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Abstract

The aim of this research was to ascertain General Practitioners’ (GPs) perceptions and experiences of prostate cancer (PCa) diagnosis, treatment, and care in metropolitan Melbourne and in a regional area of Victoria, Australia, associated with poorer PCa outcomes. Semi-structured qualitative interviews were conducted with GPs (N= 10) practising in the selected region and in metropolitan Melbourne, Australia. GPs thought that most men wanted PSA testing and were willing to undergo rectal examination. Some GPs were troubled by inconsistent screening guidelines from different professional bodies. They identified a need for resources to support them in educating patients about PCa. GPs thought it might be more difficult for young female GPs to care for patients in relation to PCa screening; differences were evident between younger female GPs and older male GPs in the approach they adopted in interviews. Regional GPs often referred patients to services in larger centres because no local specialists were available. GPs also found it hard to explain differences in PCa outcomes in regional and metropolitan areas. Potential age and gender differences in GPs in relation to prostate care warrant further examination. Although GPs were able to offer only limited insights into the poorer outcomes in regional areas, they identified ways in which they could be assisted to provide best-practice care. Multidisciplinary care, resources for patients, and consistent guidelines for the detection and treatment of PCa should contribute to better care in all areas.

Keywords

Prostate Cancer, General Practitioners, Regional, Screening, Diagnosis, Care, Qualitative Research

Author Bio(s)

Dr. Rasa Ruseckaite works on the Massive Transfusion Registry (MTR) in the Transfusion Research Unit, operating within the Critical Care Division at the Department of Epidemiology and Preventive Medicine. With an undergraduate degree in Science, Rasa has a Master of Science and two PhDs; one in Applied Computer Science from Vytautas Magnus University in Lithuania and the other in Neuroscience from the Australian National University in 2004. Rasa has been employed as a research fellow analysing large and multidimensional datasets over the past eight years. As a senior research fellow in the MTR she is leading a number of projects involving analysis of the massive transfusion registry data from Australia and New Zealand. This registry is a unique and important resource for clinicians in Australia, New Zealand and internationally, for Blood Services and for the broader community. It provides observational data regarding the types and frequency of conditions associated with critical bleeding requiring massive transfusion, the use of blood component therapy (i.e., ratios and quantities of different types of red cell to non- red cell components) and patient outcomes. Correspondence regarding this article can be addressed directly to: School of Public Health & Preventive Medicine, Monash University, The Alfred Centre, Alfred Hospital, 99 Commercial Road, Melbourne VIC 3004, Australia; Email: rasa.ruseckaite@monash.edu.

Associate Professor Sue Evans is head of the Clinical Registry Unit and an Associate Director of the Centre of Research Excellence in Patient Safety at Monash University. She is the registry custodian for the Australian Prostate Cancer Clinical Registry and holds a Monash Partner Academic Fellowship.

Associate Professor Jeremy Millar is the Director of Alfred Health Radiation Oncology, a large academic radiotherapy service at the Alfred in metro Melbourne, with a smaller satellite regional radiotherapy centre two hours away in regional Victoria, at Latrobe Regional Hospital. He’s on the Board of both the Cancer Council Victoria and Cancer Council Australia, and he has an academic appointment at Monash University where he is the clinical lead for the Victorian Prostate Cancer clinical registry he established with a Cancer Australia grant in 2009. He is part of the leadership group of a binational Australian and New Zealand Prostate Cancer Registry (PCOR-ANZ) and an international prostate cancer registry.

Dr. Sara Holton, PhD, M Gend Stud, Grad Dip Arts, BA is a Research Fellow in the School of Public Health and Preventive Medicine at Monash University, Melbourne, Australia. Her main research interests are health care delivery and women’s and men’s health.

Professor Jane Fisher, an academic Clinical and Health Psychologist, is Professor of Women’s Health and Director of the Jean Hailes Research Unit in the School of Public Health and Preventive Medicine at Monash University. She has longstanding interests in the links between illness and psychological wellbeing.

Professor Danielle Mazza (MD, MBBS, FRACGP, DRANZCOG, Grad Dip Women’s Health, GAICD) is the Head of the Department of General Practice at Monash University and the author of the textbook Women's Health in General Practice. Danielle leads a program of translational research with a focus on women’s sexual and reproductive health, improving the delivery and uptake of preventive care, and the early diagnosis of cancer in the general practice setting. Her methodological expertise in both guideline development and implementation and the development and trial of complex interventions are exemplified by her key contributions to Australian guideline development in preventive care and cancer.

Dr. Maggie Kirkman is a Senior Research Fellow in the Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University. Her research interests include psychosocial aspects of reproduction, illness, and the body, with an emphasis on gender and on qualitative research methods.

Acknowledgements

This project was made possible by a funding grant from the Prostate Cancer Foundation of Australia (PCFA). The PCFA generated the funding through fund-raising activities in the Gippsland region, including Latrobe’s Biggest Ever Blokes BBQ.

Publication Date

12-22-2016

Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 License.

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