How can primary care better support prostate health?

GPs have been under continual criticism in the last year and a recent NHS survey on General Practice revealed a significant decrease in patient satisfaction, mainly in getting appointments but in a number of other areas too.

Ageism and confusion over test results have particularly impacted men with prostate cancer risk, symptoms, diagnoses or post-treatment conditions.

But, equally, these same men have also had a tough few years, as thousands of men have been “put on hold” due to the pandemic.

Primary care is crucial to early detection and getting men on a diagnostic pathway. It is a cruel irony that diagnostic methods such as imaging and biopsies have advanced considerably, giving men choice in treatment with better outcomes – but they have to go through primary care first to access these pathways. How do we unblock the bottlenecks?

Focusing on alternatives to the GP for delivering primary care may be the way forward, and three approaches are beginning to emerge.

    1. One-stop diagnostic centres, sometimes called polyclinics, have been advocated in the NHS for some time and may be building momentum as the NHS reorganises around Integrated Care Systems. These centres are designed to be community hubs, situated away from hospitals, where local patients can receive imaging and other diagnostic services. Since the official rollout of these centres in 2020, 90 have been set up across England and over 1 million diagnostic checks have been carried out, according to the NHS.
    1. Mobile health clinics dedicated to men’s health, as in the “ManVan” set up by the Royal Marsden Hospital in London. This initiative has a potentially large role to play in reaching high-risk communities and reducing the number of men diagnosed with prostate cancer at A&E centres: “Diagnosing prostate cancer early and maintaining a healthy lifestyle result in better outcomes. Around 20% of prostate cancer is first diagnosed via A&E – the aim of the Man Van is to target groups at high risk of delayed diagnosis. We will also be carrying out a broader health check for other potentially serious conditions such as high blood pressure and diabetes” according to the Marsden.
    1. Digital apps are another approach to primary care, and as more people use smartphones and digital devices they become a realistic option for monitoring personal health indicators and using this information effectively in communicating with primary care providers. In terms of apps specific to prostate health, several are available for men who have been diagnosed and are undergoing treatment.

A 2020 review by the Urotechnology group of the EAU asked the question, “Do prostate cancer-related mobile phone apps have a role in contemporary prostate cancer management?”. After reviewing 44 prostate cancer-specific mobile apps, concluded:

“The use of [prostate cancer mobile apps] is currently in its infancy and do require further development before widespread integration into existing clinical practice. There are concerns with data protection, high readability standards and lack of information update in current PCAs. If developed appropriately with responsible governance, they do have the potential to play important roles in modern-day prostate cancer management.”

Do you have a view on how GPs or other approaches to primary care can better support prostate health? We’d love to hear from you.