Advanced Prostate Cancer Study to improve care for NZ men

Advanced Prostate Cancer Study pinpoints actions to improve care for NZ men

AUCKLAND: May 7, 2015: New Zealand men suffering from advanced or metastatic prostate cancer need new treatment guidelines to ensure improved, more consistent and more equitable care. Patients and their families could also benefit from better stage-specific information and support post-diagnosis.

These are the key findings from a new study, the first of its kind, on the treatment of New Zealand men with metastatic prostate cancer (MPC) led by Professor Ross Lawrenson of Waikato Clinical Campus, University of Auckland. The study “The Management of Metastatic Prostate Cancer 2014” was launched today at a Parliamentary Breakfast in Wellington hosted by the Health Minister, Dr Jonathan Coleman.

“This study has been able to pinpoint gaps in current practice and indicate actions that could be taken to improve care and treatment. There is evidence of significant variation in care across the country and between ethnicities, particularly Māori/non- Māori men. For example, Māori were found to be twice as likely to have metastatic disease at diagnosis as non-Māori,” comments Prof Lawrenson.

Prof Lawrenson says his study also found that only 0.2% of all men diagnosed with prostate cancer in the five years from 2006-2011 had received chemotherapy. This compares with 16% in the US.

“Our results show that pharmacologic androgen-deprivation therapy (ADT) and chemotherapy is under-utilised in NZ patients with advanced prostate cancer. However, we can now empower patients and their families to make better informed decisions and support doctors to provide better care.”

The study’s Final Report presented today is the synthesis of 2 years’ work from a multi-disciplinary team of clinicians and researchers from the Midlands Cancer Network and the University of Auckland. The study was made possible through UniServices, the University’s commercial research and consulting arm, who facilitated and oversaw the partnership with the study’s funder Janssen-Cilag.

Prof Lawrenson says that by examining linked datasets (including re-staging of all patients within their cohort) for the first time researchers were able to correctly identify all patients with a metastatic diagnosis and to see clearly what needs to be done differently to improve patient outcomes.

“It was evident there is no clear structure or clinical pathway for the treatment of men with metastatic prostate cancer. In particular, there was a lack of input from medical oncologists to this group of patients despite new treatments becoming available.”

Professor Lawrenson says that currently care has been urology-focused. Given the increased options available there would be an advantage in more patients being discussed in multidisciplinary management meetings which included an oncologist. Professor Lawrenson also believes general practitioners have a role to play in supporting men with advanced prostate cancer.

Researchers also talked to men and their families about the care and support they receive following diagnosis. The study found that there is significant variability in the information and pathway of care men and their families receive. Respondents talked about a lack of quality end of life or palliative care and a feeling of abandonment by the health services.

“Simple changes can lead to dramatic change for the patient experience. Support, primarily through better, more tailored communication and stage-specific information should be available to partners and family so they are better equipped to support their loved-one.”

ENDS

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