Abstract
BackgroundIn its 2006 report, From cancer patient to cancer survivor: lost in transition, the U.S. Institute of Medicine raised the need for a more coordinated and comprehensive care model for cancer survivors. Given the ever increasing number of cancer survivors, in general, and prostate cancer survivors, in particular, there is a need for a more sustainable model of follow-up care. Currently, patients who have completed primary treatment for localized prostate cancer are often included in a specialist-based follow-up care program. General practitioners already play a key role in providing continuous and comprehensive health care. Studies in breast and colorectal cancer suggest that general practitioners could also consider to provide survivorship care in prostate cancer. However, empirical data are needed to determine whether follow-up care of localized prostate cancer survivors by the general practitioner is a feasible alternative.MethodsThis multicenter, randomized, non-inferiority study will compare specialist-based (usual care) versus general practitioner-based (intervention) follow-up care of prostate cancer survivors who have completed primary treatment (prostatectomy or radiotherapy) for localized prostate cancer. Patients are being recruited from hospitals in the Netherlands, and randomly (1:1) allocated to specialist-based (N = 195) or general practitioner-based (N = 195) follow-up care. This trial will evaluate the effectiveness of primary care-based follow-up, in comparison to usual care, in terms of adherence to the prostate cancer surveillance guideline for the timing and frequency of prostate-specific antigen assessments, the time from a biochemical recurrence to retreatment decision-making, the management of treatment-related side effects, health-related quality of life, prostate cancer-related anxiety, continuity of care, and cost-effectiveness. The outcome measures will be assessed at randomization (≤6 months after treatment), and 12, 18, and 24 months after treatment.DiscussionThis multicenter, prospective, randomized study will provide empirical evidence regarding the (cost-) effectiveness of specialist-based follow-up care compared to general practitioner-based follow-up care for localized prostate cancer survivors.Trial registrationNetherlands Trial Registry, Trial NL7068 (NTR7266). Prospectively registered on 11 June 2018
Highlights
In its 2006 report, From cancer patient to cancer survivor: lost in transition, the U.S Institute of Medicine raised the need for a more coordinated and comprehensive care model for cancer survivors
This multicenter, prospective, randomized study will provide empirical evidence regarding the effectiveness of specialist-based follow-up care compared to general practitioner-based follow-up care for localized prostate cancer survivors
In order to care for the needs of the increasing number of prostate cancer survivors, a more comprehensive and sustainable follow-up care model is necessary
Summary
In its 2006 report, From cancer patient to cancer survivor: lost in transition, the U.S Institute of Medicine raised the need for a more coordinated and comprehensive care model for cancer survivors. Given the ever increasing number of cancer survivors, in general, and prostate cancer survivors, in particular, there is a need for a more sustainable model of follow-up care. Empirical data are needed to determine whether follow-up care of localized prostate cancer survivors by the general practitioner is a feasible alternative. Cancer survivorship care is facing challenges due to an increase in cancer incidence, improved detection, and improved survival rates [3]. In the United States, there are currently over 3 million prostate cancer survivors; in the Netherlands this is about 86.000 [5, 7]
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