Prostate Diagnostic Tests & Disorders

Question 1

diagnostics for benign hyperplasia?

Answer 1

History & physical
Digital rectal exam (DRE)
Urinalysis and C&S
Serum creatinine
Serum prostate-specific antigen (PSA

Question 2

does BPH predispose to prostate cancer?

Answer 2

NO

Question 3

what does a digital rectal exam accomplish?

Answer 3

Done to estimate the prostate size, symmetry & consistency

In BPH, the prostate is symmetrically enlarged, firm & smooth

Question 4

what will you see with urinalysis and C&S?

Answer 4

increase risk of urinary retention and hydronephrosis

Question 5

what is the prostate-specific antigen (PSA) screening?

Answer 5

PSA is a protein made solely by prostate cells, so the antigen is highly specific to the prostate.
However, it is not prostate cancer specific.
Other prostate conditions, such as BPH & prostatitis, can affect PSA levels.
The lack of specificity for prostate cancer has led to considerable controversy about the role of routine PSA testing.
And – is compounded by the knowledge that not all cancers detected by routine screening require treatment.

Question 6

what’s the recommended age to begin screening?

Answer 6

age 50

Question 7

what are the benefits of screening?

Answer 7

Small survival benefit with PSA screening in randomized trials
Use of the PSA test was associated with 50% drop in prostate cancer deaths in U.S. (1990’s)

Question 8

what are the harms of screening?

Answer 8

Would take 48 diagnoses of prostate cancer to prevent 1 death
Only 1 in 3 men with a positive PSA will have prostate cancer
Risks r/t biopsy procedure & risk r/t treatment therapy (surgery, radiation)
Over-diagnosis (dx never becomes clinically relevant)

Question 9

what’s the deal with PSA screening?

Answer 9

Many men live and die with prostate cancer, but not from it.

As screening has become more widespread, smaller cancers are being found.
Most slow-growing cancers don’t need to be treated, however –
***Early detection of aggressive cancers saves lives.

Question 10

nursing implications of PSA screening

Answer 10

Patients should be informed about potential risks (subsequent evaluation & treatment may be unnecessary) and benefits (early detection of prostate cancer) of PSA screening

Question 11

other diagnostic tests for prostate disorders

Answer 11

Ultrasound (TRUS – trans-rectal U/S)
Help differentiate BPH from cancer (if DRE & PSA abnormal)
Biopsy via trans-rectal ultrasound

Question 12

what’s the only definitive way to diagnose prostate cancer?

Answer 12

Biopsy via trans-rectal ultrasound