Prostate cancer treatment under pressure

The sheer number of men being diagnosed with prostate cancer – 47,000 men were diagnosed with the disease in 2015 in the UK – means that the system is now very stretched. Typically, men undergoing surgery like radical prostatectomy only stay a few nights in hospital and are then discharged to recover at home. This may not be a bad thing since patients in hospitals are more likely to pick up hospital-acquired infections and tend to recover more slowly, but it reflects the pressure on managers to make beds available quickly to new patients.

Not surprisingly, more pressure is being put on GPs and nurses in the primary care setting to identify at risk-individuals, counsel them about the pros and cons of having a PSA test, and manage people with prostate cancer during and after treatment. Our charity, Prostate Cancer UK, is committed to helping to support GPs and nurses who want to make sure they are fully informed about this disease and able to offer the right advice and help to men who are on the treatment pathway.

For this reason, we instituted our GP Master classes three years ago which are designed to fill in the gaps for family doctors and community healthcare workers. Although many GPs are now aware of the basics, we are aware anecdotally of doctors who don’t know all the risk factors for prostate cancer, including having a direct line relative who has had the disease, such as a father or brother. This means they are two and a half times more likely to get prostate cancer than men who don’t have a familial connection. It is also the case that one in four Black men will be diagnosed with prostate cancer in their lifetime, yet doctors may not realise the significance of ethnicity when it comes to diagnosing this disease.

Master classes can also help GPs make the most of short appointment times and help them to learn best practice for managing longer term illness and men who are in recovery.
The good news is that so many more men with prostate cancer are surviving longer. Over the last few years, we have been able to tackle advanced disease with a new range of therapeutic drugs which don’t just lengthen life span but also improve quality of life for patients.

In the past, when a man reached a point when prostate cancer became resistant to hormone therapy – the gold standard treatment – there was not much to be done except for offering palliative care.

GPs now need to know how to manage patients with advanced disease which is under control, and in particular, deal with the side effects of their treatment as they arise.

There are also a growing number of community-based initiatives which are ensuring that patients can receive care closer to home. This includes local nurse-led clinics for men with stable prostate cancer and more clinics in rural areas.

Going forward, personalised medicine for individual prostate cancer patients will become routine. At some point, we will know exactly what medication will help a patient and there will be no need for trial and error. GPs and nurses will be at the centre of this evolution and our aim is to ensure that they are fully prepared for the challenges now and to come.

https://prostatecanceruk.org/