Editing Patient Pathways: Prostate Cancer (section)

= Challenges faced by prostate cancer patients during their therapeutic journey =

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== Challenges during diagnostic evaluation ==

A diagnosis of prostate cancer can be a stressful and challenging time for patients. Support during this phase can significantly improve the patient’s emotional and physical condition. Prostate cancer patients face various difficulties during diagnosis, such as physical, psychological, financial and professional difficulties and lack of information.

'''Physical challenges'''

'''Invasive tests:''' Discomfort and pain during prostate biopsy.

'''Psychological problems'''

Waiting for test results can increase anxiety. Fear of facing the diagnosis.

'''Financial problems'''

The price of a private MRI scan (if the patient decides to speed up the procedure).

'''Lack of information'''

Patients often have difficulty finding reliable and comprehensible information about the disease, diagnostic procedures, treatment options and their rights. Insufficiently clear communication with doctors: the complexity of medical terminology and the lack of time during consultations can make it difficult to fully understand the diagnosis and treatment options.

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== Challenges during treatment ==

'''Physical complaints'''

'''Urological problems:''' Many patients experience urinary problems, including incontinence (uncontrollable urination) or frequent urination, especially after surgery or radiation.

'''Sexual dysfunction:''' Erectile dysfunction is a common side effect of prostate cancer treatment, whether it is surgery, radiation or hormone therapy.

'''Fatigue:''' Radiation, chemotherapy and hormone therapy can cause extreme fatigue and exhaustion.

'''Pain and discomfort:''' Pain in the pelvis or lower back can be present due to the disease itself or as a side effect of treatment.

'''Changes in weight:''' Hormone therapy can cause weight gain or loss of muscle mass.

'''Psychological problems'''

'''Depression and anxiety:''' Coping with a cancer diagnosis and the side effects of treatment can cause significant emotional and psychological problems.

'''Fear of relapse:''' The constant fear of the cancer returning can be emotionally draining.

'''Family relations:''' Changes in family roles and responsibilities due to illness can cause stress and tension in the family.

'''Isolation:''' Physical and emotional symptoms can lead to social isolation and feelings of loneliness.

'''Financial and professional problems'''

'''High costs of medicines, therapies and medical procedures''' they can represent a financial burden.

Due to inability to work or reduced work capacity, many patients may experience loss of income.

'''Lack of information'''

The need to understand complex medical information and make informed decisions. Difficulties in making treatment decisions due to lack of reliable and comprehensible information or conflicting advice.

'''Ignorance of patients’ rights.'''

Lack of information about medical care providers during treatment.

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== Challenges during rehabilitation and disease monitoring ==

'''Physical complaints'''

'''Urological problems: incontinence''' (urinary control problems may continue after treatment, caused by surgery or radiotherapy) and an increased need to urinate, often at night.

'''Sexual dysfunction: erectile dysfunction (problems achieving or maintaining an erection, often as a result of surgery or therapy) and decreased libido:''' loss of interest in sexual activities.

'''Chronic fatigue:''' long-term exhaustion that can be caused by treatment, anemia, or hormone therapy.

'''Hormonal problems:''' hot flashes (common in patients who have undergone hormone therapy) and weight gain (weight gain as a result of hormonal changes).

'''Psychological problems'''

'''Fear of relapse:''' continuous fear of the cancer returning.

'''Anxiety and depression:''' psychological distress and emotional problems associated with the cancer experience.

'''Changes in mood''' and emotional instability.

'''Social isolation:''' reduced social interaction due to fatigue, anxiety, or other symptoms.

'''Financial and professional problems'''

'''Return to work:''' physical and psychological difficulties with returning to the workplace. Long-term financial burden associated with ongoing medical expenses.

'''Lack of information'''

'''Insufficient education''' about life after prostate cancer treatment.

'''Complexity of Information:''' difficulties in understanding medical information and recommendations.

'''Erectile dysfunction''' it is a very common complaint that is a long-term consequence of treatment. Treatment of erectile dysfunction is important to ensure oxygenation of penile tissue. A large percentage of patients do not even seek the necessary information, which leads to the neglect of complaints and can consequently lead to atrophy and permanent structural changes.

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== Challenges during palliative care ==

The problems faced by prostate cancer patients in Croatia and their families during palliative care are multiple and include several key aspects:

'''Limited access to palliative care:''' there is a significant gap between the demand for palliative care and the available resources. Insufficient capacities of specialized palliative care providers.

'''Psychological problems'''

'''Psychosocial and emotional burden''' patients and their families is often large. Family caregivers often face high levels of stress and emotional burden.

'''Cultural and ethical issues:''' reluctance to discuss end-of-life issues can hinder the provision of effective palliative care.

'''Ethical challenges''' in decision-making and caregiving can also create additional stress for families and healthcare professionals.

'''Financial problems'''

The cost of care can be a significant burden on families, especially when considering the long-term nature of palliative care. Economic strain can further exacerbate the stress experienced by patients and their families, affecting their overall well-being and quality of life.

'''Challenges with care coordination:''' Effective palliative care requires coordination among different health care providers. In Croatia, there are challenges related to the coordination of care between hospitals, palliative care units and home care services.

Addressing these challenges requires a comprehensive approach that includes improving access to palliative care, providing emotional and psychological support to families, addressing economic burdens, and ensuring effective care coordination. In addition, public education and awareness of the benefits of palliative care can help reduce cultural and ethical barriers.

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