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Approach to primary care follow-up of patients with prostate cancer

Michael D. Brundage, MD MSc FRCPC
Head of Radiation Oncology at the Cancer Centre of Southeastern Ontario, a Professor in the Department of Oncology at Queen’s University, and a researcher with the Queen’s Cancer Research Institute

Robert Siemens, MD FRCSC
Urologist with Kingston General Hospital and the Cancer Centre of Southeastern Ontario. He is an Assistant Professor in the Department of Urology at Queen’s University

Correspondence to: Dr Anna Wilkinson, Ottawa Regional Cancer Centre, 503 Smyth Rd, Ottawa, ON K1H 1C4; e-mail anwilkinson{at}toh.on.ca

OBJECTIVE To review resources available to aid family physicians in their care of prostate cancer patients and develop an algorithm to summarize these findings.

SOURCES OF INFORMATION MEDLINE, EMBASE, and relevant website search. All relevant guidelines were level III evidence.

MAIN MESSAGE Improved screening and treatment of patients with prostate cancer is resulting in an increasing number of survivors. These men require ongoing monitoring, a responsibility that is largely falling to family physicians. We review the expected prostate-specific antigen (PSA) responses to different prostate cancer treatment modalities and provide an appropriate schedule of follow-up and monitoring techniques for prostate cancer patients.

CONCLUSION In light of the paucity of resources for family physicians in their ongoing care of prostate cancer patients, we present an algorithm, primarily based on PSA kinetics, for practical use in the continuing care of these patients.