Optimal timeframes & summary
Evidence-based guidelines, where they exist, should inform timeframes. Treatment teams need to recognise that shorter timeframes for appropriate consultations and treatment can promote a better experience for patients. Three steps in the pathway specify timeframes for care. They are designed to help patients understand the timeframes in which they can expect to be assessed and treated, and to help health services plan care delivery in accordance with expert-informed time parameters to meet the expectation of patients. These timeframes are based on expert advice from the Prostate Cancer Working Group.
Timeframes for care
|
Step in pathway |
Care point |
Timeframe |
|
Presentation, initial investigations and referral |
Signs and symptoms |
Presenting symptoms should be promptly and clinically triaged with a health professional |
|
Initial investigations initiated by GP |
The GP should have results and review the patient within 4 weeks for symptomatic patients and those with an abnormal digital rectal exam or a PSA ≥ 10 ng/mL The GP should have results and review the patient within 12 weeks for asymptomatic patients (PSA < 10 ng/mL) |
|
|
Referral to specialist |
Urgent referral is recommended for: • symptomatic patients (including psychological distress) • radiological evidence of locally advanced or metastatic disease • PSA > 50 ng/mL Asymptomatic patients should be seen by a specialist within 4 weeks of a persistently abnormal PSA result being identified or a single PSA reading > 10 ng/mL |
|
|
Diagnosis, staging and treatment planning |
Diagnosis and staging |
Investigations should be completed within 4 weeks of the initial specialist appointment |
|
Multidisciplinary meeting and treatment planning |
Should occur prior to beginning treatment and as soon as possible after the initial specialist consultation |
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|
Treatment |
Surgery |
Surgery should be conducted within 3 months of diagnosis or within 4 weeks if significant local symptoms are present |
|
Radiation therapy |
Treatment should begin within 3 months of diagnosis or within 4 weeks if significant local symptoms are present |
|
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Androgen deprivation therapy and other systemic therapy |
Treatment should begin within 3 months of diagnosis if asymptomatic, or within 4 weeks if symptomatic or extensive metastatic disease is present on imaging |
Seven steps of the optimal care pathway
Step 1: Prevention and early detection
Step 2: Presentation, initial investigations and referral
Step 3: Diagnosis, staging and treatment planning
Step 4: Treatment
Step 5: Care after initial treatment and recovery
Step 6: Managing recurrent, residual or metastatic disease
Step 7: End-of-life care
For men in Australia, prostate cancer is the most common cancer diagnosed and is the second most common cause of cancer death (AIHW 2019). It is more common in older men, with most cases diagnosed in men over 65 years of age (Rawla 2019). The five-year relative survival rate for prostate cancer depends on the stage at which the cancer is diagnosed, with the relative survival rate for patients diagnosed with stage I being almost 100 per cent and patients diagnosed with stage IV reducing to 36 per cent (AIHW 2019).
