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This study summarises research- and practice-based evidence on home-based chemotherapy, and explores existing delivery models. A three-pronged investigation was conducted consisting of a literature review and synthesis of 54 papers, a review of seven home-based chemotherapy programmes spanning four countries, and two case studies within the Canadian province of Ontario. The results support the provision of home-based chemotherapy as a safe and patient-centred alternative to hospital- and outpatient-based service. This paper consolidates information on home-based chemotherapy programmes including services and drugs offered, patient eligibility criteria, patient views and experiences, delivery structures and processes, and common challenges. Fourteen recommendations are also provided for improving the delivery of chemotherapy in patients' homes by prioritising patient-centredness, provider training and teamwork, safety and quality of care, and programme management. The results of this study can be used to inform the development of an evidence-informed model for the delivery of chemotherapy and related care, such as symptom management, in patients' homes. [ABSTRACT FROM AUTHOR]

Objective: Currently, there are no self‐management resources in Australia that support both Chinese immigrant patients affected by cancer and their caregivers. This paper reports on the development and acceptability assessment of a self‐management intervention (WeCope) in terms of its scope, social and cultural relevance and sensitivity. Methods: Using a community participatory approach in this qualitative study, patients, caregivers and community members took part in semi‐structured focus groups or interviews in Cantonese, Mandarin or English to develop and provide feedback on the acceptability of 'WeCope'. Content analysis was performed on the transcripts using inductive (codes) and deductive (themes and categories) methods. Results: Patients (n = 17), caregivers (n = 10) and community members (n = 2) participated. Four themes were developed, guided by the framework of cultural sensitivity in interventions: (1) content preference and satisfaction; (2) perceived usefulness and usability; (3) cultural relevance and acceptability; and (4) layout and presentation. Participants most commonly wanted more information about treatment‐related issues (n = 14) and available support services (n = 14). Conclusion: Chinese patients and caregivers expressed overall satisfaction with the WeCope resource and provided suggestions for improvement, including provision of more treatment‐related information and contact details for available support while reducing the overall resource length. [ABSTRACT FROM AUTHOR]

Objective. To explore variations in patterns of care over three decades for a subgroup of rectal cancer patients in South Australia according to sociodemographic characteristics. Methods. This study evaluated three decades of retrospective data from the South Australian Clinical Cancer Registry. A total of 4,131 patients diagnosed with rectal cancer between 1982 and 2015 and treated in South Australian public hospitals were included. Study outcomes were age at diagnosis, area of primary residence, cancer stage, and primary treatment (surgery, chemotherapy, or radiotherapy). Results. There was a significantly lower likelihood of conventional therapy for the elderly. Adjusted odds of receiving surgery or radiotherapy decreased by 70% and those of receiving chemotherapy by 90% in the 80+ age group, compared to the 50–59 age group. No significant variation was detected according to area-level socioeconomic status or remoteness. Conclusion. Socioeconomic factors showed little impact on the receipt of therapies for rectal cancer patients in South Australia. Variation in treatment by age, irrespective of disease stage or period of diagnosis, requires further investigation. [ABSTRACT FROM AUTHOR]

Objective. To investigate age differences in treatment and survival from acute lymphoblastic (ALL) and acute myeloid leukemia (AML). Methods. 1053 ALL/566 AML patients diagnosed in 2003–2015 on the New South Wales Cancer Registry were included. Treatment within 12 months from diagnosis was assessed using linked registry, hospital, and health-insurance data. Differences by age at diagnosis in treatment and survival were investigated using socio-demographically adjusted regression analyses, with adolescents and young adults (AYA, 15–24 years) as the reference category. Results. Children were less likely than AYA to start ALL treatment >3 days from diagnosis (adjusted odds ratio (aOR 0.39, 95% CI 0.27–0.57)) and to have multiple treatment types (aOR 0.22, 95% CI 0.14–0.34). For AML, aOR of treatment start >3 days was 0.16 (95% CI 0.09–0.29) for children compared with AYA, with no age differences in treatment types. Five-year disease-specific survival for ALL was 84%. Children were less likely than AYA to die from ALL (adjusted subhazard ratio (aSHR 0.32, 95% CI 0.22–0.50)). For AML, the corresponding survival was 73% without an age difference. Children having multiple treatment types for ALL had an increased risk of mortality at aSHR 2.67 (95% CI 1.53–4.67), but not adults at 1.26 (95% CI 0.67–2.47) (interaction p = 0.017). Time from diagnosis to initial treatment start and initial treatment type were not associated with mortality outcomes after adjusting for socio-demographic variables. Conclusion. Children with ALL had better survival. ALL Mortality were negatively associated with multiple treatment types. [ABSTRACT FROM AUTHOR]

