Opportunities for disease state management in prostate cancer

In this paper, we examine how the management of prostate cancer lends itself to a disease state management (DSM)-based approach, and propose a framework that emphasizes the patient-provider-caregiver triad in managing the long-term implications of the condition. There is often no clearly superior approach to the management of patients with prostate cancer (eg, watchful waiting and hormonal therapy), and each option entails different trade-offs in quality of life. Ideally, the physician and patient discuss the options, issues, and patient preferences for treatment through the shared decision-making process. A family caregiver such as the spouse of the patient is often involved in the treatment decision and in the long-term management of the cancer experience. In order to develop a DSM program supporting both patient and caregiver, educational, psychosocial, and health care system support needs should be tailored to each phase of cancer treatment/management. To embrace the unique aspects of prostate cancer management, the proposed framework emphasizes communication among the patient-caregiver-provider triad, inclusion of family caregivers in the program, cancer phase-specific support, and psychosocial services as a basis for implementation and evaluation of a DSM program in prostate cancer.