NP Wonders If PSA Testing Recommendations Are Correct?

I have been seeing the seemingly new recommendations that we are being too aggressive with the current PSA testing for men over 50. The logic behind the new recommendation is that we are testing too soon and too often in men that are healthy. Most prostate cancers are very slow movers and most doctors say that something else is more likely to kill the patient than the prostate cancer itself.
Most of the time elevated PSA means that there is a benign enlargement or that there is an infection in the prostate giving artificially high numbers. I am of the mind that if a patient is having urinary hesitancy, I will test the PSA level. If it's elevated, the first thing I do is a round of Cipro for 2 weeks and recheck the level. If it moves downward, it's not prostate cancer. If it continues to climb, I make a referral to urology and let them make the final call.

Most of the prior thought process is based on the age expectancy of around 70-75. Well...I have another issue. Men are living until their late 90's now. If I find an elevated PSA at 50 and I ignore it for a long time and it breaks into their bladder or bowel and kills them before their time, I would feel rather neglectful. I certainly don't want to have a painful cancer that could have been prevented. Would you?

I have also seen the reports that the treatments are bad for men's sex life. Sorry to tell you but so is death! I think that being healthy without sex is more important. I understand that most men find their sex drive to be all important but at the age of 70 plus, who really is worried? Certainly not their wives who have already been past menopause and have lost the urge a LONG time ago. I think that they would much rather have their husbands to spend quality time with in other areas.

What say you?

Nurse Practitioner Has A New Student

I received a call the other day from our HR department asking if I would like to precept a student. I was practically giddy with excitement! Yes, I love students. Too often I hear that there are not enough preceptors out here and wonder why we are so hard to find. I was lucky enough to find three different nurse practitioner preceptors and around five doctors. I would have preferred to have all NPs but I am glad that I saw the differences and similarities by using both.

You don't have to have many years experience for most to use you as a preceptor. Most will accept one year. You also don't have to be in a specialty. I work in a Rural Health office as a Family NP. Help out a local student in your area. It will help you brush up on things and you can give the pointers that you wish that you had as a student.

Do you precept? Why or why not?