Introduction: Cancer incidence and survivorship are increasing worldwide. With more people living through and beyond cancer, there is a subsequent increase in their supportive care needs. This systematic review of qualitative studies aimed to describe the impacts of unmet supportive care needs on cancer survivors in Australia. Methods: Databases MEDLINE, EMBASE and Scopus were searched, and after screening and applying eligibility criteria, 27 qualitative studies were included. Findings were synthesised according to the Supportive Care Framework for Cancer Care, including informational, physical, practical, emotional, psychological, social and spiritual need domains. Results: The systematic review identified impacts of unmet informational, physical, practical, emotional and psychological needs. Frequently identified impacts of unmet informational needs were feelings of abandonment and isolation, distress, confusion and regret. Common impacts of unmet physical and practical needs were financial burden and return‐to‐work difficulties. Over half of all unmet supportive care needs caused emotional and psychological impacts. Conclusions: Findings identify the detrimental emotional and psychological impacts resulting from a range of unmet supportive care needs. The review highlights the interconnections between supportive care need domains thereby enhancing the understanding of the impacts of unmet SCNs. Findings may inform policy and practice change to improve supportive cancer care. [ABSTRACT FROM AUTHOR]

Objective: Ovarian cancer has the highest mortality of all gynaecological cancers. This study aimed to identify the extent to which women across New South Wales experienced variation in their care in diagnosis and initial treatment for ovarian cancer against the national optimal care pathway for ovarian cancer. Method: Clinical audit methodology was utilised to explore variations for women with primary ovarian cancer; 171 eligible cases were identified through by the NSW Cancer Registry for the period of 1 March 2017 to 28 February 2018. Results: Limited variation was detected with 86% of women being reviewed by a specialist gynaecological oncology multidisciplinary team; 54% of women received their first treatment within 28 days of their first specialist appointment, 66% of women having their first surgery completed by a gynaecological oncologist and 45% of women received their first treatment in a specialist gynaecological oncology hospital. Conclusion: Deviation from effective ovarian cancer care is apparent particularly in the location and timeliness of first treatment, with implications for the quality of care received and care outcomes. Understanding factors that contribute to variation is critical to ensure optimal and appropriate ovarian cancer care and to tackle systemic barriers to the provision of effective care. [ABSTRACT FROM AUTHOR]

Objective: The COVID‐19 pandemic has accelerated the rapid expansion of telehealth, affording opportunities to study its impact on oncology care. Our qualitative study explored physician and patient perspectives of telehealth in cancer care. Methods: Semistructured interviews were conducted with seven physicians and eleven patients, recruited from an Australian hospital oncology department. Two authors independently coded the transcripts with emerging themes identified and refined iteratively in a thematic analysis. Results: Telehealth offered broadened possibilities by allowing continuity of care in the pandemic and revealing advantages of convenience in consultations. It also highlighted core elements of in‐person care that were unavailable. These included the information communicated through formal and informal physical examination, the collaboration between patient and physician in shaping outcomes and building rapport and the confidence in decisions made and physician performance. While patients and physicians envisioned the continuation of telehealth postpandemic, logistical steps are necessary to address these challenges. Conclusion: This study highlights the unprecedented opportunities that telehealth presents in widening access to oncology care and simultaneously reveals that it cannot always reach equivalence in quality of care. Further research is required to identify when and for whom telehealth is most acceptable as future care models are considered. [ABSTRACT FROM AUTHOR]

