Consider the short-term and long-term implications of cancer and drug treatments associated with men’s health, as well as appropriate preventive services.
To prepare:
* Locate and review articles examining prostate cancer in men.
* Review the U.S. Preventive Services Task Force article in the Learning Resources. Think about available preventive services that providers might recommend for patients at risk of this type of cancer.
U.S. Preventive Services Task Force. (2012). Recommendations for adults.
* Select two of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how these factors might impact decisions related to preventive services.
* Consider drug treatment options for patients diagnosed with prostate cancer, including short-term and long-term implications of the treatments.
Write a 2- to 3- page paper that addresses the following:
* Describe available preventive services that providers might recommend for patients at risk of prostate cancer.
* Explain how the factors you selected might impact decisions related to preventive services.
* Describe drug treatment options for patients diagnosed with prostate cancer. Explain the short-term and long-term implications of these treatments.
Use current resources not written or updated greater than five years. Make mention of generic drug names in paper.
Prostate Cancer and Men’s Health
In the United States, prostate cancer is acknowledged as the most common nonskin cancer that is diagnosed in men. Some of the most common symptoms of prostate cancer include frequent or difficult urination. However, some men experience no symptoms at all. Presently, the lifetime diagnosis risk is estimated to be 15.9%. A majority of the prostate cancer cases have good prognosis. However, some are aggressive and the lifetime dying risk is 2.8%. It is hard for the disease to be diagnosed before the age of fifty years. A majority of the prostate cancer patients do not die before the age of sixty years but many deaths are after the age of 75 years.
Available preventive services
It is recommended that if prostate cancer is detected and treated early, this can go a long way in reducing deaths and, therefore, increasing the length of life. Another significant outcome is a reduction in cases that develop to symptomatic metastatic disease. This encompasses prostate cancer screening that involves measuring the serum PSA levels (prostate-specific antigen) through blood tests. If there are high PSA levels, a prostate biopsy is needed to establish if there is cancer. Other methods of detection that can be used include ultrasonography and digital rectal examination. According to U.S. Prevention Services Task Force (2014), there exists immense convincing evidence that screening programs that are PSA-based lead to the detection of numerous asymptomatic prostate cancer cases. In addition, there is evidence that a considerable proportion of men whose asymptomatic cancer cases are detected through PSA screening have at least a tumor that never progresses or progresses so slowly to the extent that it would have been asymptomatic in a man’s lifetime.
As noted by U.S. Prevention Services Task Force (2014), presently there are is no certainty regarding the prostate cancer cases that are life-threatening, which calls for immediate treatment and attention. A majority of the prostate cancer cases progress very slowly. In addition, men suffering from the disease die from other diseases as opposed to prostate cancer. Klein and Jones (2013) notes with keen concern that screening only makes men vulnerable to unnecessary worry as well as the adverse impacts of treatment with hormones, radiation therapy, and surgery. USPSTF recommends that men aged more than seventy five years should not be exposed to PSA-based screening. Since the harms of prostate cancer screening outweigh the potential benefits, it is recommended that doctors should not screen for the disease. An individualized approach should always be taken.
How the 2 factors impact decisions
As far as ethnicity is concerned, there are wide arrays of differences in the manner in which prostate cancer impacts on black men in comparison to men from other ethnic and racial backgrounds. The black men have a sixty percent higher likelihood of being diagnosed with the disease as well as dying from it compared to white men. The black men’s diagnosis age is less and their tumors are ‘high grade’. This implies that the tumors grow rapidly with high chances of spreading to other body parts and causing death often.
Jones (2013) notes that genes or genetics play a huge role in prostate cancer. For example, several genes associated with black men are linked with the increased prostate cancer risk as well as ‘high grade’ tumors. However, there is a need to note that none of the gene variations have been identified in many of the prostate cancer patients who are black, which denoted their mysterious role.
Drug treatment options (generic drug names)
Taxotere (docetaxel) is a chemotherapy drug that can be taken without or with prednisone (steroid). This is acknowledged as a standard chemotherapy regimen aimed for patients who have stopped responding to the endocrine therapy. Docetaxel functions by hindering the cancer cells from growing and dividing. The regimen is administered through an injection. Some of the implications of taking docetaxel include side effects that are the same as those experienced with a majority of the chemotherapy drugs. These include hair loss, nausea, and suppression of the bone marrow. The suppression means that there is a halt or decline in the formation of blood cells. Patients also have a high likelihood of experiencing neuropathy that leads to pain in the toes and fingers, numbness, and tingling. In addition, there is fluid retention.
Docetaxel be combined with prednisone and this was the initial chemotherapy drug that assisted patients with an advanced disease to live longer. Another drug that can be used is Jevtana or Cabazitaxel and this is used together with prednisone steroid. The drug is used on men whose advanced disease condition occurred after or during treatment with Taxotere or docetaxel. Abiraterone Acetate is approved by FDA for use with prednisone in treating metastatized prostate cancer. Mostly, it is prescribed for patients whose disease condition has not improved with treatment with hormone therapy. Cabazitaxel can be used with prednisone to treat metastatized prostate cancer in men with hormone-refractory cancer and who have received other forms of chemotherapy.
The foregoing discussion has outlined the significance for screening in men with prostate cancer risks. However, it is recommended that PSA screening should not be done in men aged more than 75 years. The ethnicity and genes should be considered when making recommendations to patients.
References
Jones, J. S. (2013). Prostate cancer diagnosis: PSA, biopsy and beyond. New York: Humana Press.
Klein, E. A., & Jones, J. S. (2013). Management of prostate cancer. New York: Humana Press. U.S. Prevention Services Task Force. (2014). Recommendations for Adults.