Are Survivorship Plans Responsive to Prostate Cancer Survivors?

Large numbers of prostate cancer survivors suffer from morbidity, mortality, and cancer recurrence in part because of a lack of surveillance and cancer follow-up. Consequently, there is an urgent need for the systematic implementation of prostate cancer survivorship plans. However, a key component in this must evolve from patient input and survivorship engagement.

Learnings from a prostate cancer survivorship conference

Prostate cancer survivors can offer a level of firsthand expertise and knowledge about the needs of survivors that medical professionals might not be able to provide. This is where an alliance of community-based advocates and medical providers can form meaningful partnerships.

A good example of this came up came during my recent involvement in a prostate cancer survivorship conference among Black men that took place at Drexel University. During private conversations many of the men spoke about the strength they found in their spirituality, some about how their faith in God grew stronger following their diagnosis and some through prayer and relationships with God. These are vivid examples of how spiritual care referrals and resources can be identified as essential components for inclusion in survivorship care plans. This is particularly relevant as overall cancer survivorship continues to grow.

Unexpected health and life challenges

What we know is that cancer survivorship often brings with it additional health and life challenges. This includes comorbidities like heart disease, psychological issues like anxiety, as well as economic problems, like job issues and financial concerns. Although organizations like the Centers for Disease Control and Prevention strongly recommend survivorship care plans and personalized treatment summaries, the follow-up often gets lost in the maze of probable treatment from personal care physicians.

The role of race

In some cases templates for Black prostate cancer survivors may need to be “race-specific,” taking into account both sociological and cultural factors that can impact the survivorship experience. It is unfortunate that we still don’t have a wider range of published evidence for the management of prostate cancer survivorship after treatment.

Ultimately, the goal must be to help survivors achieve optimal health and quality of life and to increase the awareness of prostate cancer post treatment as a public health issue. The fact remains that prostate cancer survivors with less education, lower income levels, and coming from minority populations tend to have poorer quality of life and a lower likelihood of survival compared to higher income, more educated, and white prostate cancer survivors.

What should survivorship care look like?

It is often unclear who has the principal responsibility for prostate cancer survivorship care and what specific items should be included in the plan. It appears this should be the role of primary care clinicians and that the plan ought to address the patient’s psychological and physical status. In addition, it should address familial risk factors in relation to the primary cancer and comorbid conditions. This move forward would be a significant step in the advancement of prostate cancer survivorship and clinical intervention.