Title: Enhancing quality of life for men with prostate cancer: a mixed methods review and narrative synthesis of the effectiveness, availability and appropriateness of supportive care provision.
Funder: Department of Health (England)

Abstract: Background Prostate cancer is the most common cancer in men in the UK. Men with prostate cancer are likely to have a long illness pathway. As well as the individual burden to patients throughout a lengthy illness trajectory, there is a burden on NHS resources. One way of managing this efficiently is to provide good supportive care, which in turn is likely to promote self-care for men living with prostate cancer, to encourage independence in managing symptoms and side-effects, and thus avoid unnecessary visits to the doctor. Supportive care for cancer patients has been high on the Government’s agenda for the past decade, but the guidance that exists is generic to all cancer patients rather than specific to prostate cancer. However, prostate cancer has specific features which need to be addressed, particularly how long men live with a diagnosis and the trade-off of treatment for disease and quality of life. Evidence from qualitative studies suggest there is a lack of support available, with prostate cancer patients reporting poor resources, a need for sources of support and a redesign of support services. An important first step in making recommendations for appropriate support for this patient group is to review both the literature on supportive care interventions and the literature on men’s experiences and perceived needs. To the best of our knowledge this combined approach has not applied to this topic before. Our project aims to provide a systematic review of both the quantitative and qualitative literature. The inclusion of qualitative studies and a high level of patient involvement in the study will give us a unique insight into the role of supportive care for prostate cancer. Aims To determine what constitutes effective supportive care for men diagnosed with prostate cancer in order to make policy recommendations and suggest types of support that can be evaluated in a clinical trial. Where effectiveness means improving the quality of life of men with prostate cancer. Plan of investigation We will systematically review and synthesise as appropriate a) the evidence from controlled trials for the effectiveness of supportive care interventions for prostate cancer and b) the qualitative research addressing prostate cancer patients’ experiences of the disease, their need for and experience of supportive care. The next step will be to cross reference the output of the reviews in a narrative synthesis. These results will be further explored in workshops with prostate cancer patients. Potential benefits to patients The results of this study will provide an accurate picture of the evidence of effectiveness of supportive care. We will report on any gaps in provision and provide evidence-based recommendations for developing supportive care. If prostate cancer patients receive the most appropriate, well-timed effective supportive care it will improve patient outcomes in terms of quality of life, well-being, physical function & activity, psychological health, self-efficacy, self-reported health and sexual adjustment. Potential benefits to NHS Such evidence should be used by policy makers to provide customised as opposed to generic supportive care for prostate cancer patients. Improvements in the ability to self-care through the long illness trajectory of prostate cancer is likely to reduce NHS costs in terms of a decrease in consultation rates . If prostate cancer patients receive the most effective supportive care this will lead to healthier individuals who make fewer demands on NHS in terms of their long-term physical & psychological care.


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS;8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: CANCER AND NEOPLASMS