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Helping patients make informed decisions about prostate cancer
GPs have a central role in facilitating informed decision making for prostate cancer patients’ treatment options, an expert says.
Rapid and ongoing advances in prostate cancer treatment options means it is important for GPs to remain up to date in their knowledge.
‘The best way we, as GPs, can support men with newly diagnosed prostate cancer is to make sure they are fully informed about their treatment options,’ Dr Martine Walker, RACGP examiner and a GP with a special interest in prostate cancer, told newsGP.
‘Patients listen to GPs and value our opinions.’
With rapid advances in prostate cancer treatment, Dr Walker emphasises that GPs remain up-to-date with the latest options to provide appropriate advice and support their patients in this important decision.
‘Advances in treatment mean many of the complications we saw in the past are now rare,’ she said.
‘Because the management of prostate cancer straddles a number of specialties, it is often difficult to get a sense of how the different treatments compare. More education in a multidisciplinary format would be helpful for GPs to compare and contrast treatments.’
Dr Walker says it is also important that prostate cancer patients have the opportunity to speak in person with both a radiation oncologist and urologist before they make their treatment decisions, to avoid ‘decisional regret’.
‘No matter how well educated GPs are about prostate cancer treatment we cannot be expected to know the minutiae of the numerous surgical and radiation therapy alternatives for treatment … [but part of our role is to] ensure patients are fully informed,’ she said.
Dr Martine Walker believes that GPs are central in aiding patients to make informed decisions about prostate cancer treatment options.
Specialties involved in treating prostate cancer – radiation oncology and urology – are two very different areas, both of which are evolving quickly, according to Dr Walker.
‘Both radiation therapy and surgery have different potential side effects, logistics and costs. Each man will have different priorities for treatment and their post-prostate cancer life,’ she said.
‘Radiation therapy and surgery are equally effective in curing and controlling prostate cancer, and most men who need active treatment could be suitable for either.’
When referring to a specialist (urologist) to investigate possible prostate cancer, Dr Walker recommends GPs advise the diagnosing specialist that they expect the patient will have the opportunity to speak to a radiation oncologist before any definitive treatments are decided on, if the patient receives a diagnosis of prostate cancer.
‘The best way GPs can support men to make informed decisions about their prostate cancer treatment is for the GP to “front load” the referral process,’ she said.
Dr Walker advises GPs that before referring their patients, to inform them that:
- the two main treatments for prostate cancer are radiation therapy (external beam or brachytherapy) or surgery
- both treatments are equal in terms of freedom from cancer at 10 years and beyond
- before making a decision about treatment, the patient should have the chance to consult in person with both a radiation oncologist and a urologist
- if the urologist does not arrange an appointment with a radiation oncologist, that you (the GP) will be happy to arrange the appointment
- there is no benefit in rushing into treatment.
The Royal Australian and New Zealand College of Radiologists also
highlights that there is ‘rarely a need to proceed to treatment very quickly’, and Dr Walker acknowledges this time for a man and his family to seek the information they need without being rushed into treatment, in nearly all cases, even ‘aggressive’ prostate cancers.
‘It is important men are given all the time and information they need to make decisions that are best for them,’ she said.
men's health prostate cancer prostate cancer treatment options radiation therapy
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