Patients Discuss Their Perspective on Life-prolonging Treatments for Metastatic Prostate Cancer

There are several life-prolonging treatment options for patients with metastatic castration-resistant prostate cancer (mCRPC), but there isn’t a lot of information about patient experiences with these treatments. For a recent study, researchers interviewed patients to glean their perspectives on and experiences with life-prolonging treatments.

“Given the severity of mCRPC, it is important to consider the possible negative effects of specific treatments on the patients’ [health-related quality of life] and weigh these against the desired positive effects,” the study authors explained. “Still, it has been shown that men with mCRPC lack enough information about the treatments and their possible impact of them on their life.”

Sixteen men with mCRPC who were initiating (n=3), were undergoing (n=9), or just finished their first life-prolonging treatment (n=4) of either chemotherapy (Docetaxel, n=11) or hormone-regulating therapy (Abiraterone acetate, n=1; Enzalutamide, n=4) were interviewed. The mean (range) patient age was 73 (60–82) years. Twelve patients were married/living with a partner, while three lived alone and one lived with his child. Most patients had a college education (n=8) and were retired (n=14).

According to the researchers, the interviews uncovered the multidimensional nature of facing life-prolonging treatment extending past just the outcome. Four overarching themes were identified, along with quotes obtained from the interviews:

  • Considering treatment when the remainder of life is at stake. “In no way have I imagined that I will all of a sudden be completely cured. But … that … well, that I can … keep going and feel well a little longer than I would otherwise have done [without treatment].”
  • Preparing for the life-prolonging treatment after deciding to go through with it. “I probably won’t… do as much work now when going through the chemotherapy because the body, it needs to be … be as stable as possible. That’s the most important thing of all.”
  • Considering the prospect of the life-prolonging treatment not being successful. “For some, it [the treatment] just works for a couple of months but for some it can apparently work for … longer than for others. And I must hope … and believe that I’m in that category at least. No … but of course, if it comes to it … then I will have to … undergo radiotherapy or … chemotherapy and so on.”
  • Reflecting on death and dying in the light of a life-limiting illness. “I’m not afraid to die, no it’s … I don’t think I am. I haven’t come that far yet so … I don’t think so … it’s more that … am I going to be around for things?”

The study was published in the December issue of the European Journal of Oncology Nursing.

“Nurses working with these patients are important in the decision-making process and in evaluating treatments, to detect needs for interventions,” the researchers concluded.