Objective: Lung cancer patients from ethnic minorities have poorer outcomes than their Caucasian counterparts. We compared lung cancer intervals between culturally and linguistically diverse (CALD) and Anglo‐Australian patients to identify ethnic disparities. Methods: This was a prospective, observational cohort study comprising a patient survey and reviews of patients' hospital and general practice records. Across three states, 577 (407 Anglo‐Australian and 170 CALD) patients were recruited and their hospital records reviewed. The survey was returned by 189 (135 Anglo‐Australian and 54 CALD) patients, and a review was completed by general practitioners (GPs) of 99 (76 Anglo‐Australian and 23 CALD) patients. Survival and Cox regression analyses were conducted. Results: CALD patients had longer hospital diagnostic interval [median 30 days, 95% confidence interval (CI) 26–34] than Anglo‐Australian patients (median 17, 95% CI 14–20), p = 0.005, hazard ratio (HR) = 1.32 (95% CI 1.09–1.60). This difference persisted after relevant factors were taken into consideration, adjusted HR = 1.26 (95% CI 1.03–1.54, p = 0.022). CALD patients also reported longer prehospital intervals; however, these differences were not statistically significant. Conclusion: Target interventions need to be developed to address ethnic disparity in hospital diagnostic interval. [ABSTRACT FROM AUTHOR]

Objectives: To (a) compare palliative care needs of lung cancer patients on their final admission to community‐based and inpatient palliative care services; and (b) explore whether and how these care needs affect their utilisation of different palliative care services in the last days of life. Methods: Descriptive study involving 17,816 lung cancer patients who received the last episode of palliative care from specialist services and died between 1 January 2013 and 31 December 2018. Results: Both groups of patients admitted to community‐based and inpatient palliative care services generally experienced relatively low levels of symptom distress, but high levels of functional impairment and dependency. "Unstable" versus "stable" palliative care phase (Odds ratio = 11.66; 95% Confidence Interval: 9.55–14.24), poorer functional outcomes and severe levels of distress from many symptoms predicted greater likelihood of use of inpatient versus community‐based palliative care. Conclusions: Most inpatient palliative care admissions are not associated with high levels of symptom severity. To extend the period of home care and rate of home death for people with lung cancer, additional investment is required to improve their access to sufficiently skilled palliative care staff, multi‐disciplinary teams and 24‐hour home support in community settings. [ABSTRACT FROM AUTHOR]

Objective: To identify cancer survivors' perceptions of the role diet plays in their cognitive function, and how their cancer‐related cognitive changes influence their diet. Methods: Cancer survivors diagnosed with cancer in the past 5 years, not on active treatment, and with self‐reported cognitive changes since diagnosis were recruited from the general population. Semi‐structured interviews were conducted with 15 Australian breast (n = 13) and colorectal (n = 2) survivors (mean time since diagnosed: 27.0 months ± SD=16.8). Questions related to how their diet and cognitive changes influenced each other. Interviews were recorded, and transcripts were analysed using thematic analysis. Results: Four themes related to how diet impacted cognition: (a) directly (e.g. healthy diet improves cognition), (b) indirectly (e.g. diet affects tiredness which affects cognition); (c) no impact; and (d) potentially (e.g. poorer diet quality would worsen cognition). Three themes emerged for how cognitive changes were thought to impact survivors' diets: (a) planning meals is harder; (b) cooking is more difficult and complex; and, (c) choosing healthy is more challenging. Conclusions: Many cancer survivors perceived a bidirectional influence between diet and cognition that has cognitive and behavioural consequences. Diet could be investigated as a modifiable lifestyle behaviour to improve cancer‐related cognitive impairment and fatigue. Survivors may benefit from dietary guidance with meal planning and preparing. [ABSTRACT FROM AUTHOR]

Abstract: To improve understanding of the triage process following distress and problem identification and the factors associated with offer and acceptance of supportive care referrals. Review of patient records/charts at a metropolitan hospital in Melbourne, Australia. Data were collected on problem identifications from 1/1/13 to 30/6/14, including patient demographics, disease and treatment information, responses to the NCCN Distress Thermometer (DT) and Problem Checklist (PC), whether referrals to supportive care services were offered and accepted/declined. Logistic regressions examined factors associated with referral offer and acceptance. Of patients completing the DT/PC, 50.1% reported a high level of distress. Overall, 61% of patients were offered referral(s), with the majority (71%) being accepted. Referrals were more likely to be offered to patients with a greater number of problems (Odds Ratio[OR] = 1.18, 95%CI = 1.12–1.25) and higher distress (OR = 1.68, 95%CI = 1.07–2.64). Referrals were more likely to be accepted by patients with a greater number of problems (OR = 1.12, 95%CI = 1.06–1.19) and lower distress (OR = 0.58, 95%CI = 0.34–1.00). The type of problem experienced by the patient was strongly related to the type of referral they were offered. At a large metropolitan hospital with in‐house supportive care services, simple problem identification with the DT/PC enabled triage to services that reflected patients’ needs. The findings suggest that clear referral pathways and an organisational emphasis on supportive care may facilitate service use. [ABSTRACT FROM AUTHOR]

