Men’s experiences of radiotherapy treatment for localized prostate cancer and its long‑term treatment side effects: a longitudinal qualitative study

Eileen J Sutton; J. Athene Lane; Michael J Davis; Eleanor I Walsh; David Neal; Freddie C Hamdy; Malcolm Mason; John  Staffurth; Richard M Martin; Chris Metcalfe; TJ Peters; Jenny L Donovan; Julia Wade

doi:10.1007/s10552-020-01380-3

Men’s experiences of radiotherapy treatment for localized prostate cancer and its long‑term treatment side effects: a longitudinal qualitative study

Eileen J Sutton^*, J. Athene Lane, Michael J Davis, Eleanor I Walsh, David Neal, Freddie C Hamdy, Malcolm Mason, John Staffurth, Richard M Martin, Chris Metcalfe, TJ Peters, Jenny L Donovan , Julia Wade

^*Corresponding author for this work

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Abstract

Purpose
To investigate men’s experiences of receiving external-beam radiotherapy (EBRT) with neoadjuvant Androgen Deprivation Therapy (ADT) for localized prostate cancer (LPCa) in the ProtecT trial.
Methods
A longitudinal qualitative interview study was embedded in the ProtecT RCT. Sixteen men with clinically LPCa who underwent EBRT in ProtecT were purposively sampled to include a range of socio-demographic and clinical characteristics. They participated in serial in-depth qualitative interviews for up to 8 years post-treatment, exploring experiences of treatment and its side effects over time. Results
Men experienced bowel, sexual, and urinary side effects, mostly in the short term but some persisted and were bothersome. Most men downplayed the impacts, voicing expectations of age-related decline, and normalizing these changes. There was some reticence to seek help, with men prioritizing their relationships and overall health and well-being over returning to pretreatment levels of function. Some unmet needs with regard to information about treatment schedules and side effects were reported, particularly among men with continuing functional symptoms.
Conclusions
These findings reinforce the importance of providing universal clear, concise, and timely information and supportive resources in the short term, and more targeted and detailed information and care in the longer term to maintain and improve treatment experiences for men undergoing EBRT.

Original language	English
Pages (from-to)	261-269
Number of pages	9
Journal	Cancer Causes and Control
Volume	32
Issue number	3
Early online date	4 Jan 2021
DOIs	https://doi.org/10.1007/s10552-020-01380-3
Publication status	Published - Mar 2021

Bibliographical note

Funding Information:
The views and opinions expressed in this article are those of the authors and do not necessarily reflect those of the UK Department of Health and Social Care. This work was funded by the UK National Institute for Health Research (NIHR) Health Technology Assessment Programme (projects 96/20/06 and 96/20/99, with the University of Oxford as sponsor ( www.nets.nihr.ac.uk/projects/hta/962099 ). JLD, TJP, DEN, and FCH are Emeritus NIHR senior investigators. JLD was supported by the NIHR Collaboration for Leadership in Applied Health Research and Care West, hosted by University Hospitals Bristol NHS Foundation Trust. FCH is supported by the Oxford NIHR Biomedical Research Centre Surgical Innovation and Evaluation Theme and Cancer Research United Kingdom Oxford Centre. JAL is supported by the Bristol Randomized Trials Collaboration, University of Bristol. The authors declare that they have no conflicts of interest.

