Androgens - Choice of Intermittent vs Continual - Prostate Cancer
Principal / Lead Investigator
- Prof Clare Wilkinson (Bangor University)
Type of study
Multi method feasibility study (PhD Studentship)
Prostate cancer is common and increasing; 830,000 men will be living with prostate cancer in the UK by 2020. Androgen deprivation, which means suppressing the male hormones, is offered as a treatment modality to most men at some point during their cancer journey. Side effects of this treatment are common and troublesome including hot flushes (80%), sexual dysfunction (90%), fatigue (43%), anaemia (90%), thinning bones (20% increase in fracture), and increased chances of diabetes, heart disease, memory loss and depression.
Offers of treatment breaks are now recommended for about one in ten prostate cancer sufferers (defined by NICE in the UK). This allows men’s natural hormones to recover for a while; giving them better quality of life. Recent research about the risks of recurrence suggests that taking treatment breaks with careful monitoring is as good at keeping cancer in check as continual treatment. Therefore, NICE recommends that men, for whom this is considered a safe option, should be given a choice of ‘intermittent’ hormone deprivation. It appears, though, they are not offered this choice consistently, especially when older men are reluctant to complain; and when oncologists and surgeons focus more on reducing cancer recurrence risk. Simultaneously, more men are being followed up by their own GP practice, where more education is needed to support men well. Hence, this PhD project has been designed to accomplish three goals:
- Summarise the broader literature on quality of life related to hormone deprivation breaks
- Find out if men want and value a choice about treatment breaks
- Study the normal practices of the health professionals involved; and aim to gain UK consensus
Who is the study sponsor?
Does the study involve commercial partnership activity?
Total grant value
How could this research potentially benefit patients?
The studies proposed in this project are aimed to give patients’ choices a voice and empower them to make informed choices about their treatments based on what is important to them i.e. quality of life vs risk of prostate cancer recurrence.
The outputs from these studies could underpin a trial of patient choice, possibly leading to a decision aid in the future.
Outputs generated (Reports / Publications / Impact)
Nafees Din, Andrei Stanciu, Ruth Lewis, Richard Neal, Eila Watson, Clare Wilkinson. Patient perspectives and quality of life issues whilst undergoing intermittent or continuous androgen deprivation therapy for prostate cancer: a mixed methods systematic review. PROSPERO 2016:CRD42016046503
Project description on Tenovus Cancer care website: https://tenovuscancercare.org.uk/research/community-research/current-phd-studentships-community/androgens-choice-of-intermittent-vs-continual%E2%80%93-prostate-cancer-(a-choice-pc)/