Re: Anna Bill-Axelson, Hans Garmo, Lars Holmberg, et al. Long-term Distress After Radical Prostatectomy Versus Watchful Waiting in Prostate Cancer: A Longitudinal Study from the Scandinavian Prostate Cancer Group-4 Randomized Clinical Trial. Eur Urol 2013;64:920–8.

We were glad to see the article on long-term distress after radical prostatectomy versus watchful waiting in prostate cancer [1]. This paper highlights a number of problems experienced worldwide with follow-up of this cohort and the lack of available holistic care facilities. Prostate cancer is one of the most frequently diagnosed cancers in men [2]. Due to improvements in diagnosis and treatment, the number of survivors is increasing[3]. This often results in overbooked clinics, with patients only receiving treatment of acute medical conditions with no support for accompanying physical and psychological conditions [4]. Taking this into account, we developed a new model. Once patients with prostate cancer have entered the socalled survivorship phase, they are offered the option of entering the prostate cancer survivorship programme. Patients are not followed up in clinic, but their prostatespecific antigen (PSA) numbers are entered into a central database. Patients are also allocated a specialist nurse as a key worker should their clinical situation change or as a way of informing patients to attend the clinic regarding PSA changes triggered from the database.