Gestational breast cancer (GBC) presents many challenges for women and the clinicians who care for them. The aim of this study was to explore the health care experiences of women diagnosed with GBC to inform and improve clinical care of women in this predicament. Semi‐structured interviews were conducted with 17 women who had been diagnosed with GBC in the previous 5 years. The overarching themes for perceived quality of care were “communication” and “comprehensive care.” “Communication” had two sub themes: “interdisciplinary communication” (the way health professionals from different disciplines communicated with each other about the management of the woman's care) and “patient communication” (how they communicated this to the woman). The “comprehensive care” theme incorporated three sub themes: “the spirit” (psychological care); “the mind” (information provision); and “the body” (management of treatment side effects). Women's own accounts of positive and negative experiences of GBC care provide unique and specific insights which improve understanding of their concerns and needs. The findings can inform advances in quality and efficacy of clinical care; offer guidance for obstetricians, oncologists and allied health professionals about the needs of women diagnosed with GBC and how care can be optimised; and inform the development of resources to assist women and their families. [ABSTRACT FROM AUTHOR]

The purpose of the current study was to explore colorectal cancer survivors’ information and support needs in relation to health concerns and health behaviour change. Face‐to‐face interviews were conducted with participants who had completed active treatment for cancer within the previous 2 years. Participants were colorectal cancer survivors (N = 24, men = 11, women = 13 M, age = 69.38 years, SD = 4.19) recruited from a hospital in Perth, Australia on the basis that they had existing morbidities that put them at increased risk of cardiovascular disease. Interview transcripts were analysed using thematic analysis. Results: Five main themes emerged: bowel changes; Lack of knowledge concerning healthy eating and physical activity; conflicting information; desire for support; and, need for simple messages and strategies to stay healthy. Where dietary recommendations were provided, these were to resolve bowel problems rather than to promote healthy eating. The provision of lifestyle advice from the oncologists is limited and patients’ lack knowledge of guidelines for diet and physical activity. Oncologists could provide patients with clear messages from the World Cancer Research Fund ( ); that is to increase physical activity and dietary fibre and reduce consumption of red meat, processed meat, alcohol and body fatness. [ABSTRACT FROM AUTHOR]

To describe the prevalence, severity and nature of depression in a sample of prostate cancer ( PCa) survivors 10 years after diagnosis and treatment, 146 Australian patients from the RADAR trial who received their diagnosis 10 years previously completed the Zung Self-rating Depression Scale and a background questionnaire. Prevalence rates for clinically significant depression and severe depression were higher than those reported for the non- PCa men of the same age in Australia. The most common subtype of depression was Anhedonia, followed by Cognitive depression. Change in eating habits was the most powerful depression symptom predicting Anhedonia. By providing the first detailed documentation of major depression prevalence in PCa survivors, plus describing the nature of that depression, these data suggest that there is an ongoing need to provide treatments for these men and that those treatments should be focussed upon loss of previously available sources of enjoyment. [ABSTRACT FROM AUTHOR]

While psychosocial screening has been recommended in oncology for some time, widespread adoption in clinical practice has lagged. The QUICATOUCH program is one example of sustained clinic-level screening, assessment and referral. We examined whether this program was associated with reductions in pain or distress. Oncology outpatients completed a brief, computerised assessment using Distress and Pain Thermometers. We describe population levels of pain and distress and model pain and distress scores over 4 years of the program. 9,133 patients were screened on 26,385 occasions over 48 months (October 2007-September 2011). Pain over threshold (1/10) reduced over time, from 33% in the first 3 months to 16% in the final quarter of the evaluation. Distress over threshold (4/10) reduced from 28% to 10%. A reduction was also observed when restricted to patients screened for the first time. Our analysis demonstrated this effect was not explained by measured potential confounders (gender, age, treatment status) and was unlikely to be attributable to regression to the mean. Observational studies cannot prove causation. However, the significant reduction in pain and distress levels in the 48 months following commencement of QUICATOUCH is consistent with a beneficial effect of the program. [ABSTRACT FROM AUTHOR]

