Prostate Cancer - Coursework Example

Survival Analysis about a specific fatal disease : Course: Tutor: Date: Introduction People often experience different challenges in their social, health and economic dimensions that often alter the cause of their lives. Different approaches are often advised for people to take in enhancing their lifestyles, health and general well-being. People are expected to check on their dietary habits and patterns in order to lead healthy lives and achieve their goals and objectives in life. However, modern lifestyle approaches have been responsible for various diseases and health challenges that people face. Many people often resort to taking fast foods and other kinds of diets that end up affecting their health and general well-being. While some of the diseases are curable when diagnosed early, others are terminal and often lead to increased mortality rates among populations that do not afford prior health interventions in good time. Prostate cancer Lifestyle patterns have always been blamed for most of the health challenges that people face. Many people have changed their lifestyle patterns with respect to the work they do, the rising need for globalisation brought about by advancements in technology and general way of life. Prostate cancer is a disease that often attacks many people across populations; this disease is often characterized by development of cancerous cells in an individual’s prostate glands (Qaseem, 2013). In some cases, the disease is often referred to as carcinoma of the prostate, and is common among males, where it affects their reproductive system. When the cancerous cells begin to grow in the body of an individual, they can easily spread to other parts of the body, especially if an individual does not seek early diagnosis and treatment as soon as the initial signs and symptoms are felt (Cho, Timmerman & Kavanagh, 2013). It is important to note that most of the prostate cancers grow slowly, but others are fast and aggressive. For this reason, individuals are advised to seek urgent medical attention as soon as they notice any signs and symptoms that could be related to this disease. Definitions of prostate cancer Prostate cancer is the cancer that arises in the prostate glands of males; the prostate is simply the small gland that is wall-nut shaped, responsible for the production of seminal fluid, which transports and nourishes the male reproduction cells – the sperms. In males, prostate cancer forms part of the widespread types of cancers affecting them. According to medical reports, prostate cancer often develops slowly, initially confining itself to the individual’s prostate glands. It is important to understand that some cancers grow and spread quickly. They can easily spread to affect different parts of their body, starting from the pelvic region, for these kinds of prostate cancers; an individual has to seek urgent medical attention in order to avert much harm. On the other hand, other kinds of prostate cancers require minimal treatment because they grow slowly. Prostate cancer has also been described as a malignancy that affects one of the main male reproductive glands. Together with testicles and seminal vesicles, the prostate is often tasked with production of fluids that make part of the semen. According to the analysis, the size of the prostate is said to be that of a walnut, and is found behind a male’s urinary bladder. Most often, a small tumor begins to grow in the prostate, interfering with the appropriate control of an individual’s sexual functioning and urinary bladder. In other cases, prostate cancer is defined as the cancer that develops in the tissues of prostate glands, meaning that it affects male members of the human society. In many instances, prostate cancer affects the older male members of the society. However, mild cases have been recorded about the prevalence of the disease in young males, especially those that have a family history of this kind of disease. Cancerous cells It is important to understand that on their own, cancerous cells happening in the prostate glands are not always deadly. However, in the course of time, the growing tumor causes part of the cancerous cells to break off, spreading to other parts of the body. The flow of these breaking cancerous cells is aided by the lymph in the individual’s blood, often in a process referred to as metastasis. It is important to note that in the human body, common sites that encourage metastasizing of cancerous cells include the lymph nodes, seminal vesicles as well as different bones located at the hip area and the entire pelvic region. The effects that these tumors bring result in the death of people suffering from it. According to research statistics, by 2000, prostate cancer was the most diagnosed malignancy in adult males in most countries in Europe and the entire west. In as much as prostate cancer is said to be a slow-growing diseases in the people ailing from it, it can sometimes be very aggressive, particularly in most of the young males that contract it. It is from this attribute that most young men succumb from other opportunistic infections resulting from this disease, rather than the cancer itself. In many of the cases recorded in the United States and most other countries in Europe, prostate cancer is now affecting most of the African-American men compared to the whites. For this reason, the death rates resulting from this disease is two times higher than other diseases in the same people. Fig 1. SEER Incidence & U.S. Mortality 1975-2011, All Races, Males rates are Age-Adjusted (Park, 2014) Signs, symptoms and diagnosis According to medical reports, prostate cancer often results in deep excruciating pains, difficulties in passing urine, problems when having sexual intercourse and can even cause erectile dysfunction. As the disease continues to manifest, other signs and symptoms appear at the later stages. However, in the early stages, the cancer does not display any signs and symptoms. Most physicians advocate for screening tests especially to young people that are deemed at the danger of this disease. As far as prostate cancer is concerned, the most commonly preferred screening method is the Prostate-Specific Antigen (PSA), this is a protein produced from the cells of prostate glands. The PSA test is very reliable in the assessment and measurement of the levels of PSA in an individual’s blood. For a normal person that is free from prostate cancer, , he often has to have PSA measurement levels of 4.0 ng/mL; however, it may also be lower, in which case, it is still considered as