Prostate cancer follow-up needs: do patients and professionals agree?

Abstract

With recent changes in the economy and the drive for cost-effective health care, current practices in the NHS need to be reviewed and revised. In light of this, the aim of this study is to investigate the perceived benefits of routine follow-up of patients with prostate cancer and to examine perceptions of prostate cancer patients and health professionals about who should follow-up patients and where and when this should take place. A service evaluation was carried out on a sample of patients receiving follow-up assessment following radical treatment for prostate cancer and health professionals in a specialist cancer urology unit in an acute NHS trust in south-east England. Data were collected through patient (n=47) and health professional (n=17) questionnaires and through a group discussion with a sample of patients (n=52). There was agreement between patients and professionals that the main purpose of follow-up consultation was to review the prostate-specific antigen (PSA) blood test and assess urinary symptoms. The majority of patients and professionals wanted follow-up in the hospital with face-to-face consultation. There was general agreement that assessments should be carried out every six months. An overwhelming majority of patients (95%) felt that it was important to have easy access to the urology cancer nurses and doctors. Patients want to maintain the traditional model of hospital based follow-up in specialist urology cancer clinics. However, this approach is not economically sustainable. If this is to change we need to work with our patients to develop a service that meets their needs. For a new approach to follow-up to meet the needs of patients, they need to be confident that they have access to expert advice and support, and are assured of referral back to the urology team if required. Nurses are ideally placed to play a key role in the development of such a service.