New Guidelines Address Long-Term Needs of Prostate Cancer Survivors
New American Cancer Society Prostate Cancer Survivorship Care guidelines outline post-treatment clinical follow-up care for the myriad long-term and late effects that an estimated 2.8 million prostate cancer survivors in the United States may face.
The guidelines, published in the American Cancer Society’s CA: A Cancer Journal for Clinicians, are designed to promote optimal health and quality of life for prostate cancer survivors by facilitating the delivery of comprehensive post-treatment care by primary care clinicians. Based on recommendations set forth by an expert panel convened as part of the work of the National Cancer Survivorship Resource Center, the guidelines address health promotion, surveillance for recurrence and screening for second primary cancers, and the assessment and management of physical and psychosocial long-term and late effects of prostate cancer and its treatment.
The following recommendations for primary care clinicians are included in the guidelines:
♦ Since information needs evolve as men transition from treatment through various stages of survivorship, regularly assess survivor and caregiver information needs and provide or refer to information and support services as necessary.
♦ Evaluate survivors regularly to determine appropriate levels of participation in health promotion and lifestyle modification programs.
♦ Routinely assess body mass index among survivors, and recommend that survivors who are overweight or obese limit their consumption of high-calorie foods and beverages.
♦ Educate survivors on the association between physical activity and lower overall and prostate cancer-specific mortality and improved quality of life.
♦ Because smoking after prostate cancer treatment increases the risk of cancer recurrence and second cancers, ask survivors about tobacco use, and offer or refer them to cessation counseling and resources as needed.
♦ Measure PSA levels every six to twelve months for the first five years after definitive treatment, and then recheck annually.
♦ Be aware that men who have had radiation treatment have a slightly increased risk of developing second primary cancers compared to men who underwent surgery. Adhere to routine ACS screening guidelines for the early detection of any new cancers.
♦ Assess physical (urinary, sexual, bowel) and psychosocial effects of prostate cancer and its treatment; the focus of assessment should be tailored to the type of cancer treatment received and current disease state to trigger appropriate self-management and clinical management strategies for support and therapy.
♦ Identify, treat, and routinely assess survivors for psychological distress.
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This article was published in Coping® with Cancer magazine, July/August 2014.