Prostate cancer as a chronic disease: cost-effectiveness and proper follow-up

In western countries, prostate cancer (PCa) is the most common non-dermatological malignant disease in men. Bone metastases more often develop in patients with advanced PCa; the associated complications present a substantial disease and economic burden. Although the introduction of new therapeutic strategies have provided some advantages in terms of overall survival and quality of life in patients with metastatic PCa, the skeletal related events and side effects due to the therapies are associated with an important impact on the healthcare costs. In particular, the number of hospital admission, clinical consultation and the introduction of new expensive diagnostic modalities have changed the management of metastatic patients. However, the National and International guidelines suggest to follow patients with metastatic PCa by using clinical assessment, biochemical evaluation and, when necessary, diagnostic imaging. The aims of the present review were: 1) to summarize the information regarding the clinical and economic burden of metastasis; 2) to evaluate the quality of life; and 3) to suggest a proper follow-up in advanced PCa patients.