Aims: To investigate unmet needs for men with prostate cancer, reported to be highly prevalent but poorly understood, in order to inform the implementation and ongoing evaluation of a new Prostate Cancer Specialist Nurse (PCSN) service.
Methods: A mixed methods approach was used, informed by implementation science theory. A non-identifiable cross-sectional survey using the Supportive Care Needs Survey Short-Form (SCNS-SF34) and free text questions was distributed to all living men with prostate cancer who had received surgical treatment in the last 2 years or who attended Cancer Care Services in the last year. Stakeholder interviews were conducted, with qualitative content analysis used to build process maps and to describe key gaps in care. Descriptive statistical analyses were used for quantitative data, including a chi-square analysis to compare met and unmet needs.
Results: 162 men responded from the 390 surveys distributed. 60 (39%) had a radical prostatectomy and 74 (49%) had radiotherapy, 41 (27%) had >3 treatment modalities. Men reported significant needs for their relationships, including worrying about those close to them (p=0.008) and changes in sexual relationships (0.007). Unmet needs were reported for feeling down or depressed (p=0.013), feelings of sadness (p=0.003), keeping a positive outlook (p=0.005), fear of cancer spreading (p=0.008) and feeling in control (p=0.004). “Waiting” was negatively reported across open text responses. These results were supported by qualitative data with key strategies proposed by stakeholders.
Conclusions: Men have a range of unmet needs following prostate cancer treatment potentially due to personal and health system factors. The PCSN service hopes to address these needs by building relationships with men, their families and communities to streamline service provision. Additional experience will provide pragmatic evidence for comprehensive patient care.