Table of Contents
Introduction
Prostate cancer incidences are on the rise in the UK but analyzed statistics of the disease are scanty. Essentially, prostate cancer is a predominant type of cancer amongst the men, and has contributed to high mortality rates in modern times overtaking breast cancer. It is estimated that around 11,819 men lose their battle to the disease in every year. Prostate cancer accounts for about 26% of all the diagnoses of the cancers that affect men (Gospodarowicz et al., 2017). The rate at which people die because of cancer has decreased in all age categories in the UK. Necessarily, there are no differences in the rate of mortality between the people who are deprived and those that are endowed with the wealthy in the society (Center et al., 2012).
Black men are vulnerable to deaths related to prostate cancer compared to their counterparts who hail from Pakistan and Bangladesh (Rosen et al., 2006). Diagnoses of the prostate cancer disease have increased in contemporary times because of PSA testing. Incidence rates have been on the rise in some urban areas which are populated by the ethnic minorities such as the black community. Notably, there is variation regarding the social and personal factors in mortality rates of prostate cancer in the UK. An observation of the UK demographics shows that in general deaths as a result of prostate cancer are increasing because of the aging population. The differences that were associated with economic conditions of particular regions in the UK are insignificant today. The large percentage of deaths occur to men in the age bracket of 80 years and above, but this trend has been declining steadily due to efforts by the government on early testing as part of health policy (Burke and Friedman,2011). Noteworthy, the less deprived regions in the UK may have high mortality rates because of the location of specialized care services and testing. Hence, diagnosis is made when the cancer is in late stage.
Literature Review
Heath determinants are a crucial aspect that relates to the individual, community, society and the environment that make people vulnerable to ill-health. This can be exemplified by a fact in life in which people from low socio-economic backgrounds have a high likelihood experiencing worse off health conditions compared to their counterparts from high socio-economic regions (Kheirandish and Chinegwundoh, 2011). The inequalities in health are widened due to factors such as old age when diseases such as prostate cancer are diagnosed among men (Jemal et al., 2012). The cumulative life conditions of people from different backgrounds affect the overall outcomes later in life which is more evident for people from economically deprived regions in the UK.
The risk factors that expose men to prostate cancer have not over time been appropriately studied, but the western countries such as the UK have high incidences. The current research on prostate cancer has not given convincing findings on the possible lifestyle factors that lead to the high prevalence of the disease. However, there is a genetic predisposition to people whose family members were diagnosed with the disease at a young age (Fleming and Parker, 2014). These cases are mainly because of a genetic problem as opposed to an environmental problem and the investigations on the disease in this case focus on the alterations in the genes of the old people.
The health social model according to Dahlgren and Whitehouse is caused by many determinants emanating from the relationship between the environment, individual and the disease affecting them. Individuals are placed at the center, and they possess a set of genes that are fixed. Other aspects that influence health can be modified, and this is represented by a first layer which consists of personal behavior that put men at the risk of getting prostate cancer condition (Dahlgren and Whitehead, 1991). Health inequalities between the rich and the poor are significantly influenced by the tobacco smoking habits. The economic and social circumstances of people play a significant role in their access to quality healthcare and for testing on terminal diseases such as prostate cancer.
The outcomes that are related to prostate cancer have been directly related to the social-economic situation of the people that are affected by the ailment. Development needs that are essential to households in the UK such as good education, income and a source of livelihood influence the health decisions that people make. The mortality rates and the survival outcomes for prostate cancer are inter-linked with the social-economic status (Wilt et al., 2012). The people that have developed health-seeking behaviors are mainly conscious of their environment and are highly educated.
The layer of community and social influences by Dahlgren & Whitehead is relevant in explaining the reason why there is a high prevalence of the disease among the blacks and whether social relationships play a role in making these men vulnerable(Dahlgren and Whitehead,1991). The issue of willingness to access treatment and the location of health facilities are fundamental in explaining the variation in mortalities among different ethnic groups. Poor literacy among the economically deprived populations in the UK is a central factor in testing because most people from these regions access screening services when cancer is at an advanced stage (Roehrborn and Black, 2011). The community is supposed to give the social support, but in most cases, the men that are affected are alienated especially in low-income areas and parts of UK that have poor education levels.
