Exploring Unmet Needs in Prostate Cancer Care: A Cross-sectional Descriptive Study

Natasha A Roberts; Rachel Esler; Adam Pearce; David Wyld; Michael Smith; Kaylene Woollett; Carolyn Mazariego; Matthew J Roberts

doi:10.1016/j.euros.2024.01.018

Exploring Unmet Needs in Prostate Cancer Care: A Cross-sectional Descriptive Study

Eur Urol Open Sci. 2024 Feb 27:62:36-42. doi: 10.1016/j.euros.2024.01.018. eCollection 2024 Apr.

Authors

Natasha A Roberts^{1

2}, Rachel Esler³, Adam Pearce³, David Wyld^{1

3}, Michael Smith^{3

4}, Kaylene Woollett³, Carolyn Mazariego^{5

6}, Matthew J Roberts^{1

3}

Affiliations

¹ Centre for Clinical Research, Clinical School, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
² STARS Education and Research Alliance, Surgical Treatment and Rehabilitation Service (STARS), The University of Queensland and Metro North Health, Herston, QLD, Australia.
³ Department of Urology, Cancer Care Services, Surgery and Peri-operative Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.
⁴ School of Nursing, Queensland University of Technology, Kelvin Grove, QLD, Australia.
⁵ School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia.
⁶ The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Kings Cross, NSW, Australia.

Abstract

Background and objective: Prostate cancer, the most common cancer among men worldwide, has significant impact on quality of life. Supportive care needs for those affected by prostate cancer are not well understood. This study aims to describe patient-reported unmet needs and explore supportive care priorities of men treated for prostate cancer.

Methods: A cross-sectional survey was distributed to all men who had accessed prostate cancer services (including surgical, radiation, and medical oncology treatment modalities) at a tertiary hospital. The survey included qualitative questions exploring patient experience and a validated patient-reported outcome measure (Supportive Care Needs Survey Short Form 34). Clinical information was collected. Analyses included, descriptive statistics, multivariate logistic regression models and qualitative analyses using a framework method.

Key findings and limitations: A total of 162 participants provided survey data. Domains about information, self-management, and sexual function were the highest ranked items with unmet needs. A qualitative analysis also identified "relationships", "information", and "the value of hindsight" constructs. Participants who identified three or more unmet needs expressed treatment regret (odds ratio 5.92, 1.98-22.23, p = 0.01).

Conclusions and clinical implications: Understanding the unmet needs of patients may better inform supportive care interventions that address what is important to patients. Importantly, participants valued relationships. There may be opportunities to better meet the needs of patients by improving access to information and self-management resources, particularly around sexuality. Further research is warranted.

Patient summary: Prostate cancer and its treatment impacts are not well understood. Prioritisation of relationships and improving access to information and self-management resources are important. Further attention to prostate cancer supportive care in clinical practice is needed.

Keywords: Cancer care; Mental health; Patient information; Patient-reported outcome; Patient-reported outcome measure; Prostate cancer; Sexual health; Supportive care; Unmet needs; Urology.