title: Primary Care of the Prostate Cancer Survivor.
abstract: This summary of the American Cancer Society Prostate Cancer Survivorship Care Guidelines targets primary care physicians who coordinate care of prostate cancer survivors with subspecialists. Prostate cancer survivors should undergo prostate-specific antigen screening every six to 12 months and digital rectal examination annually. Surveillance of patients who choose watchful waiting for their prostate cancer should be conducted by a subspecialist. Any hematuria or rectal bleeding must be thoroughly evaluated. Prostate cancer survivors should be screened regularly for urinary incontinence and sexual dysfunction. Patients with predominant urge incontinence symptoms, which can occur after surgical and radiation treatments, may benefit from an anticholinergic agent. If there is difficulty with bladder emptying, a trial of an alpha blocker may be considered. A phosphodiesterase type 5 inhibitor can effectively treat sexual dysfunction following treatment for prostate cancer. Osteoporosis screening should occur before initiation of androgen deprivation therapy, and patients treated with androgen deprivation therapy should be monitored for anemia, metabolic syndrome, and vasomotor symptoms. Healthy lifestyle choices should be encouraged, including weight management, regular physical activity, proper nutrition, and smoking cessation. Primary care physicians should be vigilant for psychosocial distress, including depression, among prostate cancer survivors, as well as the potential impact of this distress on patients' family members and partners.
authors.affiliation: Intermountain Healthcare, Provo, UT, USA.
authors.forename: Erika M
authors.initials: EM
authors.lastname: Noonan
authors.affiliation: University of Utah School of Medicine and VA Salt Lake City Geriatric Research, Education, and Clinical Center, Salt Lake City, UT, USA.
authors.forename: Timothy W
authors.initials: TW
authors.lastname: Farrell
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D000359:Aftercare; D000726:Androgen Antagonists / Q000009:adverse effects; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D003556:Cystitis / Q000150:complications / Q000175:diagnosis; D003863:Depression / Q000175:diagnosis / Q000628:therapy; D051517:Digital Rectal Examination; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D000070497:Healthy Lifestyle; D006417:Hematuria / Q000209:etiology; D006801:Humans; D007610:Kallikreins / Q000097:blood; D008297:Male; D008403:Mass Screening; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000175:diagnosis*; D010024:Osteoporosis / Q000139:chemically induced / Q000000981:diagnostic imaging; D017410:Practice Guidelines as Topic; D011320:Primary Health Care; D011349:Proctitis / Q000150:complications / Q000175:diagnosis; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000628:therapy*; D011832:Radiation Injuries / Q000150:complications / Q000175:diagnosis; D012007:Rectum; D017741:Survivors; D014549:Urinary Incontinence / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D000317:Adrenergic alpha-Antagonists; D000726:Androgen Antagonists; D018680:Cholinergic Antagonists; C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen