[new2hospiceRN]

I have a pt with a PSA of 6.9. He is not able to tolerate surgery or biopsy. The family doesn't want to seek tx. With no pathology should he be on Hospice? His family says he has prostate ca, but how can they know this without a biopsy. I ran it by my supervisor and they want the pt admitted. I plan to speak with the Urologist. How bad does the PSA need to get to be terminal or is it not reliable in giving an estimated life expectancy. Is it possible for the PSA to be used alone to qualify a person with Prostate ca for Hospice?

[earle58]

Originally Posted by new2hospiceRN

I have a pt with a PSA of 6.9. He is not able to tolerate surgery or biopsy. The family doesn't want to seek tx. With no pathology should he be on Hospice? His family says he has prostate ca, but how can they know this without a biopsy. I ran it by my supervisor and they want the pt admitted. I plan to speak with the Urologist. How bad does the PSA need to get to be terminal or is it not reliable in giving an estimated life expectancy. Is it possible for the PSA to be used alone to qualify a person with Prostate ca for Hospice?

it can also be bph or prostatitis.
without a definitive dx (bx), there isn't any way of knowing if it's prostate ca.
furthermore, if it's a slow growing ca, he can live for yrs.
just on psa alone, he would not be qualified for the hospice benefit.

leslie

[doodlemom]

Increased PSA does not mean that the guy has prostate cancer. You need proof before admitting him.

[Allow Mystery]

You may want to pursue why patient is not able to tolerate
surgery or biopsy, possibly may find dx that will qualify for
hospice. Happy hunting!

[new2hospiceRN]

Thanks!! I think my gut was telling me that. I have found that sometimes Corporate is only thinking about the #'s.

[new2hospiceRN]

He is Diabetic and a Stroke pt. He isn't rapidly declining. Continent of u/b. His appetite is decreasing , but not any significant weight loss. We also have Home Health, I think that is what he needs at this point.