[Early detection and follow-up of prostatic carcinoma. Responsibilities of the general practitioner]

Apart from digital rectal examination, the determination of prostate specific antigen is essential for the early detection of cancer of the prostate. The combination of these two examinations significantly improves screening efficacy. With the aid of a well-tested algorithm, the family doctor can establish the need for a urological investigation, and thus help to ensure early, curative treatment. Preventive measures can be rendered more effective by providing individual advice on such matters as lifestyle (risk factors, diet). It now appears that dietary measures are capable of slowing the increase in PSA following definitive treatment. Schematic disease-specific aftercare is usually the domain of the urologist. The general practitioner, however, is confronted by such problems as logistical considerations, documentation, palliative management (e.g. treatment of pain) and the problems associated with concomitant symptoms, the relevance of which needs to be assessed. Overall, however, the main concern of the general practitioner is with aspects of rehabilitation.