Prostate cancer is the most diagnosed cancer in Australian males, accounting for more than 16,500 cancer cases and more than 3,100 deaths in 20201. But the burden of prostate cancer extends much further.
More than 95% of people diagnosed with prostate cancer survive for at least five years, and there are currently around 200,000 Australians living after their diagnosis1. More than one-third of these people have long-term problems that diminish their quality of life, and a common feature of people in this group is the use of androgen deprivation therapy to treat their disease2.
Inhibition of testosterone production, or the action of testosterone, slows prostate cancer progression and increases survival but it can also cause debilitating side effects3. The best way to help survivors of prostate cancer manage these consequences of their treatment is not known, but a new research project will soon be underway to trial evidence-based telehealth support delivered by specialist prostate cancer nurses.
The research, funded by the National Health and Medical Research Council, is led by Prof Jeff Dunn, CEO of the Prostate Cancer Foundation of Australia, in partnership with Healthy Male and other organisations.
“The supportive care needs of men on hormone therapy are not adequately addressed or treated right now, with many men experiencing unmet informational, psychological, and sexual help needs,” Professor Dunn said.
“The project will vastly improve our understanding of how specialised support can improve quality of life and survivorship outcomes for men on hormone therapy, who have had their needs ignored for too long.”
More than 200 men will participate in the trial, which will use an evidence-based survivorship framework, developed by the University of Southern Queensland, in collaboration with the PCFA and NHMRC’s Centre of Research Excellence in Prostate Cancer Survivorship.
The six features of the survivorship framework4 are:
- Health promotion and advocacy
- Shared management
- Vigilance
- Personal agency
- Care coordination
- Evidence-based survivorship interventions.
It will be delivered by specially trained PCFA nurses through four telehealth sessions over a four-week period, with a booster session a month later.
“We will be collaborating closely with Australia’s leading institutions and researchers in this field, including the team at Edith Cowan University, who will help guide the development of a home-based exercise activity program.
“Men who take part in the program will be encouraged to seek at least one planning session with an Accredited Exercise Physiologist within their treatment team, which may be by telehealth as appropriate.
“Participants will also be provided with online progress reports, resources and forms for education and motivation, including a weekly wellness check.
“The nurse specialist will encourage maintenance of exercise including both aerobic and resistance training as per Australian exercise medicine for cancer guidelines with referral to the Accredited Exercise Physiologist if required.”
The sessions will also cover distress management strategies, decision support, treatment education with self-management and skills training for symptom effects, and communicating with health professionals.
“If we prove this works, which we believe it will, our aim is to have this service made available to every man diagnosed with prostate cancer on hormone therapy,” Professor Dunn said.
References
[1] https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia/contents/cancer-summary-data-visualisation
[2] Ralph et al., 2020. Ten-year quality of life outcomes in men with prostate cancer. Psycho-Oncology
[3] Nguyen et al., 2018. Risks of Major Long-Term Side Effects Associated with Androgen-Deprivation Therapy in Men with Prostate Cancer. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy
[4] Dunn et al., 2020. Prostate cancer survivorship essentials framework: guidelines for practitioners. BJU International