Prostate Cancer in African American Men Essay

Prostate Cancer is the gland below a man’s bladder that produces fluid for semen. Prostate cancer is common among older men. Prostate cancer is a silent killer, and because it grows slowly, many men have no idea it’s there It is rare in men younger than forty. Risk factors for developing prostate cancer include being over sixty five years of age, family history, being African American, and some genetic changes. There is an estimated of 241,740 new cases and 28,170 deaths from prostate cancer in the United States in 2012 (National Cancer Institute, 2011). Prostate cancer is the second most common cancer among men, behind skin cancer, and the second leading cause of cancer deaths among men especially in African American men. one out of six men will be diagnosed with prostate cancer during their lifetime. For example, if you’re at home having a cookout with 11 of your friends, it’s likely that two of you at some point in your lives will be diagnosed with pros tate cancer. and If you’re an African-American man, those odds increase to nearly one in five. Prostate cancer affects African American men twice as often as Caucasian men; the mortality rate among African American is also twice as high. African American men have the highest rate of prostate cancer of any ethic group in the world. In the African American community men are at high risk due to low socioeconomic status, and not getting cancer screening because of no health insurance. With the increased amount of men being diagnosed each year it is shocking that many men still avoid visiting the doctor because it makes them uncomfortable and they are afraid of what the results will be even when some clinics give free prostate cancer screening. While prostate cancer screening test can have abnormal results even when cancer is not present, it is important for men to have prostate screening done.prostate cancer is usually detected through screening, and there are two methods for early detection. The prostate-specific antigen test (PSA) is used, but there are many factors that can inf luence the outcome of the PSA test. Medications such as antihistamines, physical exertion or recent ejaculation can raise a PSA level. Another test for early detection of prostate cancer has been the digital rectal exam (DRE). Although, DRE is a better method for early detection, it is also a hindrance among men, particularly African-American men, to screening and early detection According to American Cancer Society (ACS) and American Urological Association (AUA), the PSA and DRE should be offered annually for all men beginning at age 50. However, they also recommend that African-American men with a family history of prostate cancer should begin testing by age 45. Early intervention is the key to a 5 year survival rate. Prognosis of prostate cancer diagnosed at an early stage is noted as being optimistic. Despite these credible statistics, free prostate cancer screening and early detection remains a problem area for many health care practitioners when it comes to the African American population (Plowden 2009) Madeline Leininger’s Sunrise Model has been used in many studies over the past twenty years. Between 1999 and 2008, over 200 citations of articles were noted using Leininger Theory (McEwen, 2011). She postulated that nurses should attempt to increase knowledge related to the care of people who value their cultural heritage and way of life (McEwen, 2011). The Leininger Sunrise Model of cultural diversity is used to obtain compliance with prostate cancer screening among African-American men; the goal has been to build a relationship of cooperation between clients and health care workers. Educating the men as well as examining their fears and anxieties is useful in removing barriers of resistance and gaining trust, thus empowering the client (McEwen, 2011). The Health Belief Model (HBM) â€Å"postulates a person’s perception of disease threat and benefits of taking action will predetermine taking action† (Rivers, 2009). The HBM is used to determine the African American male understanding of prostate cancer and to identify factors that would motivate that populatio n to seek screening and treatment of prostate cancer. The HBM has been used to design intervention to educate as well as facilitate access to screening and treatment (Rivers, 2009). Leininger’s Theory of cultural care diversity is a middle range theory that is based upon the major concepts of culture, culture care and understanding the differences as well as the similarities to transcultural human care. Her other major concepts of transcultural care are, caring, and ethic views, the system of health care, the professional system of care and culturally congruent nursing care. (McEwen, 2011) The strength of Leininger Theory lies in the fact that it is a holistic theory seeking to cover both the diversity and universality of nursing care concepts. Caring aspects within and between cultures must include the acknowledgement of the similarities and differences. The theory has been widely used within the credibility and confirm ability of data gained from research (McGee, 1994). Because the Leininger Theory places emphasis on cultural s ensitivity and cultural congruence, it can be said that cultural knowledge will improve care. However, because the approach fails to take into account a political and structural inequality of minorities and focuses on differences and deficits, it can be construed that the culture itself is the problem. The possibility of reinforcing stereotypes and increasing the gap between provider and patient may actually make the care aspect less than culturally safe (Orià ¡, 2005). Leininger Theory can be used in a wide range of modalities when considering the problem of prostate screening. When examining the focus of this clinical problem i.e., how to get increased participation from a high risk group to prostate cancer screening, Plowden reached several conclusions that are applicable to today’s practice for advance nurse practitioners. For example, African-American men were more likely to seek screening and participate in the treatment process if 1.) There was a perceived susceptibility to prostate cancer and that threat was perceived as severe in life threatening or disabling . 2.) There were perceived benefits to the screening such as early detection and accurate diagnosis. 3.) There were no perceived barriers. 4.) Sufficient triggers need to exist to motivate behavior (Plowden, 2009). When applying these findings to advanced nurse practitioners’ practices, it can be said that men in the high risk groups must first be educated on the risks of prostate cancer. They need to understand the implications involved with failure to be screened. Early detection and accurate diagnosis are very important to the 5 year survival post diagnosis. Screening is essential to the quality of life for a person diagnosed with prostate cancer. For example, lifestyle changes would have to be made after a radical prostectomy versus a chemo radiation treatment of a localized slow growing tumor. When health care professionals can successfully manage to remove or go around barriers, whether real or perceived, the goal of seeking medical intervention is improved. Health care professionals can attempt to established sufficient triggers so that the behavior can be motivated to attain compliance to screening. The advanced nurse practitioner’s challenge will be to first establish trust and reputation as a caregiver who cares and is approachable; educate the population of the high risk group to the benefits of early detection versus late discovery; provide easy access to screening and the follow up phase of the intervention; and maintain confidentiality. Peer group discussions with professionals have shown to aid in getting better compliance (Plowden, 2009). The African-American males’ decision making process when considering prostate cancer screening is influenced greatly by cultural mores and beliefs. These cultural beliefs often lead to a lower rate of compliance to free screening versus all other races i.e. Caucasians, etc. Leisiniger’s cultural diversity theory can be used to effectively educate and increase compliance by teaching practitioners ways to overcome these cultural barriers. By following the concepts of care, caring, and understanding feelings of self, as well as the feelings of others, it is possible to overcome cultural barriers. Works Cited Cherath, Lata, et al. â€Å"Prostate Cancer.† The Gale Encyclopedia of Medicine. Ed. Laurie J. Fundukian. 4th ed. Vol. 5. Detroit: Gale, 2011. 3578-3584. Gale Virtual Reference Library. Web. 7 Dec. 2012. â€Å"LATEST RESEARCH: Faster Prostate Cancer Growth In Black Men?.† Prostate Disorders (2011): 31. Health Source – Consumer Edition. Web. 7 Dec. 2012 â€Å"Prostate Cancer.† National Cancer Institute. SEER Cancer Statistics Review, 1975-2009 (Vintage 2009 Populations), National Cancer Institute. Bethesda, MD, n.d. 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