Funding Information:
The authors would like to thank all the participants and their partners who participated in interviews. We would also like to thank Lucy Brindle and Liz Salter who conducted qualitative interviews. Data Monitoring Committee: Chairs: Adrian Grant and Ian Roberts; Deborah Ashby, Richard Cowan, Peter Fayers, Killian Mellon, James N?Dow, Tim O?Brien, Michael Sokhal. Trial Steering Committee: Chair: Michael Baum; Jan Adolfson, Peter Albertsen, David Dearnaley, Fritz Schroeder, Tracy Roberts, Anthony Zietman. Bristol Randomized Trials Collaboration, Bristol Trials Centre, University of Bristol, Bristol, UK. This study was designed and delivered in collaboration with the Bristol Randomized Trials Collaboration (BRTC), a UKCRC registered clinical trials unit which, as part of the Bristol Trials Centre, is in receipt of National Institute for Health Research CTU support funding. The ProtecT Study Group: P. Holding (Nuffield Department of Surgical Sciences, University of Oxford, Oxford UK), J. W. F. Catto (Academic Urology Unit, University of Sheffield, Sheffield UK), D. J. Rosario (Department of Urology, Royal Hallamshire, Sheffield, UK), H. Kynaston (Department of Urology, Cardiff and Vale University Health Board, Cardiff UK), O. Hughes (Department of Urology, Cardiff and Vale University Health Board, Cardiff UK), P. Bollina (Department of Urology, Western General Hospital, Edinburgh, UK), A. Doherty (Department of Urology, Queen Elizabeth Hospital, Birmingham, UK), V. Gnanapragasam (Academic Urology Group, Department of Surgery and Oncology, University of Cambridge, Cambridge, UK), R. Kockelbergh (Department of Urology, University Hospitals Leicester NHS Trust, Leicester, UK), A. Paul (Department of Urology, Leeds Teaching Hospitals NHS Trust, Leeds, UK), E. Paez (Department of Urology, Freeman Hospital, Newcastle upon Tyne, UK), D. Gillatt (Department of Urology, Macquarie University Hospital, Australia), E. Rowe (Department of Urology, Bristol Urological Institute, Bristol, UK), and J. Oxley (Department of Pathology, North Bristol NHS Trust, Bristol, UK).

Publisher Copyright:
© 2021, The Author(s).

Keywords

Prostate cancer
Radiotherapy
External-beam radiotherapy
Treatment experiences
Treatment side effects
Qualitative research

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Sutton, E. J., Lane, J. A., Davis, M. J., Walsh, E. I., Neal, D., Hamdy, F. C., Mason, M., Staffurth, J., Martin, R. M., Metcalfe, C., Peters, TJ., Donovan , J. L., & Wade, J. (2021). Men’s experiences of radiotherapy treatment for localized prostate cancer and its long‑term treatment side effects: a longitudinal qualitative study. Cancer Causes and Control, 32(3), 261-269. https://doi.org/10.1007/s10552-020-01380-3

@article{9022a2e8f8a342b292f9e91dd0d49190,

title = "Men{\textquoteright}s experiences of radiotherapy treatment for localized prostate cancer and its long‑term treatment side effects: a longitudinal qualitative study",

abstract = "Purpose To investigate men{\textquoteright}s experiences of receiving external-beam radiotherapy (EBRT) with neoadjuvant Androgen Deprivation Therapy (ADT) for localized prostate cancer (LPCa) in the ProtecT trial. Methods A longitudinal qualitative interview study was embedded in the ProtecT RCT. Sixteen men with clinically LPCa who underwent EBRT in ProtecT were purposively sampled to include a range of socio-demographic and clinical characteristics. They participated in serial in-depth qualitative interviews for up to 8 years post-treatment, exploring experiences of treatment and its side effects over time. Results Men experienced bowel, sexual, and urinary side effects, mostly in the short term but some persisted and were bothersome. Most men downplayed the impacts, voicing expectations of age-related decline, and normalizing these changes. There was some reticence to seek help, with men prioritizing their relationships and overall health and well-being over returning to pretreatment levels of function. Some unmet needs with regard to information about treatment schedules and side effects were reported, particularly among men with continuing functional symptoms. Conclusions These findings reinforce the importance of providing universal clear, concise, and timely information and supportive resources in the short term, and more targeted and detailed information and care in the longer term to maintain and improve treatment experiences for men undergoing EBRT.",

keywords = "Prostate cancer, Radiotherapy, External-beam radiotherapy, Treatment experiences, Treatment side effects, Qualitative research",