The community influence is an important element in the decision-making process for men who want to test on their status about prostate cancer. Social forces and individual traits are impactful, and hence, health professionals must be helpful in ensuring the social environment is supportive in campaigning for screening in the areas that have low screening rates. The social circle that should be consulted include the friends, family and health professionals that were involved in screening. The understanding of the role that the community and family play in the intervention programs in treatment, screening, and identification of new risks associated with the disease is important. The community space will be an important channel for mass education of the dynamics of prostate cancer and the various risk factors that different segments of the society are exposed to, regarding lifestyle, genetics and how health professionals can help them in adopting preventive measures (Cuzick et al., 2014).
Evidently, there is an ethnic aspect of prostate cancer but how this dimension affects the behavior of men from different background about screening has not been researched. Evidence available in the UK validates the argument that interaction with a particular environment, genetic and culture is responsible for the high cases of late diagnosis among black men, hence, high mortality rates (Loeb et al., 2014). Essentially, the poor health services in areas occupied by ethnic minorities in the UK and ignorance by these men on cancer symptoms has resulted in high prevalence. Differential access to cancer screening services is a main challenge in the UK because it is related to social problems such as stereotypes, cultural barriers, and racism (Cuzick et al., 2014). Cultural practices and men`s conception of their masculinity prevents them from seeking medical help because of notions that are baseless. The men are unable to develop help-seeking behavior because they prefer protecting the image of their masculinity in the society (Rebbeck et al., 2013).The performance and other aspects involved in the construction of masculinity can be traced to choices on lifestyle, diet habits and other rituals that are common among different ethnicities which may predispose men to prostate cancer.
The identification of these needs raises essential policies needs that must be implemented in the UK with a particular focus on the various factors that are recognized as contributors to high prevalence. These elements may be structured such as lack of gainful economic preoccupation and affordability of health services being provided to economically deprived areas in the United Kingdom (Torre et al., 2015). The best way to achieve better health outcomes in the UK is campaigns meant to inform men on the advantages of help-seeking habits in early detection of prostate cancer. The intervention by medical professionals must focus on competent research to understand the variations in outcomes on different diversities (Gundem et al., 2015). The study of masculinity as a concept that is embedded in society in differing ways and its influence on men about seeking services that are related to prostate cancer is important.
Public Health Approaches to Prostate Cancer
Structural Approach
What has the government done to help emergent issues in testing prostate cancer?
Structural factors that revolve around the reforms that are necessary for UK`s health sector relate to proper medical care services and other facilities that are needed by the deprived populations in the UK. The structural approach delves into the relationship between the community and systems established for healthcare in a particular region. The sociopolitical influences that help men to ignite their interest in help-seeking behaviors are mainly because of the structural approaches to intervention in community-based health (Gigerenzer et al., 2009). Furthermore, the health factors that act as deterrent or encouragers to men behavior on seeking knowledge related to prostate cancer is credited to mass campaigns in communities on the need for screening and early diagnosis of the disease.
The National Health Management Service in the UK has developed structural measures that are meant to better the PSA testing programs for men susceptible of having prostate cancer. The objective is to avail information to professionals that give primary care that are involved in giving counsel to asymptomatic males that aged 50 years and above and in most cases they request for PSA testing. Currently, the PSA testing administered for prostate cancer do not meet the standards set for the national screening program. The risk management program initiated by NHS (National Health Service) is timely as regards giving information to the primary care professionals that is evidence-based. Furthermore, an independent panel has been established among the clinical experts in an effort on elements of PSA testing that need improvement by building evidence through consensus as part structural change to address challenges of testing prostate cancer.
Currently, there is no proper support system for men who want to go for PSA testing because there are many pros and cons that are involved hence discouraging them from accessing medical services on prostate cancer (Gundem et al., 2015). The integration of the health care services, in particular, is to the community being served is important as the complexities that usually normal at pre-diagnosis stage will be addressed. The main focus of the current health policy that is employed in the UK is on the PSA test (Hickson, 2013). The aim is to arrest the disease in an early stage, provide the appropriate treatment procedure and extend the life of the patient. The structural approach is hinged a policy change to enhance the spread of information regarding the benefits of men testing for prostate cancer early to prolong their lives.
