What Are The Diagnostic Value Of The Dre?

There are multiple methods for screening for Prostate Cancer; the most common is Digital Rectal Examination. During a digital rectal exam a doctor inserts a glove, lubricated finger into the rectum to feel for any irregular or abnormal firm area in the prostate gland.

The normal prostate is a small squishy gland about the size of a walnut and is located under the bladder and in front of the rectum. The urethra runs directly through the prostate (McCance, & Huether, 2014). The nerves that control erectile function are attached to the sides of the prostate. It is a gland that is important for reproduction. The prostate gland undergoes first growth spurt during puberty and a second growth spurt during the fifth decade of life. BPH is a non-cancerous prostatic condition that develops at the transition zone that surrounds the urethra or urinary tube, due to the imbalance between androgen and estrogen secretion causing hyperplasia (Timms, & Hofkamp, 2011). Major symptoms of BPH is caused by this hyperplasia, which obstructs the urethra and bladder.

A digital rectal exam is completed yearly to establish prostate location, size, and the presence of nodules. (ACS, 2011)

A review of the records reveals the member to be an adult male with a birth date of 08/10/1949. The member has a diagnosis of metastatic castrate resistant prostate cancer. The member’s treating provider, Yu-Ning Wong, MD recommended the member be treated with Olipaub (Lynparza).

The most accurate way to detect cancer cells inside the prostate gland is the surgical removal and histopathological examination of the entire gland. As this approach is clinically inapplicable to each patient with suspicious findings, Transrectal ultrasound (TRUS) guided prostatic biopsy is considered the standard diagnostic procedure for the detection of prostate cancer for patients with a high suspicion for prostate cancer 1.

Prostate cancer is the second most frequently diagnosed cancer and the sixth leading cause of cancer death in males. Incidence rates vary more than 25-fold worldwide, with the highest rates in the developed countries this may be due to the widespread use of prostate-specific antigen testing and subsequent prostate biopsy in these regions [1]. Overall, the complex morphology, histologic heterogeneity, and the early signs of high malignant potential preclude a straightforward assessment of the metastatic potential of localized prostate carcinoma and show the requirement for extra clinical and pathologic tests for the evaluation of prostate carcinoma stage and clinical behavior[2]

The disease epidemiology has also been researched in different sub-populations. In a cohort of men that underwent screening for prostate cancer, Peyronie's disease prevalence was 8.9%. Significantly higher prevalence of 15.9% is seen in men after radical prostatectomy. Furthermore, in men evaluated for erectile disfunction, Peyronie's disease was found in 7.9% of individuals. Diabetes has also been identified as a potential risk factor for the development of this condition.

A thorough assessment of the patient’s perception of his overall health should be done. The patient should be educated on his current medical conditions and what each condition means, and how it affects the body. Since this patient's PSA is 6.0, it is above the normal range. Although, there is no specific normal or abnormal level of PSA in the blood. However, more recent studies have shown that men with PSA below 4.0 ng/ml have prostate cancer (NCI, 2012). And many men with higher levels do not have prostate cancer. I will refer this patient to a urologist. Urologist will do a further work up on him. This pt needs some education about his pending diagnoses.

al were able to calculate the amount of PSA produced per gram of benign prostatic

Mr. Cervantes underwent a transrectal ultrasound biopsy of the prostate. No cancer was seen. He was found to have BPH. I am not sure what the size of the prostate was at the time of the prostate biopsy. Nonetheless, again the pathology is notable for BPH, chronic prostatitis, adenomatous and stroma stromal hyperplasia. He is now on Flomax 0.4 mg two tablets p.o. daily. He comes in for followup.

The physical exam will focus on the genitourinary (GU) system. Important findings to look for are any discharge or lesions consistent with sexually transmitted infections. In males, the size of the prostate gland should be noted in the rectal examination. In females, any signs of a cystocele and urinary leakage from the urethra should be noted in the pelvic examination. Neurological examination should test for lower-extremity weakness and loss of sensation.

The records have been reviewed. The member is an adult male with a birth date of 03/10/1960. He has a diagnosis of prostate cancer. His treating provider, Samuel Torres, MD, recommended the Oncotype DX Prostate Cancer Assay, which was performed on 12/30/2015.

Currently, the medical castration used as the ADT is one of the treatment option for an advanced and metastatic prostate cancer. This treatment option has shown to improve the overall rate of survival among men with prostate cancer, however there are various potential side effects associated with the ADT. It is important to discuss these potential side effects with the patient prior to initiating the treatment. There are various studies that have confirmed the use of both pharmacological and nonpharmacological interventions to mitigate the side effects of the ADT. Therefore, as a provider the patient who are seeking treatment for the prostate cancer should be fully informed about the side effects of the ADT, and educate them on the prevention and management of these potential side effects by implementing up-to-date evidence-based pharmacological and non-pharmacological

I chose Laparoscopic radical prostatectomy (LRP), this particular treatment seemed to have a much better chance of taking place with much less pain, less blood and less hospital stays. It also has faster recovery. I think the Laparoscopic radical prostatectomy (LRP) is a better option treatment for prostate cancer patients because I would think the patient would want treatment that has worked in the past and something that would be done with not a lot of hospital stay. Choosing a treating is a difficult task, deciding which treatment is best and right for the patient. It is important that before making a decision have the physician further explain complication

Depiction of the two ways to screen for prostate cancer, e.g., digital rectal examination and blood test