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License for Use of "Physicians' Current Procedural Terminology", (CPT) Fourth Edition

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Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized here in must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60610. Applications are available at the AMA websiteExternal Website.

This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2)(June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a)(June 1995) and DFARS 227.7202-3(a)June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department Federal procurements.

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CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. AMA warrants that due to the nature of CPT, it does not manipulate or process dates, therefore there is no Year 2000 issue with CPT. AMA disclaims responsibility for any errors in CPT that may arise as a result of CPT being used in conjunction with any software and/or hardware system that is not Year 2000 compliant. No fee schedules, basic unit, relative values or related listings are included in CPT. The AMA does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this file/product is with CGS or the CMS and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This Agreement will terminate upon notice if you violate its terms. The AMA is a third party beneficiary to this Agreement.

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The scope of this license is determined by the AMA, the copyright holder. Any questions pertaining to the license or use of the CPT must be addressed to the AMA. End Users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL CONTAINED ON THIS PAGE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.

This license will terminate upon notice to you if you violate the terms of this license. The AMA is a third party beneficiary to this license.

POINT AND CLICK LICENSE FOR USE OF "CURRENT DENTAL TERMINOLOGY", ("CDT")

End User License Agreement

These materials contain Current Dental Terminology, Fourth Edition (CDT), copyright © 2002, 2004 American Dental Association (ADA). All rights reserved. CDT is a trademark of the ADA.

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  1. Subject to the terms and conditions contained in this Agreement, you, your employees, and agents are authorized to use CDT-4 only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. Use of CDT-4 is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT-4. You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights notices included in the materials.
  2. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT-4 for resale and/or license, transferring copies of CDT-4 to any party not bound by this agreement, creating any modified or derivative work of CDT-4, or making any commercial use of CDT-4. License to use CDT-4 for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611. Applications are available at the American Dental Association websiteExternal Website.
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September 1, 2021 - Revised: 06.03.22

September is National Prostate Cancer Awareness Month

September is recognized as National Prostate Cancer Awareness Month. According to the American Cancer Society (Key Statistics for Prostate Cancer | Prostate Cancer Facts, 2021):

  • Other than skin cancer, prostate is the most common cause of cancer in men.
  • Prostate cancer is the second leading cause of cancer death in the US among men.
  • An estimated one in every eight men will be diagnosed with prostate cancer sometime in his lifetime.
  • Around one in every 41 men will die from prostate cancer.
  • In 2021, an estimated 248,530 new cases of prostate cancer will be diagnosed and an estimated 34,130 men will die of prostate cancer.

However, with early screening , diagnosis, and treatment, most men diagnosed with prostate cancer do not die from it.  National Prostate Cancer Awareness Month presents an excellent opportunity to promote awareness of the importance of prevention, screening, early detection, and treatment of prostate cancer.

Signs and Symptoms

  • Signs and symptoms include:
    • Urinary issues (slow or weak stream, difficulty with initiating urination, increased frequency with nocturia, difficulty with completing emptying bladder, dysuria, and hematuria)
    • Reproductive issues (erectile dysfunction, blood in semen, and painful ejaculation)
    • Musculoskeletal issues (persistent pain in back, hips, pelvis, and chest, weakness and numbness in legs and feet)
  • During the early stages of prostate cancer, the patient may not present with any symptoms.
    • It is important to rule out other causes of these symptoms as some of these symptoms can point to other conditions such as benign prostatic hypertrophy or urinary tract infections.

Risk factors

  • There are several categories of risk factors for prostate cancer including age, race/ethnicity, family history/genetics, geographical region, and inherited gene traits.
  • It is also important to note that men that have been diagnosed with prostate cancer are more at risk for developing secondary cancers such as small intestine cancerExternal Website, bladder cancer, thyroid cancer, thymus cancer, soft tissue cancer, and melanoma of the skin and men that have received radiation therapy as treatment for prostate cancer are more at risk for developing rectal cancer and acute myeloid leukemia (After Treatment: Second Cancers After Prostate Cancer, 2020).

Screening, and Diagnosis

  • The Medicare-covered preventive screening tests used for detecting prostate cancer are the prostate-specific antigen (PSA) blood test and the digital rectal exam (DRE).
    • The prostate-specific antigen (PSA) blood test detects the level of prostate-specific antigen of the blood.
    • As the PSA levels go up, the likelihood of a man having prostate cancer goes up. However, there is no definitive number to determine what level the PSA needs to be to conclude whether the man has prostate cancer or not.
    • If the PSA levels are determined to be elevated, the physician may advise the patient to wait then repeat with a second PSA test, perform digital rectal exam (DRE), perform additional testing such as specialized type of PSA testing or imaging tests (MRI or ultrasound), or order a biopsy of the prostate.
  • During the digital rectal exam (DRE) , the physician performs a rectal exam to palpate for any lumps, bumps, or hardened areas on the prostate that may be indicative of cancer.
  • If the results of the prostate-specific antigen (PSA) blood test and the digital rectal exam (DRE). determine that cancer may be present, a biopsy is usually recommended for further analysis of the prostate.

Treatment

The stage of the cancer determines the treatment that will be given for the prostate cancer.  Treatment options include continuous monitoring of prostate and its disease progression, prostatectomy, radiation therapy, chemotherapy, hormone therapy, cryotherapy, biological therapy, and high- intensity focused ultrasound.

Prevention

There are several interventions health care providers can take to promote prostate health and assist their patients with prevention of prostate cancer.

  • Encourage your patients to schedule annual wellness visits and screenings.
    • Medicare covers prostate cancer screening (prostate specific antigen test-PSA and digital rectal screen-DRE) for beneficiaries aged 50 and over. Discuss prostate cancer screening with your patients and encourage them to take advantage of this Medicare-covered preventive service.
  • Discuss with your patients about prostate health including risk factors for prostate cancer.
  • Educate your patients about the importance of staying active and regularly exercising.
  • Educate your patients about eating a well-balanced diet. A healthy diet should:
    • Include plenty of fruits, vegetables, and whole grains
    • Be low in salt, fat, cholesterol, and excess sugar
    • Limit (or avoid) the amount of red meats and highly processed foods consumed
  • Discuss risks and benefits of all vitamins and supplements taken.
  • Consider the addition of medications that may reduce the risk of prostate cancer, such as 5-alpha reductase, if determined necessary.

To learn more about Medicare-covered services, visit CMS Preventive Services External Website

For More Information

References

  1. After Treatment: Second Cancers after Prostate Cancer. (2020, June 9). American Cancer Society. https://www.cancer.org/cancer/prostate-cancer/after-treatment/second-cancers.htmlExternal Website
  2. Key Statistics for Prostate Cancer | Prostate Cancer Facts. (2021, January 12). American Cancer Society. https://www.cancer.org/cancer/prostate-cancer/about/key-statistics.htmlExternal Website
  3.  Prostate Cancer Risk Factors | cancer.org. (2020, June 9). American Cancer Society. https://www.cancer.org/cancer/prostate-cancer/causes-risks-prevention/risk-factors.htmlExternal Website
  4. Prostate Cancer | Prostate Cancer Information and Overview. (n.d.). American Cancer Society. https://www.cancer.org/cancer/prostate-cancer.htmlExternal Website
  5. What Are the Symptoms of Prostate Cancer? | CDC. (2020, August 18). Centers for Disease Control and Prevention. https://www.cdc.gov/cancer/prostate/basic_info/symptoms.htmExternal Website

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