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Background. Follow-up care for prostate cancer has traditionally been led by secondary care in hospital out-patient clinics. As the number of men with prostate cancer increases and secondary care resources face pressure, alternative follow-up models are being sought. Current National Institute for Health and Clinical Excellence guidance recommends follow-up outside the hospital setting for patients who are stable 2 years following radical treatment and for those undergoing ‘watchful waiting’.Objective. To describe current practice in a sample of relevant health care professionals and to seek their views on the role of primary care in prostate cancer follow-up.Methods. Semi-structured telephone interviews with 38 UK health care professionals, from both secondary and primary care. Transcripts were analysed using the constant comparative method.Results. There are marked variations in current follow-up practice around the country, with hospital-based follow-up ranging from 6 months to lifetime. The predominant, although not universal, view expressed was that there is both scope and support for primary care to play a greater role, particularly for men with stable disease. This was qualified by the need for supporting education, including guidance on interpretation of prostate-specific antigen values, introduction of robust follow-up systems in primary care, easy access back into secondary (hospital) care, a mechanism for ensuring follow-up data can still be collected for audit purposes and appropriate resourcing.Conclusions. If primary care is to play a significant role in providing high-quality follow-up care for men with prostate cancer, then steps need to be taken to address the barriers to increased primary care involvement identified by this study. [ABSTRACT FROM AUTHOR]

Objective: To gain insight into patients’ experiences of follow-up care after treatment for prostate cancer and identify unmet psychosexual needs. Methods: Semi-structured interviews were conducted with a purposive sample of 35 patients aged 59–82 from three UK regions. Partners were included in 18 interviews. Data were analyzed using constant comparison. Results: (1) Psychosexual problems gained importance over time, (2) men felt they were rarely invited to discuss psychosexual side effects within follow-up appointments and lack of rapport with health care professionals made it difficult to raise problems themselves, (3) problems were sometimes concealed or accepted and professionals’ attempts to explore potential difficulties were resisted by some, and (4) older patients were too embarrassed to raise psychosexual concerns as they felt they would be considered ‘too old’ to be worried about the loss of sexual function. Conclusion: Men with prostate cancer, even the very elderly, have psychosexual issues for variable times after diagnosis. These are not currently always addressed at the appropriate time for the patient. Practice implications: Assessments of psychosexual problems should take place throughout the follow-up period, and not only at the time of initial treatment. Further research examining greater willingness or reluctance to engage with psychosexual interventions may be particularly helpful in designing future interventions. [Copyright &y& Elsevier]

OBJECTIVE To develop an understanding of experiences of follow-up in patients with prostate cancer, to seek explanations as to why men's needs might not be well met, and explore views on the possible role of primary care in follow-up. The experiences of these patients, and views on the delivery of follow-up care, have been relatively neglected compared to those diagnosed with other cancers. PATIENTS AND METHODS In all, 35 patients were recruited from 20 practices across three regions in the UK. Maximum variation was sought by purposely sampling by age (59-82 years), treatment, length (0.75-14 years) and mode of follow-up. RESULTS Patients' descriptions of the content and organization of follow-up showed the shortcomings of follow-up, which included system failings causing patients to be lost to follow-up, and unmet psychosexual needs. Patients were mainly positive about the prospect of follow-up taking place outside the hospital setting. However, some expressed concerns about current follow-up practices and suggested several improvements that need considering if primary care were to take a greater role. CONCLUSION This study identified some general deficiencies with the current system of follow-up, and our data indicate that primary care could have a role in addressing some of these. [ABSTRACT FROM AUTHOR]