Clinical Practice Guidelines for the management of locally advanced ...

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2.2 Effect of psychological and cognitive interventions on psychosocial adjustment No studies specifically addressed this question for men with advanced prostate cancer, although one low-quality study recruited men on hormonal manipulation but did not assess disease stage. 16 Only one medium-quality study was identified. 15 While it is reasonable to assume the general approaches utilised in studies with men with localised disease are likely to be acceptable to men with metastatic disease, the problems faced by these two groups of men differ. For example, the side-effect profile of radical prostatectomy differs markedly to that of hormonal ablation; and men who have incurable disease face a different psychological challenge to men receiving treatment with curative intent, as indeed do their spouses. However, while caution should be applied in generalising the outcomes of these studies to men with metastatic prostate cancer, the beneficial effects and clinical importance of psychosocial intervention for all cancer patients and their families is now well established through 19, 20 clinical practice guidelines both in Australia and North America. Studies differed in the type of intervention, patient group and outcome measured, nevertheless, four low quality studies were identified that utilised a primarily educational approach to intervention, and of these three investigated men receiving radiation therapy for localised prostate cancer. Johnson et al 21 undertook a randomised controlled trial assessing the effectiveness of an education audiotape about radiation therapy with 84 men scheduled to receive this treatment for localised prostate cancer. Compared with men who received general social contact from research staff, over the course of treatment men who received the audiotape experienced less disruption in recreation and pastime activities (p
sexual bother compared with controls. Men with less education, lower self esteem, lower prostate selfefficacy, and higher depressive symptoms benefited most. Scura et al 25 randomised 17 men newly diagnosed with prostate cancer to nurse-delivered telephone support over a 12-month period supplemented with written materials versus written material only. The study was low quality and no significant effects were found. Qualitative data from participants suggested that telephone nurse support was acceptable to these men. Penedo et al 26 undertook a low-quality study where 92 men treated previously for localised prostate cancer were randomised to either a ten-week group-based cognitive behavioural intervention or a halfday educational seminar. Men who received the ten-week intervention reported post-intervention improvements in quality of life (Functional Assessment of Cancer Therapy–General Module or FACT-G) (p
Page 1: Clinical Practice Guidelines for th
Page 4 and 5: 4 Biochemical relapse .............
Page 6 and 7: FOREWORD The management of prostate
Page 8 and 9: SUMMARY OF CLINICAL PRACTICE RECOMM
Page 10 and 11: SUMMARY OF RECOMMENDATIONS Chapter
Page 12 and 13: Chapter Recommendations Grade Refs
Page 20 and 21: 1 INTRODUCTION 1.1 Natural history
Page 22 and 23: 2 PSYCHOSOCIAL CARE The diagnosis a
Page 26 and 27: Evidence summary Level References T
Page 28 and 29: Recommendation Men with advanced pr
Page 30 and 31: An Australian cross-sectional study
Page 32 and 33: 10. Dunn J, et al. A review of peer
Page 34 and 35: 41. Sharpley CF, Christie DRH. An a
Page 36 and 37: different treatments from different
Page 38 and 39: Evidence summary Level References I
Page 40 and 41: Evidence summary Level References F
Page 42 and 43: Despite these reservations and the
Page 44 and 45: For non-metastatic disease there we
Page 46 and 47: Evidence summary Level References T
Page 48 and 49: monotherapy for low-to-intermediate
Page 50 and 51: Evidence summary Level References M
Page 52 and 53: for surgery, suggesting that surger
Page 54 and 55: Microscopic fully resected node pos
Page 56 and 57: All three trials demonstrated impro
Page 58 and 59: Evidence summary Level References B
Page 60 and 61: of an international multicentre ran
Page 62 and 63: 45. Melton LJ, III, Alothman KI, Kh
Page 64 and 65: 76. Little DJ, Kuban DA, Levy LB, Z
Page 66 and 67: 105. Thompson IM, Tangen CM, Parade
Page 68 and 69: 4.2 Androgen deprivation therapy (e
Page 70 and 71: Evidence summary Level References F
Page 72 and 73: therapy since such studies would be
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apparent in trials comparing CAB wi
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QLQ instrument published by Cleary
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Note: Larger well-powered studies h
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Eight trials examined acute toxicit
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half of patients experienced pain r
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olus) in addition to radiotherapy a
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References 1. Seidenfeld J, Samson
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Cooperative Group. Scandinavian Jou
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Oncology Group, TROG 96.05). Radiot
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trial. European Journal of Cancer 1
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6 CASTRATION-RESISTANT PROSTATE CAN
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the median overall survival for pat
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There are two points regarding bisp
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with bone pain at study entry. At n
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Recently, there have been reports o
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of these studies 56, 58 and in the
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Side effects (toxicity) As these ra
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hydrocortisone respectively. Tannoc
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5. Manikandan R, Srirangam SJ, Pear
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33. Elomaa I, Kylmala T, Tammela T
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60. Janknegt RA, Abbou CC, Bartolet
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physiotherapists, occupational ther
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7.5 Q2: Symptom control There was e
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Informal or family caregivers deriv
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8. Hughes SL, Weaver FM, Giobbie-Hu
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8 COMPLEMENTARY AND ALTERNATIVE (UN
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corresponding benefit in obstructiv
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3. Eisenberg DM, Kessler RC, Van Ro
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areas of the state were more likely
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8 Miller DC, Litwin MS, Bergman J,
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10 EMERGING THERAPIES It is impossi
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APPENDIX 1 GUIDELINE DEVELOPMENT PR
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study type. Studies published befor
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Grade of recommendation Description
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2. National Health and Research Cou
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Dr Carole Pinnock AM Principal rese
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Surgery Professor Villis Marshall A
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APPENDIX 3 TNM CLASSIFICATION OF PR
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Summary Prostate T1 T2 T3 T4 N1 M1a
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APPENDIX 4 ABBREVIATIONS AND GLOSSA
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Glossary Actuarial survival A metho
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Effectiveness The extent to which a
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Lymph nodes Small, generally pea-si
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Each stage is divided into subgroup
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APPENDIX 6 - ORGANISATIONS WHICH PR
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Consultant Urologist, Royal Brisban
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No conflict of interest to declare.
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Index to Clinical practice guidelin
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cardiovascular mortality 19, 54, 55
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androgen deprivation therapy (ADT)
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and surgery 32-34 survival 18 toxic
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and chemotherapy 89-90 see also bon
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spinal cord compression 62-63 see a
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systemic 141 Tasmania Association f
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