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

Eur J Cancer Care (Engl). 2019 Nov;28(6):e13140. doi: 10.1111/ecc.13140. Epub 2019 Sep 1.

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.

Keywords: advanced prostate cancer; interviews; supportive care.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Attitude to Health*
  • Decision Making
  • Health Behavior
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Pain Management
  • Prospective Studies
  • Prostatic Neoplasms, Castration-Resistant / psychology*
  • Prostatic Neoplasms, Castration-Resistant / therapy*
  • Quality of Life
  • Spouses / psychology*
  • United Kingdom

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