Download Prostate Cancer Guidelines

Prostate Cancer Guidelines
This guidance was developed by the Primary Care Sub-group
of the Prostate Cancer Working Group .
The Prostate Cancer Working Group is responsible for implementing
the Prostate Cancer Awareness and Quality Improvement Programme (the AQIP)
Unlike other cancers, prostate cancer often
grows slowly.
Therefore, routine PSA testing can lead to
many men being diagnosed with a cancer
that is not going to progress during their
lifetime.
This in turn may increase men’s exposure to
unnecessary treatment-related harms.
Some men will still develop aggressive and
potentially life-threatening prostate cancer.
These men may benefit from prompt
diagnosis and treatment.
New Zealand men currently receive
conflicting advice about prostate
cancer testing and treatment.
Some men may benefit from early
diagnosis and treatment, but have
limited opportunity to access
appropriate health services
Prostate Cancer Management
and Referral Guidance
…to help primary care practitioners
provide men and their whānau with:
consistent, culturally appropriate
information on prostate cancer testing
and treatment.
Aiming for Quality Improvement that will:
ensure that men have better and more
equitable access to information about prostate
cancer
support primary care practitioners to manage
men presenting with prostate-related concerns
removing barriers that restrict men’s access to
diagnostic and treatment services
ensuring that men receive consistent care and
have equitable outcomes across the entire
care pathway.
This guidance is part of a suite of resources that will
be developed under the AQIP.
Other resources that will be developed over the next two
years include:
an electronic decision
support tool to aid men’s decision.
making around prostate cancer testing and treatment
guidance on the use of active surveillance
guidance on the pathologic diagnosis and staging of
prostate cancer
guidance on managing men with advanced or metastatic
prostate cancer
patient information for men and their whānau.
.
District health boards and primary
health organisations will be
responsible for :
integrating this guidance into their
clinical pathways for prostate
cancer
in a way that reflects the particular
needs of their patients and
communities.
Primary care practitioners should be conscious
of the disparities that exist in prostate cancer
outcomes for different men, such as for Māori
men or men who live in rural areas.
.
For example, Māori men are less likely to be
diagnosed with prostate cancer than nonMāori men, but are 37 percent more likely to
die from the disease (Ministry of Health,
2014).
in part, they appear to be related to
differences in Māori men’s access to
appropriate information and to diagnostic and
treatment services.
.
Normal PSA and DRE
Prostate cancer unlikely
.
Discuss follow up
including option of no further testing
(unlikely to benefit men over 70 years)
If FH first degree relative affected under age
65yrs, recommend repeat PSA and DRE
every year
Abnormal PSA
(guidance cut off
. 4.0 and 10.0)
Check for red flags
Treat if UTI or prostatitis present
Repeat PSA 6-12 weeks
Refer if abnormal
(abnormal DRE -> refer)