Somatic mutations in key oncogenes in non-small cell lung cancer ( NSCLC) and melanoma are important determinants of tumour sensitivity to targeted therapies. Molecular screening for these predictive biomarkers is routinely used to inform treatment decisions; however, little is known about how best to communicate testing and results to patients. This qualitative study aimed to explore advanced cancer patients' attitudes and experiences regarding somatic tumour screening to identify their information and support needs. Sixteen NSCLC and eight melanoma patients who had undergone screening participated in a semi-structured face-to-face or telephone interview exploring their understanding, views, preferences and needs regarding screening. Interviews were audiotaped, transcribed and analysed for thematic patterns. Participants expressed positive views and unequivocal acceptance of screening, and understood its role in guiding treatment selection. They preferred to receive information verbally through simple, non-technical language from their oncologist with additional take-home materials. Patients were interested in learning about their test results, but wanted discussion to be focused on practical matters relevant to treatment. While receiving their screening results was not considered burdensome, information overload and cancer-related distress were identified as barriers to test comprehension. Patients may benefit from information and decision-related tools to better understand genomic information and adequately support psychosocial outcomes. [ABSTRACT FROM AUTHOR]

Cancer patients with bone metastases have previously been excluded from participation in physical activity programmes due to concerns of skeletal fractures. Our aim was to provide initial information on the association between physical activity levels and physical and mental health outcomes in prostate cancer patients with bone metastases. Between 2012 and 2015, 55 prostate cancer patients (mean age 69.7 ± 8.3; BMI 28.6 ± 4.0) with bone metastases (58.2% >2 regions affected) undertook assessments for self-reported physical activity, physical and mental health outcomes ( SF-36), objective physical performance measures and body composition by DXA. Sixteen men (29%) met the current aerobic exercise guidelines for cancer survivors, while 39 (71%) reported lower aerobic exercise levels. Men not meeting aerobic exercise guidelines had lower physical functioning ( p = .004), role functioning (physical and emotional) ( p < .05), general health scores ( p = .014) as well all lower measures of physical performance ( p < .05). Lower levels of aerobic exercise are associated with reduced physical and mental health outcomes in prostate cancer patients with bone metastases. While previous research has focused primarily in those with non-metastatic disease, our initial results suggest that higher levels of aerobic exercise may preserve physical and mental health outcomes in prostate cancer patients with bone metastases. Clinical Trial Registry: Trial Registration: ACTRN12611001158954 [ABSTRACT FROM AUTHOR]

This systematic review examines variations in outcomes along the breast cancer continuum for Australian women by Indigenous status. Multiple databases were systematically searched for peer-reviewed articles published from 1 January 1990 to 1 March 2015 focussing on adult female breast cancer patients in Australia and assessing survival, patient and tumour characteristics, diagnosis and treatment by Indigenous status. Sixteen quantitative studies were included with 12 rated high, 3 moderate and 1 as low quality. No eligible studies on referral, treatment choices, completion or follow-up were retrieved. Indigenous women had poorer survival most likely reflecting geographical isolation, advanced disease, patterns of care, comorbidities and disadvantage. They were also more likely to be diagnosed when younger, have advanced disease or comorbidities, reside in disadvantaged or remote areas, and less likely to undergo mammographic screening or surgery. Despite wide heterogeneity across studies, an overall pattern of poorer survival for Indigenous women and variations along the breast cancer continuum of care was evident. The predominance of state-specific studies and small numbers of included Indigenous women made forming a national perspective difficult. The review highlighted the need to improve Indigenous identification in cancer registries and administrative databases and identified key gaps notably the lack of qualitative studies in current literature. [ABSTRACT FROM AUTHOR]