author = "Sutton, {Eileen J} and Lane, {J. Athene} and Davis, {Michael J} and Walsh, {Eleanor I} and David Neal and Hamdy, {Freddie C} and Malcolm Mason and John Staffurth and Martin, {Richard M} and Chris Metcalfe and TJ Peters and Donovan, {Jenny L} and Julia Wade",

note = "Funding Information: The views and opinions expressed in this article are those of the authors and do not necessarily reflect those of the UK Department of Health and Social Care. This work was funded by the UK National Institute for Health Research (NIHR) Health Technology Assessment Programme (projects 96/20/06 and 96/20/99, with the University of Oxford as sponsor ( www.nets.nihr.ac.uk/projects/hta/962099 ). JLD, TJP, DEN, and FCH are Emeritus NIHR senior investigators. JLD was supported by the NIHR Collaboration for Leadership in Applied Health Research and Care West, hosted by University Hospitals Bristol NHS Foundation Trust. FCH is supported by the Oxford NIHR Biomedical Research Centre Surgical Innovation and Evaluation Theme and Cancer Research United Kingdom Oxford Centre. JAL is supported by the Bristol Randomized Trials Collaboration, University of Bristol. The authors declare that they have no conflicts of interest. Funding Information: The authors would like to thank all the participants and their partners who participated in interviews. We would also like to thank Lucy Brindle and Liz Salter who conducted qualitative interviews. Data Monitoring Committee: Chairs: Adrian Grant and Ian Roberts; Deborah Ashby, Richard Cowan, Peter Fayers, Killian Mellon, James N?Dow, Tim O?Brien, Michael Sokhal. Trial Steering Committee: Chair: Michael Baum; Jan Adolfson, Peter Albertsen, David Dearnaley, Fritz Schroeder, Tracy Roberts, Anthony Zietman. Bristol Randomized Trials Collaboration, Bristol Trials Centre, University of Bristol, Bristol, UK. This study was designed and delivered in collaboration with the Bristol Randomized Trials Collaboration (BRTC), a UKCRC registered clinical trials unit which, as part of the Bristol Trials Centre, is in receipt of National Institute for Health Research CTU support funding. The ProtecT Study Group: P. Holding (Nuffield Department of Surgical Sciences, University of Oxford, Oxford UK), J. W. F. Catto (Academic Urology Unit, University of Sheffield, Sheffield UK), D. J. Rosario (Department of Urology, Royal Hallamshire, Sheffield, UK), H. Kynaston (Department of Urology, Cardiff and Vale University Health Board, Cardiff UK), O. Hughes (Department of Urology, Cardiff and Vale University Health Board, Cardiff UK), P. Bollina (Department of Urology, Western General Hospital, Edinburgh, UK), A. Doherty (Department of Urology, Queen Elizabeth Hospital, Birmingham, UK), V. Gnanapragasam (Academic Urology Group, Department of Surgery and Oncology, University of Cambridge, Cambridge, UK), R. Kockelbergh (Department of Urology, University Hospitals Leicester NHS Trust, Leicester, UK), A. Paul (Department of Urology, Leeds Teaching Hospitals NHS Trust, Leeds, UK), E. Paez (Department of Urology, Freeman Hospital, Newcastle upon Tyne, UK), D. Gillatt (Department of Urology, Macquarie University Hospital, Australia), E. Rowe (Department of Urology, Bristol Urological Institute, Bristol, UK), and J. Oxley (Department of Pathology, North Bristol NHS Trust, Bristol, UK). Publisher Copyright: {\textcopyright} 2021, The Author(s).",

year = "2021",

month = mar,

doi = "10.1007/s10552-020-01380-3",

language = "English",

volume = "32",

pages = "261--269",

journal = "Cancer Causes and Control",

issn = "0957-5243",

publisher = "Springer International Publishing AG",

number = "3",

}

Sutton, EJ, Lane, JA, Davis, MJ, Walsh, EI, Neal, D, Hamdy, FC, Mason, M, Staffurth, J, Martin, RM , Metcalfe, C , Peters, TJ , Donovan , JL & Wade, J 2021, 'Men’s experiences of radiotherapy treatment for localized prostate cancer and its long‑term treatment side effects: a longitudinal qualitative study', Cancer Causes and Control, vol. 32, no. 3, pp. 261-269. https://doi.org/10.1007/s10552-020-01380-3

