Patients’ and partners’ views of treatment and care provided for metastatic castrate resistant prostate cancer (mCRPC) in the UK

Date 22 October 2018
Event ESMO 2018 Congress
Session Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Topics Prostate Cancer
Psychosocial Aspects of Cancer
Presenter Susan Catt
Citation Annals of Oncology (2018) 29 (suppl_8): viii557-viii561. 10.1093/annonc/mdy296
Authors S.L. Catt1, L. Matthews2, H. Payne3, M.D. Mason4, V. Jenkins5
  • 1Sussex Health Outcomes Research & Education In Cancer (shore-c), Brighton and Sussex Medical School, University of Sussex, BN1 9PX - Brighton/GB
  • 2Sussex Health Outcomes Research & Education In Cancer (shore-c), Brighton and Sussex Medical School, University of Sussex, Brighton/GB
  • 3Oncology, University College London Hospital UCLH NHS Foundation Trust, NW1 2PG - London/GB
  • 4Velindre Cancer Centre, Velindre Hospital, CF14 2TL - Cardiff/GB
  • 5Shore-c, BSMS, BN1 9RX - Brighton/GB

Abstract

Background

Appraisals of information needs, expectations and experiences of treatment in prostate cancer have highlighted the lack of relevant data in advanced disease. We report interview data from the EXperiences of TREatment and Quality Of Life of men with mCRPC study (EXTREQOL). It aimed to examine factors driving treatment decision-making from the perspectives of patients and healthcare professionals and gather data on the impact of treatments on quality of life (QOL).

Methods

A prospective longitudinal mixed-methods observational design was employed. This included semi-structure interviews conducted with patients and their partners, in-person or by phone, at baseline =within 14 days of starting a systemic treatment (any line) for mCRPC and after 3 months of treatment. Topics explored included experiences of treatment decisions, information provision, what assisted decision-making and how perceived benefits and harms of treatment affected patients’ and families’ lives.

Results

Thirty three men (56-89yrs) and their female partners (54-79yrs) from 15 UK centres participated. They believed treatment aimed to delay progression (>75%), improve QOL (33%), alleviate pain (≈12%) and extend life (15% -patients, 36% -partners). ≈50% made a joint treatment decision with the doctor and 39% had as long as they needed to decide. The worst symptom most frequently identified was pain (46% -patients, 33% -partners). At baseline and 3 months (50% and 67% respectively) did not need to discuss pain control, those that did received “very/fairly” useful information. At baseline fatigue, nausea/vomiting and diarrhoea were the worst anticipated or experienced side-effects (SEs). The worst SE at 3 months was fatigue, 33% experienced unexpected SEs and 52% sought help for SEs. 75% had helpful SE discussions, 85% received written information and internet searching about SEs was common (33% -patients, 55% -partners). Only 50% had opportunity to talk with a specialist nurse and 50% accessed other supportive services.

Conclusions

More help to manage pain and other symptoms is required. Dedicated clinics maybe warranted, better specialist nurse access and earlier palliative care links would help to optimise symptom control.

Clinical trial identification

Legal entity responsible for the study

Brighton & Sussex Medical School, University of Sussex.

Funding

Sanofi Aventis.

Editorial Acknowledgement

Disclosure

H. Payne: Honoraria for advisory boards, travel expenses, consultant: AstraZeneca, Astellas, Janssen, Sanofi Aventis, Takeda, Amgen, Ipsen, Ferring, Sandoz, Novartis; Work support: UCLH/UCL Comprehensive Biomedical Research Centre. M. Mason: Scientific expert: Ellipsis Pharma. All other authors have declared no conflicts of interest.