Settings within the structural approach
The structural approach is in essence meant to improve the treatment procedures by developing the systems that are involved. The betterment of the PSA test as the diagnostic tool is important to avoid cases of overtreatment and over-diagnosis (Sweeney et al., 2015). Asymptomatic men who are curious to know their health status must be provided with concise information to make choices. The information must be specific to the benefits the patient will derive from taking a PSA test, the treatment procedures that are undertaken for prostate cancer and the biopsy (Tao et al., 2015). Essentially, this will enable them to make an informed choice regarding their health status and the entire procedure of taking the test for prostate cancer.
The structures that are created with the interaction between the health professionals and the community are crucial in the identification of people that are at great risk of acquiring the disease compared to the average of a particular area. Issues relating to the common fear of the disease will be addressed by the community health officials as part of the campaign to reach out to the male population in the UK (Parvanta, 2010). Furthermore, the basic settings are necessary because they aid in enhancing the scientific evidence that legitimizes the testing and treatment procedures that are adapted for prostate cancer disease (Riegelman and Kirkwood, 2014). More significantly, the medics are in a position to interact with men while giving relevant information on the potential impacts of cancer treatment complications that may have a bearing on their life.
Behavioral Approach to Prostate Cancer
Psychosocial care is an important element of oncological services with an approach that delves on how men react psychologically to a diagnosis of cancer. Possible experience after a definite diagnosis of prostate cancer presents a man with a threat to their social life, body integrity, and professional security which results in a lot of distress. An important element of treatment is to ensure that there is distress screening to help them in dealing the psychological needs that arise out of fear and uncertainty over their condition (Boron and Boulpaep, 2012). Furthermore, men with prostate cancer may have suicidal thoughts and an unhealthy lifestyle to cope with the psychological toll of the disease. Cancer survivors in modern times have led to a review into some of the conditions of the disease as to be chronic rather than acute. Modern methodological tools are used in monitoring the systems of influence that are central in the establishment of a support system that will help the prostate cancer patients to cope with the condition (Kheirandish and Chinegwundoh, 2011). High cancer mortality rates and the progression of the disease have been associated with the change of change of the social sphere through isolation, trauma and other stressful events that face prostate cancer patients.
Prostate Cancer Interventions
The current intervention programs in the UK relate to research and a change in policy with an effort of coming up with more effective diagnosis process. A consensus has to be drawn about PSA testing and whether it is ideal and what modifications that can be done to this diagnostic tool. The accessibility and availability of the prostate cancer treatment procedures in the UK is a major issue that has resulted to health inequalities in this country, by focusing on the economically deprived areas in this country (Rosen et al., 2006). The commissioning process of the drugs that needed by prostate cancer patients is important, and this can be made seamless through cooperation between various stakeholders such as the health department, charity organizations, and pharmaceutical companies.
Other interventions focus on the side effects of treatment such as erectile dysfunction and with the introduction of updated guidelines for treatment early treatment can enhance sexual function (Burke and Friedman, 2011). The priority regarding health policy about prostate cancer is coming up with risk assessment tool that can apply across the board. The other element that has been identified as an essential goal is the ability of the medical professionals in differentiating prostate cancer that is aggressive and the non-aggressive one (Gigerenzer et al. 2009). Another goal by the researchers in this disease is developing advanced treatment procedures for prostate cancer in late stage.
SWOT Analysis of the various approaches to Prostate Cancer
Structural Approach
Strength
The primary strength in using this approach lies in the development of systems for a relationship between the communities as the recipient of health services and the institutions hence creating a network for information sharing. This can be exemplified by the current strategy in the UK where research communications have given insights on obesity to be a risk factor that exposes men to prostate cancer.
Weakness
The major weakness associated with the structural approach is that there has to be an initiative by the government to make it operational (Gofin, 2010).
Opportunity
This method presents an opportunity in which the oncologists can encourage men to take up responsibility for their general body health.
Threat
The main threat to this strategy is lack of cooperation from the government in expanding the health infrastructure to deprived areas in the UK.
