By Kelli Deter
I was intrigued by Daniel Stone in THCB in May entitled “Biden cancer diagnosis as a time of teaching”. In my practice as a practiced nurse certified by the Board, they often ask me about the specific prostate antigen tests (PSA) by my male patients.
The practice of nursing and the medical practice of being blurred or grouped. In the state of Colorado, practicing nurses practice under their own license and can independently diagnose and treat patients. In some environments in which I have worked, I frequently found correcting patients who refer to me as ‘doctor’. “I am not a doctor, I am a practical nurse,” is repeated for me multiples of times per day. In this discussion about PSA tests, I want to share my decisions to order or order PSA tests for people, according to my nursing training.
It is important to refer to Guidelines for the PSA tests recommended by the US preventive services task group. (USPSTF), and published by The Journal of the American Medical Association (Jama). The latest updates made to the guidelines were in 2018. It is key to remember that these are guidelines, and that doctors, doctors, doctors attendees and nursing practitioners use these guidelines when considering the patient. In the nursing, a holistic and team approach with the preferences, the history, the cultural considerations and the desired result of the patient will get into decision making for the evaluation, the tests, the derivation and the treatment. The guidelines are just that, a guide, not an absolute.
Guidelines indicate that for patients aged 55 to 69: Detection sacrifices a small potential benefit to reduce the possibility of death from prostate cancer in some men. However, many men will experience possible detection damage, including the results of the false position that require additional evidence and a possible prostate biopsy; overdiagnosis and supernadation; and complications of treatment, such as incontinence and erectile dysfunction … doctors should not detect men who do not express a preference for the screen. And for patients over 70 years: USPSTF recommends against PSA -based detection for prostate cancer. This does not mean that we, as suppliers, should not try men under 55 years of age or older than 70. We need to look at each patient case independently of each other and not group everyone.
In addition, patients may not know how to “express a preference for detection.” It is imperative that the suppliers have the assigned time to explore their family history of prostate and other cans, explain the benefits and risks of the tests, listen and discussion their signs and symptoms, make a digital rectal the patried and agreed tea and agreed tea and their age, as well as if they wanted to because the treatment or not. Certainly, if they are symptomatic, and a new medication is prescribed for their symptoms, or if they are symptomatic and a dre is obtained that is abnormal, a PSA must obtain a pain with the tacient appotine, and a factory of the ablish laboratories at the height of the topis-toish-up. If there is a family history of prostate cancer, an early PSA detection test could be preferable to establish a baseline. Again, patient preferences should take into account tasks.
People have very different feelings about Western medicine and what they want for themselves and their bodies. We must realize that just because anyone has a growing PSA with or without symptoms, it is possible that you do not accept a dre or toerdral to urology, surgery or oncology. As a supplier, we must obtain negative attention or recommended attention. It is fine not wanting evidence, monitoring or treatment, regardless of the age of one. In the case of Biden, no PSA tests have been carried out since 2014, during its vice presidency. The fact that no reason was given is irrelevant, in 2014 he was 72 years old. The guidelines are not to try from the age of 70. The PSA level, if drawn, may not have achieved its health outcome or treatment, but may have affected the result of their nomination for the presidency, what nursing and medical practice police. Pointing to the fingers now does not change anything. I agree with Stone, that this is a teaching moment: lawyer for you as a patient, your patient’s lawyer, and consider that much of health is a personal option and that it must be honored and protected.
I agree with Peter Attia’s statement on May 24, 2024, a tragic lesson in timely thought about the detection of prostate cancerthat PSA detection guidelines are outdated; The last review was in 2018. Attia indicates that many men remain healthy and live much more than 80 years, and aggressive cancers if they are trapped early and treated, will better benefit the quality of life and the duration of the patient’s life. I would also argue that this is true for the detection previously in life, at 50. Access to medical care is a problem for many in our society. Marginalized populations, such as homeless, homeless people, geriatric, mentally ill and imprisoned, experience greater disparities, and have a high risk of losing any PSA test. In my work as a practicing nurse in the correctional system, for people who enter prisons and prisons, this is the first time they have removed a medical care provider. These individuals have a history of destitution, lack of housing and/or mental illness. Besides, The new cancer diagnoses are increasing and for men; 29% of new types of cancer are prostate.
50 years is a milestone for most people, and they know that they are supposed to detect colorectal cancer at this age, as well as other detection tests. Consolidate attention by capturing a PSA at the same time would establish an early baseline; There is never a guarantee that a patient with access problems will return to another appointment, due to finance, transport, fear or other factors. Another consideration to review PSA detection guidelines is to reduce the threshold for PSA levels based on the patient’s age That promote derivation to urology to obtain images and placing a simple language in the guidelines to see an increase of a double of PSA for 6-12 weeks as a probable urgent referral to urology. Starting the early vigilant waiting with the projection of PSA has the potential to save more lives and caress the desired qualities of life.
Kelli Deeter is a family nurse certified by the Board with 12 years of experience in geriatrics, rehabilitation, correction, women’s health, mental health and complex chronic care.
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