Posted: June 28th, 2022

Assessment Tool/Diagnostic tool : PSA

Assessment Tool/Diagnostic tool : PSA

Cancer of the prostate is the second most diagnosed pathologic condition in adult males only exceeded by the non-melanoma skin cancer (David and Leslie, 2021; Ilic et al., 2018). Early diagnosis and intervention is very effective as it provides healthcare providers the ability for early intervention. This is effective in preventing morbidity and rise in mortality in adult males. With limited clinical signs and symptoms prior to its diagnosis, prostate cancer remains to be a major risk among most adult males. David and Leslie (2021) identify that the majority of men with early prostate cancer do not show any symptoms; prostate-specific antigen or PSA is a key malignant process used to elevate serum markers as such provide early prostate cancer victims a chance for them to find healthcare and achieve a cure. With nearly $10 billion dollars spent in treating prostate cancer annually and has been increasing for the last 20 years (David and Leslie, 2020). As such, increased capacity for diagnosis will be advantageous for policy makers, and potential victims.

Adult Assessment Tools or Diagnostic Tests:

Assessment Tool/Diagnostic tool : PSA

Include the following:

A description of how the assessment tools or diagnostic tests you were assigned is used in healthcare.
What is its purpose?
How is it conducted?
What information does it gather?
What information does it gather?
Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values.
Include references in appropriate APA formatting.

Prostatic secretion play a key function in providing spermatozoa’s the ability to move independently using metabolic energy (motility). The secretion is usually acidic with a pH of about 6.4, the acidity of the secretion is useful in balancing the vaginal alkalinity. The PSA (which is part of the secretion) works to liquidize the semen and dissolve cervical mucus (Arneth, 2009). PSA is a serine protease enzyme synthesised by the columnar epithelium which is a part of the prostatic tissue. It enters the system circulation and is additionally used to prevent seminal coagulation by breaking down semenogelin and fibronectin proteins which are of thick and gel-like consistency (David and Leslie, 2021). PSA allows for impregnation of the female.
PSA test is a blood test that measures the amount of prostate-specific antigen in an individual’s blood. PSA is a protein produced by tissues in the prostate (both cancerous and non-cancerous tissues). The PSA is a screening exam that is mostly advised for asymptomatic and healthy looking male. The PSA is mostly found in the semen and small amount if the PSA usually circulate within the male’s blood. It is in low concentration across the body, but it may increase with prostate irritation, infection and benign prostatic hyperplasia (BPH) which is a normal condition of aging (Arneth, 2009). PSA test can be used to identify any amount of prostate-specific antigen in the blood system. High amounts of PSA in the blood system may indicate presence of prostate cancer. But this is not always the case.
As men grow older, their sperm count, relative to sperm production starts to decrease. While spermatozoa production decreases, PSA production does not decrease, but it does the opposite and increases. David and Leslie (2021) identify that the increase in PSA production is explained as an evolutionary adaptation that allows genetic fitness in other males as opposed to others. This consequently increases BPH across the male general population. Inflammation irritation and increased BPH, all work to increase serum PSA levels.
The PSA test on the other hand employs the use the blood withdrawn. The test is 91% more effective in cancer rates detection from a sample as small as 4 ng/mL, as compared to digital rectal examination or DRE (51%) and transrectal prostatic ultrasonography (David and Leslie, 2021). The PSA tests is necessarily not effective in reducing prostate cancer morbidity and mortality rates. REcent research identify that it often leads to prevention 3 out of 1000 men from dying of prostate cancer, while also misdiagnosis of 60 out of 1000 men, which often ends up in increased and unnecessary cancer treatments (Informed Health Organization, 2020). Other researchers identify that the PSA monitoring are often ambiguous and lead to greater uncertainty in both patients and physicians as there remains to be limited interpretation especially when using variable PSA quotient given (Arneth, 2009).
While PSA screening are on the increase, researchers identify that there is limited significance in the test. David and Leslie (2021) identify that PSA sensitivity sully varies between 9% and 33% relative to age of the patient and the PSA cut-off levels used. Majority of people who are diagnosed with prostate cancer usually have normal PSA levels (Ilic et al., 2018). Benign conditions, that are not risky to individual health but a part of aging, may play a role in increasing PSA levels. While their blood levels may indicate a higher value of PSA through the PSA test, this does not necessarily imply presence of prostate cancer. Effectively the test becomes less important in significantly reducing morbidity and mortality rates. Ilic et al (2018) identify that overall, in an empirical research conducted over 10 year period, scientist discovered that PSA test led to small reduction in disease-specific mortality but in the long run they did not affect mortality trends across the world.
While the test is more effective than DRE and transrectal prostatic ultrasonography, it has proven unreliable on a variety of fronts. Summarily, the PSA test is not reliable and it has not been able to achieve significant changes in diagnosis and treatment of cancer. A high PSA level does not guarantee the existent of prostate cancer. Also a variety of men, who may be diagnosed with prostate cancer usually have normal PSA levels.

References
Arneth, B. (2009). Clinical Significance of Measuring Prostate-Specific Antigen. Laboratory Medicine, 40(8), 487-491. doi: 10.1309/lmeggglz2edwrxuk
David, M., & Leslie, S. (2021). Prostate Specific Antigen. Retrieved 14 June 2021, from https://www.ncbi.nlm.nih.gov/books/NBK557495/
Ilic, D., Djulbegovic, M., Jung, J., Hwang, E., Zhou, Q., & Cleves, A. et al. (2018). Prostate cancer screening with prostate-specific antigen (PSA) test: a systematic review and meta-analysis. BMJ, k3519. doi: 10.1136/bmj.k3519
Informed Health Organization. (2020). Localized prostate cancer: PSA tests for prostate cancer screening. Retrieved 14 June 2021, from https://www.ncbi.nlm.nih.gov/books/NBK284938/

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