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

Abstract

Objective Documentations of the experiences of patients with advanced prostate cancer and their partners are sparse. Views of care and treatment received for metastatic castrate‐resistant prostate cancer (mCRPC) are presented here. Methods Structured interviews conducted within 14 days of a systemic therapy for mCRPC starting and 3 months later explored the following: treatment decisions, information provision, perceived benefits and harms of treatment, and effects of these on patients’ and partners’ lives. Results Thirty‐seven patients and 33 partners recruited from UK cancer centres participated. The majority of patients (46%) reported pain was their worst symptom and many wanted to discuss its management (baseline‐50%; 3 months‐33%). Patients and partners believed treatment would delay progression (>75%), improve wellbeing (33%), alleviate pain (≈12%) and extend life (15% patients, 36% partners). At 3 months, most men (42%) said fatigue was the worst treatment‐related side effect (SE), 27% experienced unexpected SEs and 54% needed help with SEs. Most patients received SE information (85% written; 75% verbally); many additionally searched the Internet (33% patients; 55% partners). Only 54% of patients said nurse support was accessible. Conclusion Pain and other symptom management are not optimal. Increased specialist nurse provision and earlier palliative care links are needed. Dedicated clinics may be justified.

Facing life-prolonging treatment: The perspectives of men with advanced metastatic prostate cancer – An interview study

“…The men in the present study considered the life-prolonging treatment an opportunity to inhibit the disease progression but expressed awareness of that they would not be cured, which is in line with the results of another interview study by Catt et al (2019). However, this contrasts against previous research showing that palliative and life-prolonging treatments of cancer might be misunderstood by patients as being curative (Weeks et al, 2012;Nowicki et al, 2015;Mitera et al, 2012).…”

A Systematic Review of Patients’ Values, Preferences, and Expectations for the Treatment of Metastatic Prostate Cancer

“…Of the 573 articles identified, 15 studies with a total of 1491 participants met the prespecified eligibility for inclusion in this systematic review, as outlined in the PRISMA-P flow diagram ( Fig. 1 ) [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] . The mean number of participants per study was 99 (standard deviation [SD] 117.14).…”

“…A summary of the demographics and study design of the qualitative studies is presented in Table 1 [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] . A complete list of all findings by study is available in Supplementary Table 7 .…”

“…Cancer progression and/or OS benefits related to treatment were a key theme extracted from five of the studies [35] , [36] , [37] , [38] , [39] . Dearden et al [37] undertook semistructured interviews with 38 patients with mCRPC who were receiving a novel antiandrogen therapy (abiraterone acetate or enzalutamide).…”

“…Fatigue was a key theme related to treatments identified in five of the studies [32] , [34] , [35] , [36] , [38] . Catt et al [36] undertook structured interviews with 37 patients with mCRPC, exploring experiences of treatment decisions, perceived benefits and harms of treatment, and the effects on patients’ lives. At 3 mo after starting a systemic therapy, 42% of patients said that fatigue was the worst treatment‐related side effect.…”