Objective: To examine the screening-treatment-mortality pathway among women with invasive breast cancer in 2006-2014 using linked data., Methods: BreastScreen histories of South Australian women diagnosed with breast cancer (n = 8453) were investigated. Treatments recorded within 12 months from diagnosis were obtained from linked registry and administrative data. Associations of screening history with treatment were investigated using logistic regression and with cancer mortality outcomes using competing risk analyses, adjusting for socio-demographic, cancer and comorbidity characteristics., Results and Conclusion: For screening ages of 50-69 years, 70% had participated in BreastScreen SA ≤ 5 years and 53% ≤ 2 years of diagnosis. Five-year disease-specific survival post-diagnosis was 90%. Compared with those not screened ≤5 years, women screened ≤2 years had higher odds, adjusted for socio-demographic, cancer and comorbidity characteristics, and diagnostic period, of breast-conserving surgery (aOR 2.5, 95% CI 1.9-3.2) and radiotherapy (aOR 1.2, 95% CI 1.1-1.3). These women had a lower unadjusted risk of post-diagnostic cancer mortality (SHR 0.33, 95% CI 0.27-0.41), partly mediated by stage (aSHR 0.65, 95% CI 0.51-0.81), and less breast surgery (aSHR 0.78, 95% CI 0.62-0.99). Screening ≤2 years and conserving surgery appeared to have a greater than additive association with lower post-diagnostic mortality (interaction term SHR 0.42, 95% CI 0.23-0.78). The screening-treatment-mortality pathway was investigated using linked data., (© 2021 John Wiley & Sons Ltd.)

Workforce recruitment and retention are issues in radiation oncology. The working environment is likely to have an impact on retention; however, there is a lack of research in this area. The objectives of this study were to: investigate radiation therapists' (RTs) and radiation oncology medical physicists' (ROMPs) perceptions of work and the working environment; and determine the factors that influence the ability of RTs and ROMPs to undertake their work and how these factors affect recruitment and retention. Semi-structured interviews were conducted and thematic analysis was used. Twenty-eight RTs and 21 ROMPs participated. The overarching themes were delivering care, support in work, working conditions and lifestyle. The overarching themes were mostly consistent across both groups; however, the exemplars reflected the different roles and perspectives of RTs and ROMPs. Participants described the importance they placed on treating patients and improving their lives. Working conditions were sometimes difficult with participants reporting pressure at work, large workloads and longer hours and overtime. Insufficient staff numbers impacted on the effectiveness of staff, the working environment and intentions to stay. Staff satisfaction is likely to be improved if changes are made to the working environment. We make recommendations that may assist departments to support RTs and ROMPs. [ABSTRACT FROM AUTHOR]

Cancer survivorship is recognised globally as a key issue. In spite of the key role played by nurses in survivorship care, there is an identified gap in nurse's knowledge in this area. This study reports on the development and evaluation of an educational resource for nurses working with people affected by cancer. The resource was designed using adult learning principles and includes a variety of learning materials and point of care resources. A mixed-methods sequential exploratory design was used to undertake an evaluation of the programme. This included the use of online surveys and semi-structured interviews with pilot participants. A total of 21 participants completed an online survey and 11 participants completed a telephone interview. Overall, the participants found the Cancer Survivorship resource to be engaging, practical and intuitive. A major theme emerging from the survey and interview data was that the resource was applicable to practice and useful in developing survivorship care plans. Respondents requested additional information be included on the role of various health professionals working in survivorship as well as guidelines on when to make referrals. This study provides evidence that the Cancer Survivorship tool may be a promising vehicle for delivering evidence-based education on survivorship care. [ABSTRACT FROM AUTHOR]

Radiation therapists ( RTs) plan and deliver radiotherapy treatment for patients diagnosed with cancer. They need to communicate regularly with their patients and may have a role to play in reducing patient anxiety and distress. The objectives were to explore how the environment of radiotherapy departments supports or inhibits communication generally and information giving and supportive care provision in particular. An ethnographic approach was used to gather rich descriptive data through observations and interviews conducted in two Australian radiotherapy centres. Time, space and a technology driven culture was found to negatively affect the quality of interaction that occurred between RTs and their patients. This research has shown design/modification of spaces is needed in the radiotherapy environment to reflect a patient care centred culture and to enhance opportunities for RTs to provide supportive care for their patients. [ABSTRACT FROM AUTHOR]

The purpose of this study was to understand the extent, nature and variability of the current economic burden of prostate cancer among Australian men. An online cross-sectional survey was developed that combined pre-existing economic measures and new questions. With few exceptions, the online survey was viable and acceptable to participants. The main outcomes were self-reported out-of-pocket costs of prostate cancer diagnosis and treatment, changes in employment status and household finances. Men were recruited from prostate cancer support groups throughout Australia. Descriptive statistical analyses were undertaken. A total of 289 men responded to the survey during April and June 2013. Our study found that men recently diagnosed (within 16 months of the survey) ( n = 65) reported spending a median AU$8000 (interquartile range AU$14 000) for their cancer treatment while 75% of men spent up to AU$17 000 (2012). Twenty per cent of all men found the cost of treating their prostate cancer caused them 'a great deal' of distress. The findings suggest a large variability in medical costs for prostate cancer treatment with 5% of men spending $250 or less in out-of-pocket expenses and some men facing very high costs. On average, respondents in paid employment at diagnosis stated that they had retired 4-5 years earlier than planned. [ABSTRACT FROM AUTHOR]

