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I'll be back. Currently meditating...

Priority Topic: Prostate

1/1/2019

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Key Feature 3: In patients with prostate cancer, actively search out the psychological impact of the diagnosis and treatment modality.
Skill: Patient Centered, Communication
Phase: History

Key Feature 4a: In patients with prostate cancer, considering a specific treatment option (ex: surgery, radiotherapy, chemotherapy, hormonal treatment, no treatment): Advise about the risks and benefits of treatment.
Skill: Clinical Reasoning, Patient Centered
Phase: Treatment

Key Feature 4b: In patients with prostate cancer, considering a specific treatment option (ex: surgery, radiotherapy, chemotherapy, hormonal treatment, no treatment): Monitor patients for complications following treatment.
Skill: Clinical Reasoning
Phase: Hypothesis generation, Follow-up

Key Feature 5: In patients with prostate cancer, actively ask about symptoms of local recurrence or distant spread.
Skill: Clinical Reasoning
Phase: History, Hypothesis generation

In patients who undergo investigations for prostate cancer and who subsequently are considering or have received treatment, it is important to assess the impact of this on their physical and psychological well-being. The diagnosis of cancer is rarely an easy thing to accept without some stress, and when it comes to the treatment of prostate cancer, the available modalities are also not without at least potential negative ramifications. In fact, the lack of options without a decent enough risk of negative side effects for treatment of prostate cancer is one of the main reasons some groups of health care providers lobby against population-wide screening for it. (As well, there is always the chance that despite treatment the cancer could recur, so it's also important to inquire about symptoms suggestive of this and to be on alert for new complaints that could indicate metastatic spread.) This PDF of the harms vs benefits of prostate cancer screening takes into account available treatment options and helps to shed some light in framing this discussion. As well, check out the video below by Dr. Mike Evans for more context on the side of the debate that encourages caution when it comes to screening for prostate cancer. In any case, in my opinion all patients diagnosed with prostate cancer deserve to make an informed choice as to how they wish to proceed, with the option of speaking to a Urologist to discuss the available treatment options in detail.
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