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Press Release

Prostate cancer diagnosis and treatment poses difficulties for GPs

20 October 2011

Controversies over the diagnosis and treatment of prostate cancer mean that GPs often find themselves in a difficult position when patients' expectations cannot be met says the MDU, which represents over half of UK GPs.

In the latest issue of Good Practice, the MDU's journal for GPs and GPSTs which is published today, MDU medico-legal adviser, Dr Sally Old, writes: “Prostate cancer has been described as 'perhaps the most enigmatic malignancy in men' because many men are found to have the condition after their death without it ever having caused them a problem. There are diverging opinions over the management of prostate cancer, most notably the use of screening. Over time there has perhaps been a move to more active intervention but this is not without risks and treatment can adversely impact the quality of a patient's life.

“Patients rightly expect their GP to make a timely and accurate diagnosis of prostate cancer, as well as appropriate advice about managing the condition. However, the controversy over the best way to diagnose and treat prostate cancer means that GPs can find themselves in a difficult position when deciding whether a prostate specific antigen (PSA) test is appropriate and then deciding how to handle the results.”

Of the 178 complaints reported to the MDU in relation to prostate cancer patients over the last ten years, 70% (124) concerned an alleged failure to diagnose the condition while others centred on management of patients after diagnosis, including allegations of failure to provide or refer for what the patient considered the most appropriate treatment.

However Dr Old explains: “Patients who are referred to a specialist who recommends intervention are likely to perceive any delay by their GP in testing or referral as significant, compared to those whose consultant advocates a 'watch and wait' strategy. However this may be a matter of clinical opinion rather than an indication that the GP has been negligent.

“The best way for GPs to help themselves is by ensuring their practice has a system in place to follow up results of investigations, such as PSA tests, which are carried out and clearly communicating the implications of an abnormal finding to the patient with referrals made when necessary. Where a decision is made not to carry out a PSA test, the reasons should be explained to the patient, as well as their right to obtain a second opinion.”

Also in Good Practice, MDU adviser Dr Sally Barnard looks at the most common queries from GP members about home births while Dr Rachel Sutcliffe outlines the rules surrounding Lasting Power of Attorney decisions and offers advice for GPs who are asked to act as a witness or certificate provider.



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