Early Localized Prostate Cancer: Nurses Can Help Men Weigh Diagnostic, Treatment Options

By Jacob Molyneux, AJN senior editor

A new diagnosis of prostate cancer can be daunting. Nurses play an increasingly important role in helping men and their partners find their way through the maze of available information and choices. One of the two March CE feature articles in AJN, “Early Localized Prostate Cancer,” gives a thorough overview of tests and treatments.

The author, Anne Katz, is a certified sexuality counselor at CancerCare Manitoba, a clinical nurse specialist at the Manitoba Prostate Centre, and a faculty member in the College of Nursing at the University of Manitoba, Winnipeg, Canada, and Athabasca University, Alberta, Canada. She is also the editor of Oncology Nursing Forum. Writes Katz:

. . . as many as 233,000 men in the United States are diagnosed with prostate cancer each year, 60% of whom are ages 65 or older. Most diagnoses are low grade and localized . . . . Since low-grade, localized prostate cancer is slow growing and rarely lethal, even in the absence of intervention, it can be difficult for men to make treatment decisions after diagnosis—particularly if they do not understand the nuanced pathology results they receive and the potential for treatment to result in long-term adverse effects that can profoundly affect quality of life.

Pros_Cons_PSA_ScreeningThe article discusses options for intervention, potential adverse effects associated with each option, and, crucially, the nurse’s “role in helping men […]

Shared Decision Making and PSA Screening

PSA article screenshot“Should men get PSA tests to screen for prostate cancer?”

The Wall Street Journal posed the question in an informal, online poll last September. An accompanying article featured a debate between Richard Ablin, who’d discovered the prostate-specific antigen (PSA) in 1970, and an oncologist, Oliver Sartor. Ablin argued that the PSA test should be used only to screen men with a family history or active symptoms. For all other men, he said, a coin toss would be as effective. Sartor countered that the test finds cancers that can be treated early, acknowledging that for most men surveillance instead of active treatment is appropriate. Ablin retorted, “If we really could determine which cancers need treatment and which don’t, we wouldn’t be having this debate.”

The passage above is from this month’s AJN Reports by Joy Jacobson, “Navigating the PSA Screening Dilemma.”

The article gives a great overview of one of the big screening debates of the moment. Many of these debates are driven by changes in guidelines along with a dawning awareness in the medical community that certain tests we’ve assumed to be wholly beneficial, wholly necessary for most patients, may in fact be more harmful than not for many patients, leading to unnecessary treatment, anxiety, and waste of valuable resources.

The article also incorporates a discussion of the role being envisioned for “shared decision making” in helping patients make informed choices that are right for them. Let us know […]

2016-11-21T13:08:30-05:00January 23rd, 2013|Nursing|0 Comments
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