Men’s experiences of radiotherapy treatment for localized prostate cancer and its long‑term treatment side effects : a longitudinal qualitative study. / Sutton, Eileen J; Lane, J. Athene; Davis, Michael J et al.

In: Cancer Causes and Control, Vol. 32, No. 3, 03.2021, p. 261-269.

Research output: Contribution to journal › Article (Academic Journal) › peer-review

TY - JOUR

T1 - Men’s experiences of radiotherapy treatment for localized prostate cancer and its long‑term treatment side effects

T2 - a longitudinal qualitative study

AU - Sutton, Eileen J

AU - Lane, J. Athene

AU - Davis, Michael J

AU - Walsh, Eleanor I

AU - Neal, David

AU - Hamdy, Freddie C

AU - Mason, Malcolm

AU - Staffurth, John

AU - Martin, Richard M

AU - Metcalfe, Chris

AU - Peters, TJ

AU - Donovan , Jenny L

AU - Wade, Julia

N1 - Funding Information: The views and opinions expressed in this article are those of the authors and do not necessarily reflect those of the UK Department of Health and Social Care. This work was funded by the UK National Institute for Health Research (NIHR) Health Technology Assessment Programme (projects 96/20/06 and 96/20/99, with the University of Oxford as sponsor ( www.nets.nihr.ac.uk/projects/hta/962099 ). JLD, TJP, DEN, and FCH are Emeritus NIHR senior investigators. JLD was supported by the NIHR Collaboration for Leadership in Applied Health Research and Care West, hosted by University Hospitals Bristol NHS Foundation Trust. FCH is supported by the Oxford NIHR Biomedical Research Centre Surgical Innovation and Evaluation Theme and Cancer Research United Kingdom Oxford Centre. JAL is supported by the Bristol Randomized Trials Collaboration, University of Bristol. The authors declare that they have no conflicts of interest. Funding Information: The authors would like to thank all the participants and their partners who participated in interviews. We would also like to thank Lucy Brindle and Liz Salter who conducted qualitative interviews. Data Monitoring Committee: Chairs: Adrian Grant and Ian Roberts; Deborah Ashby, Richard Cowan, Peter Fayers, Killian Mellon, James N?Dow, Tim O?Brien, Michael Sokhal. Trial Steering Committee: Chair: Michael Baum; Jan Adolfson, Peter Albertsen, David Dearnaley, Fritz Schroeder, Tracy Roberts, Anthony Zietman. Bristol Randomized Trials Collaboration, Bristol Trials Centre, University of Bristol, Bristol, UK. This study was designed and delivered in collaboration with the Bristol Randomized Trials Collaboration (BRTC), a UKCRC registered clinical trials unit which, as part of the Bristol Trials Centre, is in receipt of National Institute for Health Research CTU support funding. The ProtecT Study Group: P. Holding (Nuffield Department of Surgical Sciences, University of Oxford, Oxford UK), J. W. F. Catto (Academic Urology Unit, University of Sheffield, Sheffield UK), D. J. Rosario (Department of Urology, Royal Hallamshire, Sheffield, UK), H. Kynaston (Department of Urology, Cardiff and Vale University Health Board, Cardiff UK), O. Hughes (Department of Urology, Cardiff and Vale University Health Board, Cardiff UK), P. Bollina (Department of Urology, Western General Hospital, Edinburgh, UK), A. Doherty (Department of Urology, Queen Elizabeth Hospital, Birmingham, UK), V. Gnanapragasam (Academic Urology Group, Department of Surgery and Oncology, University of Cambridge, Cambridge, UK), R. Kockelbergh (Department of Urology, University Hospitals Leicester NHS Trust, Leicester, UK), A. Paul (Department of Urology, Leeds Teaching Hospitals NHS Trust, Leeds, UK), E. Paez (Department of Urology, Freeman Hospital, Newcastle upon Tyne, UK), D. Gillatt (Department of Urology, Macquarie University Hospital, Australia), E. Rowe (Department of Urology, Bristol Urological Institute, Bristol, UK), and J. Oxley (Department of Pathology, North Bristol NHS Trust, Bristol, UK). Publisher Copyright: © 2021, The Author(s).

