some men with normal PSA levels still have prostate cancer, while other men with high PSA levels do not. PSA levels increase with age often due to a higher prevalence of benign prostate hypertrophy (BPH). Therefore, no PSA cutoff can accurately guarantee that a man does not have prostate cancer.
Organizations are not the only ones at odds with current screening methods. Depending on which organization a physician prefers to follow, a patient may be told to have PSA screening by one physician and be advised to avoid PSA screening by another physician. There are several different factors why this screening is controversial. The most important is the sensitivity and specificity of PSA screening. Research has shown that PSA screening presents with an unusually high amount of false positive results (U.S. Preventative Services Task Force, 2012). This raises some concerns whether the benefit of screening outweighs the possibility of over
Prostate cancer is the most common type of cancer in American men after skin cancer. There are many risk factors that increase the disease such as age, being the far most important risk factor, along with race, family history and diet (ASCO, 2015). The prostate is a walnut shaped gland of the male reproductive system that functions to create part of the semen, which is fluid in which sperm swim in when ejaculation occurs. It is located inferior to the bladder, anterior to the rectum, surrounding the urethra. For this reason, when a prostate becomes abnormal, many signs and symptoms manifest themselves when a male urinates. When the prostate becomes enlarged by cancer or any other disease, it blocks the neck of the urethra causing a weak stream,
The participants were fully involved in all the exercises, taking part in discussion, voicing out their opinions and questioning each other’s ideas. Our observation was that social constructions of masculinity were more criticised by the girls because they are mostly the ones at the receiving end of the gender based violence and sexual violence that is perpetuated by this social construction of what a man should be or should behave like. Both girls and boys found that it became difficult to be a different kind of man who believes in equality because the social norms around masculinity were rigid. Girls further added that boys who failed to conform to social acceptable norms of what it meant to be a man were vulnerable to physical, emotional
Men should talk with a doctor if they are 45 and at high risk for prostate cancer. This includes those with a family history, especially African American men.
In A Doll’s House by Henrik Ibsen, the roles of masculinity and femininity as apparent in Nora Helmer and Torvald Helmer appear, though in a way one would not expect-- Nora being masculine and Torvald being feminine. Throughout the play, Nora is portrayed as defying societal standards of the Victorian Era, the time period which lasted from 1837-1941, by doing things that were not accepted by many people at the time, especially when she abandons Torvald at the end of the piece (BBC). From this, more masculine traits are presented in her characterization. In contrast, Torvald presents more feminine traits, especially proven by the aforementioned final scene, as he then realized how much he had relied on Nora for self-confirmation and his happiness. This is, additionally, present in Torvald’s use of pet names for Nora and treating her like a child, as a mother would to her child. In A Doll’s House by Henrik Ibsen, the roles that Nora Helmer and Torvald Helmer are expected to appear as on the surface to fit into in a Victorian Society are challenged by Nora being more masculine, presenting traits like rebellion and independence and Torvald being more feminine such as being dependent on Nora and motherly.