Keele Research Repository

Purpose
Delaying progression, ameliorating symptoms and maintaining Quality of Life (QoL) are primary aims of treatment for metastatic Castrate Resistant Prostate Cancer (mCRPC). Real world rather than clinical trial data about symptoms and side effects are sparse. In EXTREQOL patients’ QoL, pain and information needs were recorded during treatment.

Methods
Men with mCRPC from 20 UK cancer centres commencing various systemic mCRPC treatments completed QoL, pain and information needs questionnaires at baseline, 3 and 6 months.

Results
132 patients were recruited. Overall QoL declined significantly by 6 months (Functional Assessment of Cancer Therapy-Prostate (FACT-P) mean=-3.89, 95% CI: -6.7 to -1.05, p =0.007; Trial Outcome Index analysis (TOI) mean=-3.10, 95% CI: -5.34 to -0.83, p = 0.007. Those who came off novel therapy and remained on LHRH agonist therapy alone had worse scores than patients receiving concomitant chemotherapy (Prostate Concerns Subscale (PSC) mean difference= -4.45, 95% CI: 95% CI: -7.06 to -1.83, p-value=0.001; TOI mean difference = -5.62, 95% CI: -10.97 to -0.26, p =0.040). At 3 & 6 months men who reported
pain at baseline improved (43%; 40% respectively), but for others pain levels remained the same (45%; 42%) or worsened (13%; 18%). Information regarding supportive care was lacking throughout the period of time on the study.

Conclusion
Most mCRPC treated patients experience reduced QoL and inadequate pain control. More help with pain management and better information provision regarding supportive care is warranted.