RESUMEN
INTRODUCTION: Prostate cancer (PC) is one of the tumours with the highest incidence in recent years. PC therapies have several adverse effects. A panel consensus recommendation has been made to prevent or ameliorate complications in PC treatment to improve quality of life. MATERIAL AND METHODS: Fifteen specialists have met to analyse the different toxicities associated with PC treatment. Each medical specialist performed a National Library of Medicine PubMed search citations searching about these secondary effects and his specialty from 1999 to 2009 to propose measures for their prevention/amelioration. RESULTS: Surgery is associated with incontinence and impotence. Radiotherapy can produce acute, late urological and gastrointestinal toxicity. Brachytherapy can produce acute urinary retention. Chemotherapy is associated with haematotoxicity, peripheral neuropathy and diarrhoea, and hormone therapy can produce osteoporosis, metabolic syndrome, cognitive and muscular alterations, cardiotoxicity, etc. CONCLUSIONS: Improvement in surgical techniques and technology (IMRT/IGRT) can prevent surgical and radiotherapeutic toxicity, respectively. Brachytherapy toxicity can be prevented with precise techniques to preserve the urethra. Chemotherapy toxicity can be prevented with personalized schedules of treatment and close follow-up of iatrogenia and hormone therapy toxicity can be prevented with close follow-up of possible secondary effects.
Asunto(s)
Carcinoma/terapia , Consenso , Práctica Clínica Basada en la Evidencia , Directrices para la Planificación en Salud , Neoplasias de la Próstata/terapia , Calidad de Vida , Algoritmos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Braquiterapia/métodos , Carcinoma/psicología , Terapia Combinada , Humanos , Masculino , Neoplasias de la Próstata/psicología , Traumatismos por Radiación/prevención & control , Traumatismos por Radiación/psicología , Dosificación RadioterapéuticaRESUMEN
Developing and maintaining a comprehensive cancer control program are two distinct entities. Key issues related to building and sustaining cancer control programs include how to integrate initiatives and efforts across multiple constituencies addressing components of the implementation of cancer control and non-communicable disease programs, the processes used in different resource settings to achieve effective drug budgeting, health technology assessment and health economics, and how countries can support public and societal engagement. There are promising examples in both resource-rich and resource-challenged countries of constituencies that have developed programs which can contribute to comprehensive cancer control. Some take advantage of newer technology and information services, while others are more people and patient focused. Critical issues and factors for establishing and maintaining population-based comprehensive cancer control programs are identified and reviewed.