The Healthcare In Australia

Published Date: 02 Nov 2017

Jeanne Carlo L. Santos

30113441

ABSTRACT

Prostate cancer is an abnormal growth of cells in the prostate that form a lump. It is the most common cancer among Australians after non-melanoma skin cancer and the second-leading cause of cancer death after lung cancer. Numerous large, early detection programs have clearly documented the synergy of DRE and PSA testing in increasing the sensitivity for the detection of prostate cancer over the use of either test alone. A thorough discussion on the upside and downside of screening was done to promulgate the most efficient way of going about prostate cancer detection which must be carried out between health care workers and the potential participant. Early detection guidelines do not address the management of prostate cancer.

INTRODUCTION

Prostate cancer is a significant health issue in Australia. After non-melanoma skin cancer, it is the most commonly diagnosed malignancy in men and it is responsible for as many deaths each year as breast cancer in Australian women. However, unlike breast cancer, national screening programs are not available despite a widespread understanding that prostate-specific antigen (PSA) testing in conjunction with digital rectal examination (DRE) facilitates early detection of this disease. The controversy is whether the use of such a strategy for mass-population screening directly results in decreased mortality rates (Lam, Q. & Frydenberg, M. 2009). However, Melville (2012), presented the number of men getting prostate cancer screening has suddenly diminished since the publication of a key study showing no improvement of death rates from screening with the prostate-specific antigen (PSA) test. On the other hand, Nelson (2009) compared a vast study from the United States that prostate cancer screening does not decrease death from the disease besides another European study suggests that it does, and that it decreases prostate cancer mortality by about 20%. Population-based screening of asymptomatic men for prostate cancer in New Zealand is not endorsed by the National Health Committee because of its lack of demonstrated advantage and the potential harm arising from needless radiotherapy, surgery or other treatment (McAvoy, B., Steginga, S., & Pinnock, C. 2006). Hence, this report targets to explore the different strengths, weaknesses, opportunities as well as threats of early detection strategies of prostate cancer.

BODY

STRENGTHS

Simple

Accessible

Low-cost

WEAKNESSES

Patient selection

Inaccuracy

Gold Standard

OPPORTUNITIES

Improve diagnosis

Early treatment

Reduce mortality

THREATS

Overdiagnosis

Overtreatment

Complications

Screening comprises methodical structured efforts to recognize presymptomatic individuals in a population who is deemed to be at sufficient risk of a particular illness to warrant supplementary examination. Parpart, Rudis, Schreck, Dewan and Warren (2007) explicated that the PSA test and Digital Rectal Examination (DRE) are the most extensively used forms of prostate cancer screening. The PSA test is basically a blood test, commonly available to the general population. Crawford et. al. (as cited in Parpart et. al. 2007) mentioned it is inexpensive, amounting the patient approximately $30-60, and there are on no account hazards. The DRE is also low-priced, costing around $28. It is readily accessible by appointment in a doctor's office.

Kelly et al. (2008) talked about serum prostate-specific antigen (PSA) as the groundwork of prostate cancer screening. This test is flawed by the fact that PSA is formed both by normal and abnormal prostate. Thus, not unexpectedly, serum PSA screening for early identification of prostate cancer is neither sensitive nor specific and leads to needless biopsies in men with benign prostatic hypertrophy (BPH) and high serum PSA as well as missed prostate cancer in men with smaller prostate glands and low serum PSA. In fact, it has been disputed that in the era of PSA screening, serum PSA is much more highly interrelated with mass of the prostate than with the presence of cancer itself. Whereas numerous variations of serum PSA may increase its features marginally, generally it is a relatively meagre screening test.

The National Comprehensive Cancer Network (2010) explained that the choice about whether to employ early detection of prostate cancer is multifaceted. When, who, and how to test persist major topics of deliberation among physicians. The predicament is that because most men with prostate cancer will not die of this disease, treatment (often with significant side effects) is unnecessary for some patients.

Berg mentioned it is essential that better and more accurate methods of diagnosing prostate cancer and vital to be able to recognize which prostate tumors are the most likely to be deadly (as quoted in Nelson, 2009). Improving prostate cancer detection will ultimately lead to improving mortality rates. Moreover, accurately measuring cancer rates burden could dramatically improve the ability to select appropriate candidates for active surveillance (Kelly et al., 2008).

Fadich added, on the upside, the buzz around the recommendations against PSA screening has caused the issue to come to the forefront of men's health discussions (as quoted in Melville, 2012).

Katz, M.J. & Swan, J. (2012) supplemented that healthcare providers are critical in the management of prostate cancer all through the disease continuum. Education and emotional upkeep to the patient and his significant are vital from screening to diagnosis. Holistic care is requisite from identification to treatment. Nursing plays a crucial role in facilitating and maintain the utmost possible quality of life for each patient.

Tice (2012) described the harms associated with early detection, such as false positive results are typical and have been made known to escalate anxiety about prostate. Prostate biopsy is also concomitant with pain, bleeding problems, and infections with the need for hospitalization. More noteworthy harms arise because of overdiagnosis. Up to half of prostate cancers established with screening would not cause symptoms in the individual's lifetime. However, we do not presently have precise tools to decide which will progress and need treatment and which can be observed. Most of these men are managed with surgery, radiation, or hormone therapy. Each of these actions is related to high rates of sterility, incontinence, and bowel problems that will haunt the remainder of a person's life.

CONCLUSION

Published methodical evaluations and analyses measured figures and concluded that PSA testing should not be customarily used to screen for prostate cancer because of outstanding uncertainty revolving around the benefits of screening and the degree of the recognized harms. New findings published in 2011 and 2012 do not change that assumption. PSA is an imperfect screening test because it can be elevated in benign prostate disorders and it is not precise for the aggressive cancers that will cause medical illness at some point in time. Prostate cancer necessitates a gold standard screening procedure, yet recognition of such diagnostic test has been elusive.

Hence, at every single stage of a prostate cancer patient’s contact with the medical system, nurses are fundamental to guaranteeing that the patient obtains comprehensive care. In order for nurses to meet the informative needs of both patient and significant others, it is indispensable for them to be well-versed with the male genitourinary system in total. Education of male patients begins with each contact the nurse has with them. The goal of the nurse is to increase awareness, decrease apprehension, and support the patient and his significant other to openly converse their concerns.

It is therefore recommended that a global study be done not only for early detection of prostate cancer but also guidelines for active surveillance of probable patients which will include a multidisciplinary team of all allied health care workers most especially registered nurses.