Counselling Flashcards
1
Q
PSA test
A
- Brief history- urinary symptoms
- Family history
- PSA stands for ‘prostate specific antigen’ is a protein made only by the prostate gland. Some of it leaks into your blood, but how much depends on your age and the health of your prostate.
- If you’re aged 50 to 69, raised PSA is 3ng/ml or higher.
- It’s not a good a test as we would like which is why it isn’t a screening programme: about 3 in 4 men with a raised PSA level will not have cancer. The PSA test can also miss about 15% of cancers.
- A raised PSA level in your blood may be a sign of prostate cancer, but it can also be a sign of another condition that’s not cancer, such as an enlarged prostate, prostatitis, urinary infection.
- Benefits: it may reassure you if the test result is normal. It can find early signs of cancer, meaning you can get treated early. PSA testing may reduce your risk of dying if you do have cancer
- Negatives: It can miss cancer and provide false reassurance. It may lead to unnecessary worry and medical tests when there’s no cancer. It cannot tell the difference between slow-growing and fast-growing cancers. It may make you worry by finding a slow-growing cancer that may never cause any problems.
- Before having the test: If you’re having a PSA test, you should not have: ejaculated in the past 48 hours. Exercised heavily in the past 48 hours. A urinary infection. Had a prostate biopsy in the past 6 weeks. DRE <1w ago.
- If it is positive: you may need other tests, such as a biopsy. This involves taking small samples of your prostate (via rectum) and checking them for cancer. Biopsies miss 1 in 5 prostate cancers and can sometimes cause complications. The most common are bleeding and infections.
-If you have prostate cancer, your specialist will discuss your options with you. Possible treatments include:
Watchful waiting. Active surveillance. Radical prostatectomy (surgery). Radiotherapy. Side effects of some treatments can include problems with erections, loss of fertility and incontinence.
-SCALF
2
Q
Newly diagnosed COPD
A
Smoking cessation advice
pneumococcal (one off) and flu (annual) vaccines
