The next phase of development will focus on improving the user interface and allowing easier transfer of information between the tracker and notes within the Computerized Patient Record System. The team will also look into automating additional parts of the process but feels that a clinician (ideally a nurse practitioner or physician assistant working with the radiation oncologist) must be part of the team, because clinical decisions must be made based on multiple variables and patient preferences.
The development of this PSA tracking system has significant future implications for improving biochemical control and extending patient survival. The tracker could be easily adapted to monitor prostatectomy patients and PSA failures requiring early intervention with salvage radiotherapy. It has been shown in several publications that early treatment with radiotherapy while PSA is relatively low results in higher rates of long-term biochemical control. 10-22
Conclusions
Access to the VA CDW was essential for the success of the PSA tracking system. Furthermore, veteran patients with prostate cancer tend toward a high rate of adherence and typically stay within the system. Prostate cancer is one of the few cancers where disease recurrence is detected and determined by a quantitative laboratory value, which lends itself well to objective arithmetical tracking and detection.
Patients with prostate cancer are at risk of recurrence years after their treatment and require a long-term follow-up that includes annual PSA checks. Identifying patients who have missed follow-up appointments and not had their PSA checked is essential for combating prostate cancer recurrences. The VA CDW makes it possible to track the majority of the patients with prostate cancer who are treated in the system and identify those most in need of early treatment or early intervention before they become
symptomatic.
Author disclosures
The authors report no actual or potential conflicts of interest with regard to this article.
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