World-first trial of new prostate cancer survivorship care model

A translational research trial headed by Professor Jeff Dunn AO will be based on the Australian developed Prostate Cancer Survivorship Essentials Framework to inform health service delivery in a real-world setting. The trial will get underway in Australia in 2022, testing the clinical and cost-effectiveness of nurse-led survivorship care for improving the health and well-being of men on hormone therapy for prostate cancer.

Hormone therapy is widely used to treatment prostate cancer, with between 30-50 per cent of all men diagnosed with the disease undergoing the treatment. Although it slows disease progression and increases survival, hormone therapy can cause loss of muscle mass and bone density, sexual dysfunction, and other chronic health conditions including cardiovascular disease and diabetes. Compared to men with prostate cancer who are not on hormone therapy, these men are more likely to develop mental health issues, such as depression and anxiety, and are at a higher risk of suicide.

The trial seeks to establish a sustainable tailored care model and bring better understanding of how specialised support improves quality of life and survivorship outcomes for men on hormone therapy. More than 200 men will participate in the trial, with care provided by around 100 specially-trained Prostate Cancer Foundation of Australia (PCFA) prostate cancer care nurses through four telehealth sessions over four weeks, with a booster session a month later.

Health psychologist Professor Suzanne Chambers AO, a world leading specialist in the psychology of cancer, is constructing the content for both training and session implementation around her existing low-intensity mental health intervention, Facing the Tiger. Sessions will cover distress management strategies, decision support, treatment education with self-management and skills training for symptom effects, and communicating with health professionals.

Following the trial, it is hoped that a tailored care service will be integrated into mainstream practice and thus made available to every man diagnosed with prostate cancer on hormone therapy. The manual created for the trial on how to best use the Facing the Tiger book with prostate cancer survivors will also be available for use by a range of health professionals including psychologists.


Urologists initiative to achieve stronger survivorship for men with prostate cancer

Stronger survivorship for men with prostate cancer

In a world-first health initiative, urologists across Australia and New Zealand are receiving a free copy of a low-intensity mental health intervention called Facing the Tiger to assist men with prostate cancer and their partners achieve stronger survivorship as they move through treatment.

The Urological Society of Australia and New Zealand (USANZ) and the Prostate Cancer Foundation of Australia (PCFA) have jointly funded the initiative as part of their shared commitment to the priority of ensuring men with prostate cancer have access to evidence-based psychosocial care.

Presented in the form of a slim self-help paperback, Facing the Tiger: A Survivorship Guide for Men with Prostate Cancer and their Partners was specifically designed to be provided to men upon diagnosis and those undergoing treatment and watchful waiting. It encourages access to best-practice psychosocial care based on recently updated Australian guidelines for multidisciplinary treatment.

The book is written by Professor Suzanne Chambers AO, who has been working as a practitioner and researcher in psycho-oncology, the psychology of cancer, for over 25 years. It forms part of a fresh approach to cancer survivorship as detailed in the 2019/20 Prostate Cancer Survivorship Essentials Framework.

The essentials framework was developed by an inclusive expert clinical and community panel which identified key survivorship domains extending beyond traditional healthcare parameters. The framework provides guidance for policymakers, clinicians, community and consumers on what is essential for a step-change in prostate cancer survivorship outcomes.

The vital need for an updated approach to prostate cancer survivorship was expressed by Professor Chambers at a recent worldwide meeting of urology professionals. She reminded participants that the current American Cancer Society prostate cancer survivorship care guidelines have no documented consumer input, limited evidence, are reliant on expert opinion, lack translation into policy and practice, and given that they were written in 2014, due for an update.

Prof. Chambers also noted that the high incidence of prostate cancer, coupled with improving long-term survival, is leading to a high community disease burden. Given that many men with prostate cancer experience long-term deterioration of their mental and physical quality of life, they are overall at greater suicide risk than non-cancer peers. Thus, survivorship care for men with prostate cancer is crucial both in the short and long term.

The essentials framework includes the call for proactive interventions for psychosocial care, based on the understanding that older men are often reluctant to seek help for mental health issues.

Endorsed by both the USANZ and PCFA as well as the Australia and New Zealand Urological Nurses Society, Facing the Tiger works to achieve better survivorship outcomes through better mental health; helping patients manage stress and anxiety, improve their decision-making, understand the realities of their unique treatment journey, access support, and increase the effectiveness of communications with their health care team.

Over 600 practising urologists will receive a copy of the book, along with a signed letter from PCFA National Chair Steve Callister and USANZ President A/Prof Prem Rashid encouraging its use with patients.

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