The American Cancer Society (ACS) recently released its Prostate Cancer [PCa] Survivorship Care Guidelines, designed to address posttreatment services for the estimated 2.8 million men in the United States affected by the disease.
Published in CA: A Cancer Journal for Clinicians (2014;64:225-249), the guidelines include the following recommendations for primary-care providers:
- Regularly measure the body mass index of survivors and recommend reduced intake of high-calorie items for overweight or obese men.
- Instruct survivors on the link between physical activity and lower overall mortality, lower PCa-specific mortality, and improved quality of life.
- Because smoking after prostate cancer treatment raises the risk of recurrence, assess survivors for tobacco use and refer users to smoking-cessation resources.
Because the type of information and support men require changes as they move from treatment through stages of survivorship, evaluate these needs frequently and offer the appropriate resources.
Note that the National Comprehensive Cancer Network recommends measuring serum levels of prostate-specific antigen (PSA) every 6 to 12 months for the first 5 years after treatment, and then annually.
Note that because radiation therapy carries a small, increased risk of second primary cancers compared with surgical treatment, routine ACS screening guidelines for early detection of new cancers are recommended.
Evaluate survivors for physical (e.g., urinary, sexual, bowel) and psychosocial effects of prostate cancer and its treatment. As many as 30% of men with prostate cancer report clinically relevant general distress, 25% have increased anxiety, and nearly 10% experience major depressive disorder.