Which of the following is a diagnostic test for the diagnosis of prostate cancer?

Chitranjjan National Cancer Institute Kolkata - 2021

Medical & Surgical Nursing

Medium

Appeared in: Chitranjjan National Cancer Institute Kolkata - 2021

Explanation

The diagnosis of prostate cancer is a comprehensive process that utilizes multiple tests, not just one.
A Digital Rectal Exam (DRE) is a physical screening test to feel for abnormalities in the prostate.
A Prostate-Specific Antigen (PSA) blood test is used to screen for elevated levels of a protein that can indicate cancer risk.
A prostate biopsy, which involves examining a tissue sample, is the only definitive method to confirm a cancer diagnosis.
Since all three methods are part of the standard diagnostic workup, 'All of the above' is the most complete and correct answer.

Option A: This option is incomplete. While a DRE is part of the initial assessment, it is not sufficient on its own for a definitive diagnosis and is used in conjunction with other tests.
Option B: This option is incomplete. A PSA test is a screening tool, not a definitive diagnostic test. Elevated levels can be caused by other conditions like BPH or prostatitis.
Option C: This option is incomplete in the context of the overall diagnostic process. Although a biopsy is the definitive test to confirm cancer, the decision to perform a biopsy is typically based on the results of a DRE and/or PSA test.

Clinical Relevance

Nursing practice connection: Use the key finding related to Diagnostic methods for prostate cancer to guide bedside assessment, documentation, and the next nursing action.
Nurses play a vital role in educating patients about the purpose of each test, what to expect during the procedures, and managing anxiety associated with a potential cancer diagnosis.
Post-biopsy care is a key nursing responsibility, including monitoring for complications like bleeding, infection, and urinary retention, and providing clear discharge instructions.
What if a patient has a high PSA level but a normal DRE? The nurse should explain that PSA can be elevated for various reasons and that the doctor will likely recommend further investigation, such as a repeat PSA, a free-PSA test, or an MRI, before deciding on a biopsy. The normal DRE is reassuring but doesn't rule out cancer.

How to Approach the Question

First, read the question carefully: 'Which of the following is a diagnostic test for the diagnosis of prostate cancer?'.
Analyze each option individually. Is DRE used in diagnosis? Yes. Is PSA used? Yes. Is a biopsy used? Yes.
Notice the option 'All of the above'. When this option is present, you must evaluate if each of the other options is a correct statement in the context of the question.
Since DRE, PSA, and biopsy are all part of the diagnostic process for prostate cancer, the most comprehensive and accurate answer is 'All of the above'.
This question tests your understanding that medical diagnosis is often a process involving multiple steps (screening, risk assessment, confirmation) rather than a single test.

Concept Tested & Keywords

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E6 Medicine Harrison 22e Part 1 pp. 737-739, 738-740