[Photograph of African American patient lying in bed] (2018). Retrieved from https://corporate.dukehealth.org/news-listing/black-patients-show-stronger-response-hormone-therapy-prostate-cancer
A 72-year-old African American man, H.C., presents in the emergency room for concern of dysuria and abdominal tenderness. H.C. states he does not like going to the hospital or seeing the doctor, but he is now fatigued because he is awoken several times during the evening to urinate. The wife explains that this has been progressive in severity for the past several months.
H.C. has a Past Medical History of benign hypertension, hyperlipidemia, gastroesophaeal reflux disease (GERD), and a urinary tract infection twice within the last two years.
H.C.’s only Past Surgical History was a vasectomy in 1990.
Social History
H.C. is a retired mailman and is a proud Army Veteran. His wife adds that he wanted to keep working but he said he was just too tired to keep up with the needs of his route. He lives at home with his wife. He is the father of three children.
Familial History
H.C. is youngest of four children in his family. He stated his family has overall been healthy, but reports that his older brother died from cancer last year and says that his mother died of breast cancer when he was in college. He also states his father just recently was discharged from cardiac rehabilitate after a coronary artery bypass graft (CABG).
Chart Review
H.C. admits to not going to his primary care physician often, but when he was last there two years ago, he did not have issues with urination. During his urgent care visit, his physician ordered a PSA level which resulted at 3.4 ng/mL in July 2019.
Further Assessment Plans and Additional Laboratory Studies Ordered
- Abdominal exam with auscultation and palpation
- Digital Rectal Exam
- Prostate Specific Antigen Test
- Urinalysis with reflex culture
- Prostate Tissue Biopsy
- Hormone Testing (serum testosterone, free testosterone, luteinizing hormone and follicle-stimulating hormone)