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Review
. 2008 Feb;54(2):204-10.

Approach to primary care follow-up of patients with prostate cancer

Anna N Wilkinson  1 , Michael D Brundage, Robert Siemens
Affiliations
Review

Approach to primary care follow-up of patients with prostate cancer

Anna N Wilkinson et al. Can Fam Physician. 2008 Feb.

Abstract
in English, French

Objective: To review resources available to aid family physicians in their care of prostate cancer patients and develop an algorithm to summarize these findings.

Sources of information: MEDLINE, EMBASE, and relevant website search. All relevant guidelines were level III evidence.

Main message: Improved screening and treatment of patients with prostate cancer is resulting in an increasing number of survivors. These men require ongoing monitoring, a responsibility that is largely falling to family physicians. We review the expected prostate-specific antigen (PSA) responses to different prostate cancer treatment modalities and provide an appropriate schedule of follow-up and monitoring techniques for prostate cancer patients.

Conclusion: In light of the paucity of resources for family physicians in their ongoing care of prostate cancer patients, we present an algorithm, primarily based on PSA kinetics, for practical use in the continuing care of these patients.

OBJECTIF: Faire le point sur les ressources disponibles pour aider les médecins de famille à soigner des patients atteints un cancer de la prostate et développer un algorithme pour résumer ces constatations.

SOURCES DE L’INFORMATION: MEDLINE, EMBASE et sites WEB pertinents. Toutes les directives applicables présentaient des preuves de niveau III.

PRINCIPAL MESSAGE: Avec l’amélioration du dépistage et du traitement du cancer prostatique, de plus en plus de patients y survivent. Ces patients requièrent une surveillance continue, et cette responsabilité repose en grande partie sur le médecin de famille. Cet article fait le point sur les réponses habituelles de l’antigène prostatique spécifique (PAS) à différents modes de traitement de ce cancer et propose un calendrier de suivi commode et des techniques de monitorage pour les patients.

CONCLUSION: Vu le peu de ressources dont dispose le médecin de famille dans le suivi des patients atteints de cancer prostatique, nous suggérons un algorithme, basé principalement sur les variations du PAS, comme outil pratique dans le suivi de ces patients.

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Figures

Figure 1
Figure 1
Treatment options available for patients with prostate cancer
Figure 2
Figure 2
Care for patients after curative therapy or on active surveillance
Figure 3
Figure 3
Care for patients with systemic disease on watchful waiting or ADT
See this image and copyright information in PMC

Comment in

  • The sounds of silence.
    Kelsall D. Kelsall D. Can Fam Physician. 2008 Feb;54(2):163. Can Fam Physician. 2008. PMID: 18272618 Free PMC article. No abstract available.

References

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    1. American Urological Association. Prostate-specific antigen (PSA) best practice policy. Oncology. 2000;14(2):267–86. - PubMed
    1. National Comprehensive Cancer Network. Clinical practice guidelines in oncology version 2. Fort Washington, PA: National Comprehensive Cancer Network; 2005. [Accessed 2008 January 11]. Available from: www.nccn.org/professionals/physician_gls/PDF/prostate.pdf.
    1. Kawashima A, Choyke PL, Bluth EI, Bush WH, Jr, Casalino DD, Francis IR, et al. Expert panel on urologic imaging. Posttreatment follow-up of prostate cancer. Reston, VA: American College of Radiology; 2005.

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