physical and psychological side-effects following prostate cancer treatments - heather kinnear
DESCRIPTION
A presentation given at the Irish Cancer Society's Survivorship Research Day at the Aviva Stadium, Dublin on Thursday, September 20th, 2013. Physical and psychological side-effects following prostate cancer treatments - Heather KinnearTRANSCRIPT
Past and current physical and psychological side-effects following prostate cancer treatments – an All-Ireland population-based study
Heather Kinnear, Frances Drummond, Linda Sharp, David Donnelly, Eamonn O’Leary, Anna Gavin
Investigation differences There has been a vast increase in the number of
PSA tests performed over last 10 yearsTreatment differences RoI patients receive more radiotherapy and
surgery and less hormone treatment than NI patients
More younger men in RoI are diagnosed with prostate cancer than in NI
Rates of diagnosis have been higher in RoI from 1996 onwards
Differences between NI and RoI
Why this research in Ireland?
• Incidence of prostate cancer is 34% higher
in RoI than in NI
Postal Questionnaire to men, any age, identified by Cancer registries, vetted for exclusions (end of life care, not aware of own diagnosis, cognitive/physical impairments) by Research Nurses/Clinicians/GP’s◦ 2 reminders◦ Standardised instruments used (EORTC QLQ C30,
EORTC PR25, DASS, Decision regret scale, EQ5D-5L)◦ Freephone facility set up – high volume of calls (13%
in both RoI (n=632/4,838) and NI (274/2,106)) ◦ Ethics and research governance etc
Methods
From Cance
r Registries
• Men diagnosed in NI and RoI with prostate cancer up to 17 years ago• N=12,900 (Stratified by time since diagnosis – 1-2.9, 3-4.9, 5-9.9, 10+ years)
Eligible
cases
• Research nurses checked patient eligibility according to inclusion/exclusion criteria
• N=4,838 (RoI) and n=2,106 (NI)
Questionnai
res return
ed
• N=2,494 (RoI) RR 54%• N=1,010 (NI) RR 48%• Overall n=3,504 RR 50%
Cohort
NI RoI
Same as expected
27% 26%
Worse than expected
19% 20%
No side effects experienced
13% 18%
Q. Overall were your side effects …?
Pro
state
ctom
y
Horm
one T
hera
py
Radio
thera
py
Monit
ori
ng
Pro
state
ctom
y
Horm
one T
hera
py
Radio
thera
py
Monit
ori
ng
Pro
state
ctom
y
Horm
one T
hera
py
Radio
thera
py
Monit
ori
ng
Urinary Symptoms Impotence Loss of interest in sex
0
10
20
30
40
50
60
70
80
90
100
PreviousOngoing
Symptom/Side effect
Perc
enta
ge o
f P
ati
ents
Urinary symtoms, impotence and loss of interest in sex
Urinar
y in
cont
inen
ce
Loss
inte
rest
sex
Impo
tenc
e
Bowel
Pro
bs
Breas
t Cha
nges
Hot Fl
ushe
s
Depre
ssio
n0
10
20
30
40
50
60
70
80
90
100
ProstatectomyRadiotherapyHormone TherapyMonitoring
Ongoing side effects
Perc
enta
ge o
f P
ati
ents
Ongoing side effects
Preliminary analysis Biases relating to responders (prostate
cancer survivors) and first survey responders
Not yet standardised for age, stage and treatment received
Multiple treatment groups need to be identified
Limitations
Large cohort of prostate cancer survivors It compares 2 healthcare systems with
different levels of uncovered disease and treatment
It contributes to the debate of whether increased investigation and treatment, in the era of increased PSA testing leads to better health
It is population-based Validated treatment data It used standardised instruments
Strengths of study
[email protected]: 028 9063 2618