Improvements in early detection and treatment have led to substantial improvements in cancer survival rates in Australia. Long term cancer survivors have unique health needs as a result of living through cancer and its treatment. The late-effects of chemotherapy and radiotherapy are increasingly well documented, including fatigue, chronic pain, infertility, anxiety and depression. Many survivors also face the risk of recurrence and secondary neoplasms. The growing number of cancer survivors makes long term hospital-based follow-up increasingly unsustainable for publically funded healthcare systems. Consequently, alternative models of follow-up that recognise an important role for primary care have been examined. The key elements of generalist practice include accessibility, holistic patient-centred, team-based care, care coordination, continuity and management of complex multiple problems. Primary care is therefore potentially better suited than current models of hospital follow-up to meet the complex needs of cancer survivors.
This presentation will discuss the existing evidence identified through a Rapid Review conducted by PC4 about the role of primary care in cancer survivorship and follow-up. It will also discuss the ProCare Trial which is currently testing a model of shared care for prostate cancer. Novel elements of the ProCare Trial intervention include a prostate cancer survivorship care plan, and applying the Distress Thermometer and screening for unmet need in primary care. The issue of risk-stratification will also be discussed as a future approach to developing appropriate and cost-effective survivorship care in Australia.