Family members (FMs) regularly attend cancer consultations with patients, may assume an array of roles (e.g. emotional, informational) and their involvement may result in benefits and/or challenges. Little is currently known about how oncology health professionals (HPs) view FMs who accompany a patient in consultations. This study aimed to explore the attitudes and practices of Australian oncologists and oncology nurses regarding family involvement in consultations. Eleven oncologists and 10 nurses from a range of subspecialties and tumour streams participated in semi-structured interviews. Interviews were transcribed and qualitatively analysed using framework analysis methods. Five relevant themes were identified: (1) the varied and dynamic nature of family roles during consultations; (2) positivity towards FMs; (3) the benefits of family involvement to the FM themselves; (4) current HP practices to facilitate positive family involvement; and (5) the challenges of family involvement in consultations and HP practices to manage them. Overall, participants held mostly positive attitudes towards family involvement. Although they identified a number of challenges which can arise when family are involved, many noted these situations are the exception, that there are strategies which can help to overcome the challenges, and that the benefits of family involvement typically outweigh the costs. [ABSTRACT FROM AUTHOR]

Objective: To trial collecting patient-reported outcome measures (PROMs) to assess psychosocial outcomes in men with prostate cancer (PC)., Methods: A cross-sectional postal survey was sent to three groups of 160 men with PC (6, 12 and 24 months post-initial treatment; n total  = 480), through the South Australian Prostate Cancer Clinical Outcomes Collaborative (SAPCCOC) registry (2017). Outcomes were as follows: response rate, completeness, general and disease-specific quality of life, distress, insomnia, fear of recurrence, decisional difficulties and unmet need., Results: A response rate of 57-61% (n = 284) was achieved across groups. Data completeness was over 90% for 88% of survey items, with lower response (76-78%) for EPIC-26 urinary and sexual functioning subscales, sexual aid use (78%) and physical activity (68%). In general, higher socio-economic indicators were associated with higher completion of these measures (absolute difference 12-26%, p < 0.05). Lower unmet need on the sexuality domain (SCNS-SF34) was associated with lower completion of the EPIC-26 sexual functioning subscale [M (SD) = 12.4 (21.6); M (SD) = 26.3 (27.3), p < .001]. Worse leaking urine was associated with lower completion of urinary pad/diaper use question (EPIC-26) [M (SD) = 65.9 (26.5), M (SD) = 77.3 (23.9), p < .01]., Conclusion: Assessment of psychosocial PROMs through a PC registry is feasible and offers insight beyond global quality of life assessment, to facilitate targeting and improvements in services and treatments., (© 2020 John Wiley & Sons Ltd.)

This study aimed to compare and contrast the contents of different types of written patient information about radiotherapy, namely (1) hospital radiotherapy departments vs. cancer control organisations and (2) generic vs. tumour-specific materials. A coding framework, informed by existing patients' information needs literature, was developed and applied to 54 radiotherapy information resources. The framework comprised 12 broad themes; cancer diagnosis, general information about radiotherapy, treatment planning, daily treatment, side effects, self-care management, external radiotherapy, internal radiotherapy, impact on daily activities, post-treatment, psychosocial health and other content, such as a glossary. Materials produced by cancer organisations contained significantly more information than hospital resources on diagnosis, general radiotherapy information, internal radiotherapy and psychosocial health. However, hospital materials provided more information about treatment planning, daily treatment and the impact on daily activities. Compared to generic materials, tumour-specific resources were superior in providing information about diagnosis, daily treatment, side effects, post-treatment and psychosocial health. Information about internal radiotherapy, prognosis and chronic side effects were poorly covered by most resources. Collectively, hospital and cancer organisation resources complement each other in meeting patients' information needs. Identifying ways to consolidate different information sources could help comprehensively address patients' medical and psychosocial information needs about radiotherapy. [ABSTRACT FROM AUTHOR]