normal. For patients found to have PSA levels above 4.0 ng/mL, medical experts recommend they go through prostate biopsy, so that they can have reliable medication regimes. Various research conducted on the prevalence of prostate cancer have shown that certain issues exist in the interpretation of PSA results by medical practitioners. One of the arguments given for the various interpretations as far as PSA tests are concerned is that an enlarged prostate gland and not necessarily the cancer can at times cause it. In this case, medical practitioners are expected to be careful and thorough in their tests so that they do not induce one to the treatment regime when in actual sense, he is not suffering from the disease. On the other hand, PSA levels can be low, to mean that an individual does not have the disease, which may at times be the exact opposite (Qaseem, 2013). PSA treatment approaches given to patients when in actual sense they do not have the disease itself can be dangerous to their health. However, other tests can be carried out to give reliable results about the presence of prostate cancer, these includes urine and digital tests. Just as the previous test, these tests have to be conducted by the right medical practitioners in order to be sure about an individual’s PSA levels. Risk factors Qaseem (2013), explains that research shows many risk factors associated with prostate cancer; some of these factors include age, which in most cases refers to people of 60 years and over, the particular sizes of the cancer tumors as well as family history of prevalence cases of prostate cancer. It is important to note that lifestyle patterns and behaviours can also play a role in the prevalence of this disease. These include use and abuse of drugs and alcohol as well as the overweight cases recorded in the BMI (commonly known as Body Mass Index). In addition, some fast foods that people like to take in restaurants have also been known to cause this disease, although scientific data has been lacking over some of these foods like whole milk. In the United States, statistics from the American Cancer Society indicated that approximately 30% of men ranging in their 30s had been diagnosed with prostate cancer. Those in their 50s were approximately 50% while those with 85 years and above accounted for 75% of the prostate cancer cases by 2012. In addition, the statistics revealed that by the same year, the recorded median age for diagnosis of prostate cancer among males was 64.5 years (Qaseem, 2013). Furthermore, the results from the statistics indicated that people at the risk of death from prostate cancer were those that contracted the disease at their younger ages. Following these revelations, men are advised to make consistent checks with medical doctors on a regular basis so that prostate cancer cases can be dealt with effectively. The resulting size of tumors has also been cited as an important risk factor as far as prostate cancer rates are concerned. According to evidence from medical research reports, when the size of the tumor increased, chances of it being malignant also grew and increased exponentially. This is very dangerous because it often causes the cancerous cells to increase to other parts of the body, causing serious health problems and complications to people suffering from it. In fact, it is recorded that tumor cells were closely associated with the risk of deaths resulting from prostate cancer especially in patients under watchful waiting. For this reason, patients diagnosed with this disease are advised to stick to the treatment schedule as recommended by the doctor so that they can improve their chances of long life. Other risk factors associated with prostate cancer include fruits, vegetables, alcohol, cigarette smoking and the family history relating to prostate cancer. Decision making over the treatment of prostate cancer is very important especially for those patients diagnosed with this disease. Many treatment plans recommended for this disease include surgery to remove the cancerous cells and tumors as well as radiotherapy regimes to kill the cancerous cells (Cho, Timmerman & Kavanagh, 2013). In other instances, doctors often recommend a combination of these methods, depending on the severity of the diseases and the extent to which a patient has been affected. According to Qaseem (2013), research has indicated that among the different treatment regimes recommended for treatment of prostate cancer, some are better than others in terms of performance. Prostate cancer intervention programs in the United States In the United States, the American Cancer Society has been instrumental in devising strategies and other intervention programs to help people diagnosed with this disease. Efforts towards combating this health challenge have seen the creation of the SEER program (Surveillance, Epidemiology and End Results). This system is well coordinated to aid in data collection on various patient demographics, stages of cancer especially at the diagnosis level, particular cancer markers as well as primary tumor sites. Currently, the SEER program is tasked with collecting cancer registries in population-based areas across the countries. It is estimated that 28% of the United States population have so far been represented in the collection of this demographies with respect to prostate cancer Users of SEER Data In health research, SEER data has become a very important tool not only in the United States, but also in many other countries. Many legislators, policymakers, cancer registrars, clinicians and many other groups have become active consumers of SEER data. SEER data on prostate cancer evaluates the effectiveness of screening programs and other prevention approaches as well as the quality in cancer care approaches, disparities in gender and race as well as other intervention strategies adopted as far as prostate cancer is concerned. It is important to note that the increased importance for SEER data by health experts and other interested groups has prompted the need for proper maintenance and improvement in the quality of data collected. Research data from SEER reports has identified the following data relating to prostate cancer prevalence rates in the United States (Lertkhachonsuk, 2013). The diagram indicates the intervention stages often used in the diagnosis and treatment of prostate cancer cases among the white and the African-Americans Fig 2. Schematic Network diagram for prostate cancer (Chan & Tsokos, 2013) Quality Maintenance in SEER Programs Due to the increased significance for SEER data, quality practice is