Steve P McCombie1,2,3, Cynthia Hawks1,2, Jon D Emery4,5,6, Dickon Hayne1,2,3,7. 1. Fiona Stanley Hospital, Murdoch, Australia. 2. Fremantle Hospital, Fremantle, Australia. 3. School of Surgery, University of Western Australia, Crawley, Australia. 4. School of Primary, Aboriginal and Rural Health Care, University of Western Australia, Crawley, Australia. 5. University of Melbourne, Parkville, Australia. 6. Western Health, Melbourne, Vic, Australia. 7. West Australian Urologic Research Organisation, Perth, WA, Australia.
Abstract
OBJECTIVE: To report on the structure and outcomes of a new 'One Stop' Prostate Clinic (OSPC) designed specifically for rural and remote men. PATIENTS AND METHODS: Prospective cohort study of the first 200 rural or remote men to access a new OSPC at a public tertiary-level hospital in Western Australia between August 2011 and August 2014. Men attended for urological assessment, and proceeded to same-day transrectal ultrasonography-guided prostate biopsies, if appropriate. Referral criteria were either two abnormal age-related prostate-specific antigen (PSA) levels in the absence of urinary tract infection (UTI), or an abnormal digital rectal examination (DRE) regardless of PSA level. RESULTS: The median (range) distance travelled was 1545 (56-3229) km and median (range) time from referral to assessment was 33 (2-165) days. The median (range) age was 62 (38-85) years, PSA level was 6.7 (0.5-360) ng/mL and 39% (78/200) had a suspicious DRE. In all, 92% (184/200) of men proceeded to prostate biopsies, and 60% (111/184) of these men were diagnosed with prostate cancer. Our complication rate was 3.5% (6/172). Radical prostatectomy (46/111), active surveillance (28/111) and external beam radiation therapy (26/111) were the commonest subsequent treatment methods. A $1045 (Australian dollars) cost-saving per person was estimated based on the reduced need for travel with the OSPC model. CONCLUSION: The OSPC is an effective and efficient model for assessing men suspected of having prostate cancer living in rural and remote areas of Western Australia, and this model may be applicable to other areas.
OBJECTIVE: To report on the structure and outcomes of a new 'One Stop' Prostate Clinic (OSPC) designed specifically for rural and remote men. PATIENTS AND METHODS: Prospective cohort study of the first 200 rural or remote men to access a new OSPC at a public tertiary-level hospital in Western Australia between August 2011 and August 2014. Men attended for urological assessment, and proceeded to same-day transrectal ultrasonography-guided prostate biopsies, if appropriate. Referral criteria were either two abnormal age-related prostate-specific antigen (PSA) levels in the absence of urinary tract infection (UTI), or an abnormal digital rectal examination (DRE) regardless of PSA level. RESULTS: The median (range) distance travelled was 1545 (56-3229) km and median (range) time from referral to assessment was 33 (2-165) days. The median (range) age was 62 (38-85) years, PSA level was 6.7 (0.5-360) ng/mL and 39% (78/200) had a suspicious DRE. In all, 92% (184/200) of men proceeded to prostate biopsies, and 60% (111/184) of these men were diagnosed with prostate cancer. Our complication rate was 3.5% (6/172). Radical prostatectomy (46/111), active surveillance (28/111) and external beam radiation therapy (26/111) were the commonest subsequent treatment methods. A $1045 (Australian dollars) cost-saving per person was estimated based on the reduced need for travel with the OSPC model. CONCLUSION: The OSPC is an effective and efficient model for assessing men suspected of having prostate cancer living in rural and remote areas of Western Australia, and this model may be applicable to other areas.
Authors: Jon D Emery; Victoria Gray; Fiona M Walter; Shelley Cheetham; Emma J Croager; Terry Slevin; Christobel Saunders; Timothy Threlfall; Kirsten Auret; Anna K Nowak; Elizabeth Geelhoed; Max Bulsara; C D'Arcy J Holman Journal: Br J Cancer Date: 2017-09-19 Impact factor: 7.640
Authors: Dickon Hayne; Jeremy Grummet; David Espinoza; Steve P McCombie; Venu Chalasani; Kate S Ford; Mark Frydenberg; Peter Gilling; Barbara Gordon; Cynthia Hawks; Alex Konstantatos; Andrew J Martin; Anthony Nixon; Colin O'Brien; Manish I Patel; Shomik Sengupta; Shekib Shahbaz; Shalini Subramaniam; Scott Williams; Henry H Woo; Martin R Stockler; Ian D Davis; Nick Buchan Journal: BJU Int Date: 2021-07-30 Impact factor: 5.969