PY - 2021/3

Y1 - 2021/3

N2 - Purpose To investigate men’s experiences of receiving external-beam radiotherapy (EBRT) with neoadjuvant Androgen Deprivation Therapy (ADT) for localized prostate cancer (LPCa) in the ProtecT trial. Methods A longitudinal qualitative interview study was embedded in the ProtecT RCT. Sixteen men with clinically LPCa who underwent EBRT in ProtecT were purposively sampled to include a range of socio-demographic and clinical characteristics. They participated in serial in-depth qualitative interviews for up to 8 years post-treatment, exploring experiences of treatment and its side effects over time. Results Men experienced bowel, sexual, and urinary side effects, mostly in the short term but some persisted and were bothersome. Most men downplayed the impacts, voicing expectations of age-related decline, and normalizing these changes. There was some reticence to seek help, with men prioritizing their relationships and overall health and well-being over returning to pretreatment levels of function. Some unmet needs with regard to information about treatment schedules and side effects were reported, particularly among men with continuing functional symptoms. Conclusions These findings reinforce the importance of providing universal clear, concise, and timely information and supportive resources in the short term, and more targeted and detailed information and care in the longer term to maintain and improve treatment experiences for men undergoing EBRT.

AB - Purpose To investigate men’s experiences of receiving external-beam radiotherapy (EBRT) with neoadjuvant Androgen Deprivation Therapy (ADT) for localized prostate cancer (LPCa) in the ProtecT trial. Methods A longitudinal qualitative interview study was embedded in the ProtecT RCT. Sixteen men with clinically LPCa who underwent EBRT in ProtecT were purposively sampled to include a range of socio-demographic and clinical characteristics. They participated in serial in-depth qualitative interviews for up to 8 years post-treatment, exploring experiences of treatment and its side effects over time. Results Men experienced bowel, sexual, and urinary side effects, mostly in the short term but some persisted and were bothersome. Most men downplayed the impacts, voicing expectations of age-related decline, and normalizing these changes. There was some reticence to seek help, with men prioritizing their relationships and overall health and well-being over returning to pretreatment levels of function. Some unmet needs with regard to information about treatment schedules and side effects were reported, particularly among men with continuing functional symptoms. Conclusions These findings reinforce the importance of providing universal clear, concise, and timely information and supportive resources in the short term, and more targeted and detailed information and care in the longer term to maintain and improve treatment experiences for men undergoing EBRT.

KW - Prostate cancer

KW - Radiotherapy

KW - External-beam radiotherapy

KW - Treatment experiences

KW - Treatment side effects

KW - Qualitative research

U2 - 10.1007/s10552-020-01380-3

DO - 10.1007/s10552-020-01380-3

M3 - Article (Academic Journal)

C2 - 33394204

VL - 32

SP - 261

EP - 269

JO - Cancer Causes and Control

JF - Cancer Causes and Control

SN - 0957-5243

IS - 3

ER -

Men’s experiences of radiotherapy treatment for localized prostate cancer and its long‑term treatment side effects: a longitudinal qualitative study

Abstract

Bibliographical note

Keywords

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