5 0 3What ' s known on the subject? and What does the study add? Although androgen deprivation therapy (ADT) is widely used to treat men with prostate cancer, little is known about the information needs of patients on ADT.We found that patients are generally very satisfi ed with using ADT and expressed minimal decisional regret with its use up to four years later. For men receiving ADT in the adjuvant setting, their survival estimates with the addition of ADT were quite reasonable when compared to fi ndings in randomized trails. A key area to enhance patient education appears to be side effects, especially around hot fl ashes and fatigue, which were also the most bothersome treatment sequelae for patients. OBJECTIVE• To evaluate information needs of men receiving androgen deprivation therapy (ADT). PATIENTS AND METHODS• A cross-sectional survey was distributed to English-speaking prostate cancer patients receiving ADT adjuvant to radical therapy or for biochemical relapse.• Three cohorts were recruited based on duration of ADT use: < 6 months (cohort 1), 6 -18 months (cohort 2) and 18 months to 4 years (cohort 3).• Several validated questionnaires were used, including the Control Preferences Scale (CPS), Satisfaction with Treatment Decision Scale (SWD) and Decisional Regret Scale (DRS).• Patients on adjuvant ADT were asked to estimate their overall survival with and without ADT. RESULTS• Eighty-fi ve men were recruited, of whom 91.8% were receiving a gonadotrophinreleasing hormone agonist, 4.7% were receiving anti-androgen monotherapy and 3.5% were receiving combined androgen blockade.• Patients preferred the following decision-making roles: 23.5% active, 50.6% collaborative, 27.0% passive.• Mean patient satisfaction for ADT use was high at 24.0/30 and decisional regret was low at 7.9/25.• There was a perceived overall survival benefi t of 3.9 -6.9% at 5 years, 3.6 -17.8% at 10 years and 5.7 -18.1% at 15 years with the addition of adjuvant ADT.• Hot fl ushes and fatigue were reported as the most common theoretical adverse effects as well as those experienced most commonly by patients. CONCLUSIONS• Patients on ADT were generally satisfi ed with their decisions to start ADT and expressed minimal decisional regret up to 4 years later.• A key area to enhance patient education appears to be adverse effects, especially around hot fl ushes and fatigue. [ 3 ] . There has been a substantial increase in the use of ADT across all cancer stages and grades in the last two decades [ 4 ] . More and more, ADT is being used in the adjuvant setting with curative treatment, or in the setting of biochemical relapse after potentially curative treatment [ 5 ] . KEYWORDSHowever, despite the long history of ADT as a treatment for prostate cancer, coupled with its increased use, not much is known about patients ' information needs associated with taking ADT or understanding how ADT works as a treatment. Addressing information defi cits for men on ADT would improve their ability to seek appropriate medical care and may increase patient ...

Objective: Androgen deprivation therapy (ADT) is a common treatment for prostate cancer with numerous side effects. We assess primary care physicians' (PCPs) knowledge of ADT side effects and their interest in increasing their knowledge in this area. Methods: A list of active Canadian PCPs was obtained using the Canadian Medical Directory. A cross-sectional survey was distributed to 600 randomly selected physicians. We collected PCPs' demographic information, experience with ADT management, knowledge regarding ADT side effects and desired sources for obtaining knowledge on ADT management. Results: In total, we received 103 completed questionnaires. Of these, 89% of PCPs had patients on ADT. One-third of respondents prescribed ADT and over half of them administered ADT annually. Thirty-eight percent felt their knowledge of ADT side effects was inadequate and 50% felt uncomfortable counselling patients on ADT. Many PCPs were less familiar with the incidence of functional side effects of ADT (i.e., hot flashes, fatigue and erectile dysfunction) compared to life-threatening side effects (i.e., cardiovascular events, metabolic syndrome, fractures). In terms of increasing their knowledge of ADT side effects, 82% of PCPs would use educational resources if they were available (52% and 32% preferred continued medical education [CME] events and educational pamphlets, respectively). Conclusions: PCPs play an important role in managing ADT side effects. There is poor awareness of the prevalence of ADT side effects, and many are uncomfortable in managing these side effects. These areas may be addressed through CME programs and educational pamphlets.

Background:Generalized rash is amongst the most common conditions presented to practicing General Practitioners and common differentials include contact dermatitis, atopic eczema, sun-induced damage, drug eruption and general manifestations of systemic diseases or infections.Materials and Methods:We illustrate with differential diagnoses our clinical case of a generalized rash in a 55-year-old man with pathognomonic signs of a diagnosis, which has received increasing global concern.Conclusion:Despite the array of available laboratory tests, a detailed history and physical examination is still of paramount importance to arrive at the most likely diagnosis for any patient with a generalized skin rash.

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