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      Prostate cancer and supportive care: a systematic review and qualitative synthesis of men's experiences and unmet needs

      review-article
      , BA, MA 1 , , , MA, PhD 1 , , BSc, MSc 1 , , MSc, PhD, MB, ChB, DRCOG, MRCGP 1 , , MA, BM, BCh, PhD, FRCGP, DRCOG 1 , , ChM, FRCS, FEBU 2 , , BSc, PhD 1
      European Journal of Cancer Care
      John Wiley and Sons Inc.
      prostate cancer, supportive care, systematic review, peer support, specialist nurse, qualitative synthesis

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          Abstract

          Prostate cancer is the second most common cancer in men worldwide, accounting for an estimated 1.1 million new cases diagnosed in 2012 ( www.globocan.iarc.fr). Currently, there is a lack of specific guidance on supportive care for men with prostate cancer. This article describes a qualitative systematic review and synthesis examining men's experience of and need for supportive care. Seven databases were searched; 20 journal articles were identified and critically appraised. A thematic synthesis was conducted in which descriptive themes were drawn out of the data. These were peer support, support from partner, online support, cancer specialist nurse support, self‐care, communication with health professionals, unmet needs (emotional support, information needs, support for treatment‐induced side effects of incontinence and erectile dysfunction) and men's suggestions for improved delivery of supportive care. This was followed by the development of overarching analytic themes which were: uncertainty, reframing, and the timing of receiving treatment, information and support. Our results show that the most valued form of support men experienced following diagnosis was one‐to‐one peer support and support from partners. This review highlights the need for improved access to cancer specialist nurses throughout the care pathway, individually tailored supportive care and psychosexual support for treatment side effects.

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          Most cited references28

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          Estimates of cancer incidence and mortality in Europe in 2008.

          Up-to-date statistics on cancer occurrence and outcome are essential for the planning and evaluation of programmes for cancer control. Since the relevant information for 2008 is not generally available as yet, we used statistical models to estimate incidence and mortality data for 25 cancers in 40 European countries (grouped and individually) in 2008. The calculations are based on published data. If not collected, national rates were estimated from national mortality data and incidence and mortality data provided by local cancer registries of the same or neighbouring country. The estimated 2008 rates were applied to the corresponding country population estimates for 2008 to obtain an estimate of the numbers of cancer cases and deaths in Europe in 2008. There were an estimated 3.2 million new cases of cancer and 1.7 million deaths from cancer in 2008. The most common cancers were colorectal cancers (436,000 cases, 13.6% of the total), breast cancer (421,000, 13.1%), lung cancer (391,000, 12.2%) and prostate cancer (382,000, 11.9%). The most common causes of death from cancer were lung cancer (342,000 deaths, 19.9% of the total), colorectal cancer (212,000 deaths, 12.3%), breast cancer (129,000, 7.5%) and stomach cancer (117,000, 6.8%). Copyright 2009 Elsevier Ltd. All rights reserved.
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            Reconceptualization of the uncertainty in illness theory.

            M H Mishel (1989)
            The theory of uncertainty in illness has its strongest support among subjects who are experiencing the acute phase of illness or are in a downward illness trajectory (mishel, 1988a). The theory has not addressed the experience of living with continual, constant uncertainty in either a chronic illness or in an illness with a treatable acute phase and possible eventual recurrence. Since uncertainty characterizes many, most prevalent, long-term illness conditions, there is a need to reconceptualize the theory of uncertainty to include the experience of living with continual uncertainty. A close examination of the theoretical statements and the empirical data reported by Mishel resulted in the identification of areas of the theory that could be expanded and reconceptualized. The reconceptualization effort was primarily fueled by questions about the outcome portion of the uncertainty theory. To provide a contest for the expansion and reconceptualization of uncertainty, applicable parts of the theory are summarized below.
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              Supportive care needs of men living with prostate cancer in England: a survey

              Men with prostate cancer have various treatment options depending upon their stage of disease, age and presence of comorbidity. However, these treatments typically induce side effects, which generate currently ill-defined supportive care needs. This study examined the supportive care needs of men with prostate cancer within England. A postal questionnaire survey was conducted in six acute NHS Trusts. Seven hundred and forty-one men with prostate cancer participated. They had been diagnosed 3–24 months prior to the survey and had received various treatments. Men surveyed had specific and significant unmet supportive care needs. Areas of greatest need are related to psychological distress, sexuality-related issues and management of enduring lower urinary tract symptoms. High levels of psychological distress were reported, and those reporting psychological distress reported greater unmet supportive care needs. Unmet sexuality-related need was highest in younger men following radical prostatectomy. Lower urinary tract symptoms were almost universal in the sample. Perceived quality of life varied; men unsure of their remission status reported lowest quality of life. Psychological distress impacts significantly on perceived unmet need and is currently not being assessed or managed well in men living with prostate cancer in England.
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                Author and article information

                Contributors
                Role: Research Associate
                Role: Research Fellow
                Role: Research Associate
                Role: Research Fellow
                Role: Professor of Primary Health Care
                Role: Director
                Role: Research Fellow
                Journal
                Eur J Cancer Care (Engl)
                Eur J Cancer Care (Engl)
                10.1111/(ISSN)1365-2354
                ECC
                European Journal of Cancer Care
                John Wiley and Sons Inc. (Hoboken )
                0961-5423
                1365-2354
                29 January 2015
                September 2015
                : 24
                : 5 , Themed issue: Survivorship/Consequences of Treatment ( doiID: 10.1111/ecc.2015.24.issue-5 )
                : 618-634
                Affiliations
                [ 1 ] Centre for Academic Primary Care School of Social and Community MedicineUniversity of Bristol BristolUK
                [ 2 ] UrologyBristol Urological Institute Southmead Hospital BristolUK
                Author notes
                [*] [* ]Correspondence address: Anna J.L. King, Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, 39 Whatley Road, Canynge Hall, Briston BS8 2PS, UK (e‐mail: Ajl.King@ 123456bristol.ac.uk ).
                Article
                ECC12286
                10.1111/ecc.12286
                5024073
                25630851
                431d5c8e-9698-445a-b0fe-e46926a963de
                © 2015 The Authors. European Journal of Cancer Care published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 09 December 2014
                Page count
                Pages: 17
                Funding
                Funded by: National Institute of Health Research, Research for Patient Benefit
                Categories
                Feature and Review Papers
                Feature and Review Paper
                Custom metadata
                2.0
                ecc12286
                September 2015
                Converter:WILEY_ML3GV2_TO_NLMPMC version:4.9.4 mode:remove_FC converted:15.09.2016

                Oncology & Radiotherapy
                prostate cancer,supportive care,systematic review,peer support,specialist nurse,qualitative synthesis

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