Question

Discuss factors that contribute to cancer of the prostate and investigate the controversy concerning PSA testing.

Discuss patient education about a testicular self-exam and emphasize the importance of monthly exams.

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Answer 1

The factors that contribute to cancer of the prostate are

a.Age:it is found that men are more susceptible to get cancer and it is often diagnosed in men older than 65.

b.Race :ethnic groups such as Black men have higher incidence of having prostrate cancer compared to Whites.

cf.Family History:A history of CA Prostate in the family ,also raises the chance of getting cancer..If a man has a firs t degree relative,ie father,brother or son ,with prostate cancer,his risk of developing prostate cancer is 2 to 3 times higher than the average risk.

d.Diet:There is no such evidence as to prove that diet has any relationship with cancer of prostate,but some studies shows links between certain eating behaviours and CA prostate.

There are many controversies revolving around PSA testing .Due to false positive or overdiagnosed cancer,most of the health care organizations do not recommend PSA screening for prostate cancer .This is mainly based on two randomised controlled trials The European Randomised Study of screening for Prostate cancer(ERSPC) and Prostate,Lung,Colorectal and Ovarian Cancer trial(PLCO).They are both of high quality.There was a significant discrepancy when the end results came,the former one showed deecrease in mortality in men screened with PSA compared to those that did not recieve a PSA,whereas the PLCO showed no difference in mortality between the two groups.There was a lot of difference mainly in terms of screening interval,PSA threshold to biopsyand higher prostate incidence in the USAand degree of contamination in control groups..All four extended analyses and the traditional analyses concluded that PSA screening significantly reduced mortality.

2.It is important to perform monthly testicular self exams to notice changes in ones testicles,as testicular cancer is the most common cancer in men ages 20 to 35,as it can occur any time after15 and it is curable if found and treated early.Do a testicular self-exam after a warm bath or shower as the heat causes the scrotal skin to relax,thereby it will be easier to feel anything unusual

a.Stand in front of the mirror and check for swelling on the scrotal skin.

b.Examine each testicle gently with both hands.Place the index and middle fingers should be placed under the testicle while thumbs are placed on top,then roll the testicles gently between the thumbs and fingers.One testicle may feel longer than the other and it is normal.Feel for changes in the testicles that were not there before

c.The epididymis is cord like and is quite tender to touch.it is the location of most non cancerous problems and there is a chance to cofuse the epididymis with a lump

if you suspect a lump ,call your Doctor,but not all lumps are cancerous and it can also be due to infection.Regular testicular self-exams are important and your Doctor should also do an exam of your testicles when yearly physical exam is done.Therefore performing a monthly testicular exam is very important.