Prostate cancer is now the most common cancer in men in the UK. There were 47,300 cases diagnosed in 2013. With improvements in treatment men are living longer with the disease – 80% of men now survive beyond five years, compared with 20% in the 1970s.1 Their holistic needs have changed as they are living longer. Many of these men are also living with one or more long-term conditions.2
New pathways of care
With more men living with prostate cancer, providers and commissioners are developing innovative pathways to manage the increasing demand. The National Cancer Survivorship Initiative and NHS Improvement have developed principles to provide alternative follow-up pathways to traditional models.3,4 These approaches range from nurse-led follow up in secondary care, remote surveillance, shared care between secondary and primary care and primary care-led follow-up (Figure 1).
As men continue to live longer following their prostate cancer diagnosis, they are increasingly being cared for in primary care at some stage after treatment or during a period of watchful waiting.
For clinicians and patients, this represents behavioural and organisational change as cancer care has traditionally been secondary care-led and still perceived, by many, to be a specialist area of practice.