Settings
Strength
The UK government has established budgets to fund efforts in research to come up with better solutions which are a major strength of the health department.
Weakness
However, the current systems have an obstacle due to the aspect of masculinity among men to consult health professionals on prostate cancer (Parvanta, 2010).
Opportunity
The UK government has an opportunity by investing in a strategy that will ensure a healthy male population for the prosperity of the nation.
Threat
Threats will be alleviated by ensuring there is proper research on the procedures that are accepted as guidelines by the medics.
Behavioral Approach
Strength
The approach ensures that the psychological well-being of a prostate cancer patient is enhanced during the diagnosis and treatment process.
Weakness
A weakness that is associated with the approach is lack of supporting evidence of the role it plays in treatment.
Opportunity
However, there is an opportunity for the medics to do intensive research as a lot of men are suffering from prostate cancer and do not have access psychosocial care (Frame and Cant, 2015).
Threat
A common threat with this approach is that it has a preventive solution but cannot apply to the healing process of cancer which requires medical procedures.
Managing Prostate Cancer through Policies
The model of health policy that was applied in theory by Dahlgren and Whitehead about a social-ecological approach is employed in this strategic plan to improve the experiences of men who have prostate cancer within the UK. The strategies that guide this policy include research on better treatment procedures, modern diagnosis methods, social support and prevention which is necessary because of research that predisposes men to risks of having this medical condition. Research has established that obesity is a possibly one of the risk factors that expose men to prostate cancer which is a crucial measure in prevention (Ali et al., 2017). Furthermore, there is a realization that drugs used in the treatment of other types of cancer can be repurposed with beneficial results to prostate cancer patients hence reducing the overall cost of treatment.
The other policy areas that will be instituted in the strategy will focus on assessment for the various risk factors that men are exposed to about prostate cancer by use of methods that have been validated over time. The tools will play a fundamental role in filtering men that do not need to undergo testing and ensuring that those who are diagnosed with the disease get proper medical care. The testing tools that are used by the health facilities in the UK must contribute in deriving a practical value which administering treatment to men (Marmot and Bell, 2012). Effective diagnostic tools enable me to access the best services for the management of the disease. Improvement of diagnosis will help in identification of the existence of prostate cancer in the body and essence; give the medics a perspective on whether the disease will harm the patient (Klein et al., 2014). The policy obstacle in contemporary times is the development of technology that can help in screening prostate cancer. The aim of the government in the development of the policy is the detection and diagnosis of cancers that are considered to be aggressive in the first stage so as to reduce the mortality rate.
Conclusion
Procedures involved in prognosis are meant to identify the possibility of the cancer being aggressive and hence the health professional will give the patient information on how the treatment procedure will be undertaken. Additionally, the initiative to monitor the process of treatment will provide great insight on the alternatives that should be provided in the administering of treatment. Patients must be provided with balanced information which is crucial in the decision-making process and the government as part of the policy directive must make the cancer drugs readily available to all the men in the UK suffering from prostate cancer.
Evidently, in the UK men do not receive the crucial support system for them to cope with the side effects of treatment. The government should upscale campaigns meant to educate the public on the need to offer social support to the cancer patients (Roehrborn and Black, 2011). Noteworthy, the government must encourage medical scholars to take an interest in research on this area as there shortage of clinicians studying the dynamics of prostate cancer. Multi-Faceted research that borrows knowledge from other disciplines and conversion of research results into tangible benefits that will be impactful to the patients is the main focus of the future while dealing with problems on prostate cancer.
The UK government must continually invest in the healthcare to increase the number of professionals that are dealing the prostate cancer that has become a modern scourge in the country. The research objectives must be reduced the impact of prostate cancer on families and make it manageable to live with. The policy perspective adopted by the government highlights the main issue that we reduce prevalence in the different demographic diversities that are existent in the United Kingdom. Every man in the society must have access to affordable and best care for the government to realize the desired health outcomes (Mohler et al., 2010).The new models of treatment that are socio-ecological must be cost-effective to have a dominant influence in changing the behaviors of low-income areas in the UK to adopt health-seeking habits as a priority in their daily lives. Conclusively, information that has been published in this area of medicine must be open to becoming public knowledge in enhancing the health status of men in the UK.
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