always not an option; SEER programs have clearly designed systems through which quality and excellence in the data collection exercise is ensured (Lertkhachonsuk, 2013). The program has a Quality Improvement team, which plays a significant role ensuring quality standards are always maintained in the data collected. The functions of this team are varied, they include; evaluating the accuracy and consistency used in coding systems as conducted by cancer registrars, preparation of guidelines and databases used in describing the coding rules as well as standardizing summary writing and medical coding exercises. Additionally, they also help in the training and education of cancer registrars so that they handle their duties effectively and reliably. Parametric analysis of prostate cancer Parametric analysis refers to the branch of statistics, which presupposes that data originates from probability distribution. Depending on the particular probability distribution, we can get information from inference statistics about the specific parameters (Vinceti, 2014). In most cases, it has often been understood that African-Americans have higher chances of getting prostate cancer compared to the whites. To test whether these assumptions is true, we have to identify the respective probability density function, abbreviated as PDF, which characterizes that size of the malignant tumor according to race (Vinceti, 2014). Additionally, other useful information like the perceived size of the malignant tumor beside its confidence limits and variance are developed depending on the particular probability distribution. From this information, it is evident that an exponential growth pattern exists between the chance of the particular tumor being malignant and its respective size. In this analysis, a patient having a tumor with a millimeter of measurement can expect to have up to 99.25% chances of having the tumor being malignant. According to these findings, we can therefore expect that chances for contracting prostate cancer is higher in the whites compared to African American males. Additionally, test results have revealed that all people irrespective of their race have almost equal chances of getting this illness. Pointing to the fact that higher chances for African Americans contracting the disease than whites is merely a myth (Lertkhachonsuk, 2013). In this case, all people should take the responsibility of undergoing medical checks and diagnosis to ensure they are aware of their health status as far as prostate cancer is concerned. Survival Analysis Survival analysis refers to the popular method used in dealing with the failure of various mechanical systems and biological organisms. Overall, survival analysis describes the statistical model that entails time to various event data (Vinceti, 2014). It is important to note that as far as this analysis is concerned, one of its important features is the censoring ability and not necessarily non-normality. The non-normality attribute of the information in this analysis contravenes the normality postulation, which is evident in many of the statistical methods used in research like multiple linear regression (Cho, Timmerman & Kavanagh, 2013). Censoring, as used in survival analysis plays a significant role in the process of defining incomplete data as shown in the analysis exercise. Survival analysis has two important censoring schemes, first is the right scheme; here, individuals in the analysis exercise are assumed to be alive at any point. On the other hand, left censoring indicates that the particular individual has already experienced the particular event at some point. Another significant concept in survival analysis relates to the hazard rate, which is the chance that a particular individual will encounter the event at some point. In this case, the individual has higher chances of getting the event; for this reason, he has to be aware and take the necessary approaches to prevent the severity and impact of the event on his health and life in entirety. The main goal of these two analyses systems is to make comparison between the survivorship rates for patients diagnosed with prostate cancer according to their various treatment regimes (Vinceti, 2014). In the foregone discussion, treatment regimes used in prostate cancer vary depending on the extent of severity and the time the sickness is diagnosed in the particular patient. Overall, these treatment regimes include surgery, radiation therapy, watchful waiting as well as surgery and radiation practices. Prostate cancer prevention It is important to note that the exact cause of prostate cancer among males has remained unknown, although many assumptions have been made regarding the potential causes of the disease (Cho, Timmerman & Kavanagh, 2013). Following this development, males are always advised to undergo regular rectal examination to ascertain their chances of contracting prostate cancer. In addition, they have also been advised to have yearly PSA tests, which are to be taken as soon as they hit 50 years. For those that have a family history of this disease, they should seek early medical examination and begin their PSA tests earlier than the recommended age of 50 (Cho, Timmerman & Kavanagh, 2013). It is important to understand that mandatory screening as recommended for prostate cancer remains to be controversial. This is because; prostate cancer is a slow growing disease and therefore, may not be easily detected in the tests. It is expected that in the future, survival rates for patients suffering from prostate cancer will improve because of advances in research, science and technology. References Chan, Y.M., Tsokos, C. P. (2013). Parametric Survival Analysis: A Comparison of Prostate Cancer Survivorship by Race. International Journal of Mathematical Sciences in Medicine (IJSMS), 1(1), 31-47. Cho, L. C., Timmerman, R., & Kavanagh, B. (2013). Hypofractionated external-beam radiotherapy for prostate cancer. Prostate Cancer. 1(1), 1-11. Lertkhachonsuk A, A, et al. (2013). "Cancer prevention in Asia: resource-stratified guidelines from the Asian Oncology Summit 2013". Lancet Oncology 14 (12), 497–507 Park K. (2014). Prostate cancer: Overexpression of ERG in HGPIN predicts prostate cancer. Nature Reviews Urology. 11(45), 312-9 Qaseem, M.J. et al. (2013). Screening for Prostate Cancer: A Guidance Statement from the Clinical Guidelines Committee of the American College of Physicians. Annals of Internal Medicine, 158(10), I-28. Vinceti, M et al., (2014). "Selenium for preventing cancer." The Cochrane database of systematic reviews 3(5), 34-54: Read More