At the Australian Prostate Centre (APC) in Melbourne we have established a novel role for a specialist General Practitioner (GP) with a focused interest in prostate cancer (PCa) playing a central role in the multidisciplinary care of men undergoing androgen deprivation therapy (ADT) for their PCa. ADT is associated with a range of physical and psychological side effects, including hot flushes, sexual dysfunction, fatigue, sarcopenia, osteoporosis, diabetes, increased cardiovascular disease and mood disorders such as depression and anxiety. Many of these concerns go undetected if not specifically screened for.
Within the survivorship clinic, the GP conducts comprehensive assessments beginning with a detailed medical history, in particular focusing on PCa diagnosis, staging, treatment history, and any current concerns. Relevant blood tests to identify any metabolic disturbances, and a DEXA scan, are utilized to monitor and manage the ongoing impact of ADT.
A key aspect of the GP role involves patient and partner engagement. The GP explores their understanding of the disease and treatment plan, clarifies any uncertainties, and provides education on the chronic nature of PCa and the long-term implications of hormone therapy. The GP consultations include tailored lifestyle advice, particularly around diet, alcohol use, and physical activity.
Collaboration is essential for this role, and the GP works closely with PCa nurses and exercise physiologists and other allied health professionals to deliver integrated survivorship care. The GP role in survivorship is a pivotal component of this survivorship program to help manage ADT specific patient comorbidities, and general health concerns, thereby ensuring holistic support to improve overall quality of life.
The innovative incorporation of GP services into the APC survivorship program provides a framework for delivery of comprehensive supportive care. This model could be replicated within other health care settings to better meet the widespread survivorship needs of men on ADT.