“The purpose of A Psychosocial Care Model for Men with Prostate Cancer is to guide health professionals to an optimal approach in delivering psychosocial care for men affected by prostate cancer. The approach is multi-disciplinary including psycho-oncology, health psychology, nursing, sociology, exercise physiology, urology; and is evidence-based and underpinned by best practice where clear evidence is not available. It is envisaged that health care professionals will apply this model as a practical guide to developing a care plan for men with prostate cancer in their setting.”
Chambers SK, Galvão DA, Green A, Lazenby M, Newton RU, Oliffe JL, Phillips JL, Phillips R, Ralph N, Sara S, Heathcote P, Dunn J. A psychosocial care model for men with prostate cancer. Sydney: Prostate Cancer Foundation of Australia and University of Technology Sydney; 2019.
The idea of formulating and disseminating structured guidelines for psychosocial care for men with prostate cancer is a relatively new idea. Indeed, it was only in 2003 in Australia that the first recognised extensive set of clinical practice guidelines for psychosocial care for cancer patients, in this case for breast cancer, was developed. The guidelines resulted from the deliberations of a panel of experts who recommended interventions based on the evidence in the literature. [DOI: 10.1002/pon.897 ]
In 2007, the Institute of Medicine in the US published a landmark report which recommended that “quality cancer care must integrate the psychosocial domain into routine cancer treatment”. [DOI: 10.17226/11993 ] By 2011 the International Psych-Oncology Society (IPOS) had released its Standard of Quality Cancer Care stating that “quality cancer care must integrate the psychosocial domain into routine care and that distress should be measured as the 6th Vital Sign after temperature, blood pressure, pulse, respiration and pain.” [DOI: 10.1002/pon.1978]
Meanwhile, leading initiatives to focus attention on psychosocial care for prostate cancer patients had already begun across two continents.
In the US, following the establishment of the National Cancer Survivorship Resource Center (NCSRC) in 2010, efforts focused on coordinating the work of experts in oncology, primary care, and other health care professions to develop follow-up care guidelines for 10 priority cancers including prostate cancer. This resulted in the American Cancer Society using recommendations from the NCSRC to release in 2014 its first prostate cancer survivorship care guidelines. [DOI: 10.3322/caac.21234] This was further enhanced by the release in the following year of American Society of Clinical Oncology Practice Guideline Endorsement [DOI: 10.1200/JCO.2014.60.2557 ]
In Australia, driven by the Prostate Cancer Foundation of Australia (PCFA), specific guidelines for prostate cancer patients were formulated into the pioneering monograph ProsCare: A Psychological Care Model for Men with Prostate Cancer published in 2013. This was later refined and republished in 2019 as A Psychological Care Model for Men with Prostate Cancer with the endorsement of The Urological Society of Australia and New Zealand, the Australian and New Zealand Urological Nurses Society, the Royal Australian and New Zealand College of Radiologists, the Medical Oncology Group of Australia, the Australian and New Zealand Urogenital and Prostate Cancer Trials Group, the European Association of Urology Nurses, and five universities across Australia working in prostate cancer survivorship research.
The PCFA and Australian National Health and Medical Research Council Centre for Research Excellence in Prostate Cancer Survivorship partnered with key Australian medical, nursing and research leaders to develop a position statement on screening for distress and on providing psychosocial care for men with prostate cancer. The statement was included in A Psychological Care Model for Men with Prostate Cancer.
The statement recommends:
1. After the diagnosis of prostate cancer and regularly through treatment and surveillance, men who have been diagnosed with prostate cancer should be screened for distress and their psychological and quality of life concerns should be explored.
2. Men who have high levels of distress should be further evaluated for anxiety and/or depression and evidence of suicidality.
3. Men who have high distress or need for support should be referred to evidence‐based intervention matched to their individual needs and preferences for support.
4. Research is needed to develop effective methods to identify partners of men with prostate cancer with high distress or who are at risk of high distress as well as effective interventions for partners and for couples where the man has a diagnosis of prostate cancer.
5. Investment in prostate cancer survivorship research is a national health priority.
If not now when?
The experience of prostate cancer provides significant physical, social, psychological and relationship challenges that for many men will be long term, if not lifelong. Using an evidence-based model of psychosocial care for men with prostate cancer, refined for the specific needs of national culture and health systems, will make a difference.