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OPTIMIZING THE PATH OF CARE FOR PATIENTS WITH PROSTATE CANCER: WORKING IN A NETWORK
According to the status of disease, multiple therapies and observational strategies are available for prostate cancer patients, including surgery, external radiotherapy, brachytherapy, hormonal therapy, chemotherapy, and radionuclide metabolic therapy, as well as observational programs such as activ...
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Published in: | Anticancer research 2018-04, Vol.38 (4), p.2504 |
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Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Online Access: | Get full text |
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Summary: | According to the status of disease, multiple therapies and observational strategies are available for prostate cancer patients, including surgery, external radiotherapy, brachytherapy, hormonal therapy, chemotherapy, and radionuclide metabolic therapy, as well as observational programs such as active surveillance and watchful waiting. The path of care for this malignancy is rather complex, involving several health care professionals, and it requires a multidisciplinary approach at specific time points of the disease trajectory. When the health settings cannot provide prostate cancer patients with all the consultations and procedures required for a proper disease management, efforts should be made to implement the path of care, in order to address all patient needs through the collaboration among institutions. This is also in line with Valdagni et al. (1, 2), who stressed the importance of formalizing networks to meet all requirements of a Prostate Cancer Unit. Although multidisciplinary clinics (weekly multidisciplinary first consultations and twice a week observational program followup) and activities (weekly tumor boards) for prostate cancer patients had been running on a regular basis since 2004, the Prostate Cancer Unit at Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (INT PCU), was only formalized in 2009, and updated with respect to staff and activities in 2013. In 2014, also with the help of external auditors, bottlenecks and areas with room for improvement were identified (3). Besides organizational and administrative problems, the auditors stressed the lack of robot-assisted surgery and of emergency department (ER). In addition, the uro-oncologists attending the PCU had limited experience with functional and andrologic urology. The Division of Urology at Fondazione IRCCS CĂ Granda Ospedale Maggiore Policlinico (Policlinico) of Milan, hosting the Specialty in Urology of Milan University, was a referring center for robot-assisted surgery, with extensive experience in urology and andrology. Policlinico had no radiotherapy or brachytherapy unit as well as no experience in the multidisciplinary management of prostate cancer patients and no significant caseload of patients on active surveillance or watchful waiting. In February 2017, INT PCU and with INT become an academic center as Policlinico, and Policlinico formalized an agreement aimed to join efforts, share common diagnostics and therapeutic guidelines to implement the path of care for pro |
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ISSN: | 0250-7005 1791-7530 |