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Physical and psychological side-effects following prostate cancer treatments - Heather Kinnear

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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 Kinnear

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Physical and psychological side-effects following prostate cancer treatments - Heather Kinnear

  1. 1. Heather Kinnear, Frances Drummond, Linda Sharp, David Donnelly, Eamonn O’Leary, Anna Gavin
  2. 2. Investigation differences  There has been a vast increase in the number of PSA tests performed over last 10 years Treatment 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 2
  3. 3. •Incidence of prostate cancer is 34% higher in RoI than in NI
  4. 4.  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
  5. 5. From Cancer 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) Questionnaires returned •N=2,494 (RoI) RR 54% •N=1,010 (NI) RR 48% •Overall n=3,504 RR 50% 5
  6. 6. NI RoI Same as expected 27% 26% Worse than expected 19% 20% No side effects experienced 13% 18%
  7. 7. 0 10 20 30 40 50 60 70 80 90 100 Prostatectomy HormoneTherapy Radiotherapy Monitoring Prostatectomy HormoneTherapy Radiotherapy Monitoring Prostatectomy HormoneTherapy Radiotherapy Monitoring Urinary Symptoms Impotence Loss of interest in sex PercentageofPatients Symptom/Side effect Previous Ongoing
  8. 8. 0 10 20 30 40 50 60 70 80 90 100 Urinary incontinence Loss interest sex Impotence Bowel Probs Breast Changes Hot Flushes Depression PercentageofPatients Ongoing side effects Prostatectomy Radiotherapy Hormone Therapy Monitoring
  9. 9.  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
  10. 10.  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 10

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