To investigate health professionals' perspectives about factors that impede or facilitate cancer care for Indigenous people. Semi-structured interviews with 22 health professionals involved in Indigenous cancer care. Data were interpreted using an inductive thematic analysis approach. Participants presented their perspectives on a number of barriers and enablers to Indigenous cancer care. Barriers were related to challenges with communication, the health system and coordination of care, issues around individual and community priorities and views of cancer treatment and health professional judgement. Enablers to cancer care were related to the importance of trust and rapport as well as health care system and support factors. The findings highlighted the need for recording of Indigenous status in medical records and a coordinated approach to the provision of evidence-based and culturally appropriate cancer care. This could go some way to improving Indigenous patient's engagement with tertiary cancer care services. [ABSTRACT FROM AUTHOR]

Despite the need to urgently reduce smoking rates among Indigenous Australians, in order to close-the-gap in life expectancy, little is known regarding how this can be achieved. This study aimed to explore whether a focus on gender specific determinants of smoking among Indigenous Australians could be identified, thus providing a potentially novel approach to underpin future efforts at intervention. A qualitative research design was employed. Eighty-two participants, comprised of 43 Indigenous women (mean age 32.15, SD, 12.47) and 39 Indigenous men (mean age 34.91, SD, 11.26), participated in one of 12 focus groups held in metropolitan, regional and rural locations in South Australia. Facilitators prompted discussion in response to the question: 'What is it like being a smoker these days?' Two experienced coders assessed data for themes using Attride-Stirling's (2002) method of analysis. Two global themes emerged for men and women. The first theme, 'It's Harder to Smoke Nowadays', encompassed sub-themes capturing changed smoking practices in response to tobacco control strategies implemented in Australia. Sub-themes of 'smoking in secrecy' coupled with an 'awareness of the effects of passive smoking' were identified among women. Among men, sub-themes that depicted tension between 'a desire to be a role model' and 'guilt about smoking' emerged. The second theme, 'Push and Pull Factors', identified a range of gender specific determinants of smoking. While similar reasons for smoking ('pull factors') were identified in men and women (e.g. addiction, boredom, stress, pleasure, mood stabiliser), different 'push factors' (reasons for not wanting to smoke) emerged. For men, sport, fitness and children were identified as reasons for not wanting to smoke, whereas women identified factors such as respect for non-smokers, and body image concerns. The current findings suggest that there may be fundamental differences in the determinants of smoking (pull factors) as well as reasons for wanting to quit (push factors) between Indigenous men and women. A focus on interventions that target gender specific determinants, or motivators of smoking, offers a novel, and potentially efficacious approach to reduce smoking rates among Indigenous Australians. [ABSTRACT FROM AUTHOR]

The Australian Youth Cancer Service ( YCS) is part of a growing international movement to provide advocacy and better targeted health-care services for adolescents and young adults ( AYAs) with cancer. One of the key initiatives of the YCS is to determine and implement priorities within Australian AYA cancer research. The YCS used the value-weighting online survey technique of allocating 100 hypothetical units of funding across pre-determined topics of research in order to determine Australian consumers' and health professionals' AYA cancer research priorities. A total of 101 participants (26 consumers and 75 health professionals) took part in the online survey. Biomedical and Clinical Medicine Research was allocated the greatest proportion of available funding. A number of priority populations were also identified, although these were distributed across pre-treatment and post-treatment stages. The preferences of consumers and health professionals to invest available AYA cancer research funds in Biomedical and Clinical Medicine Research will be an important consideration in guiding the Australian YCS decision-making process in the immediate future. 'Prevention, screening and early detection' was also an important research funding target, along with survivorship populations. [ABSTRACT FROM AUTHOR]

Introduction: Australia has one of the highest incidence rates of colorectal cancer (CRC) in the world. Residents in rural areas of Australia experience disadvantage in health care and outcomes. This review investigates whether patients with CRC in rural areas demonstrate poorer survival and more advanced stages of disease at diagnosis. Methods: Systematic review of peer‐reviewed articles and grey literature. Studies were included if they provided data on survival or stage of disease at diagnosis across multiple geographical locations; focused on CRC patients; and were conducted in Australia. Results: Twenty‐six articles met inclusion criteria. Twenty‐three studies examined survival, while five studies investigated stage at diagnosis. The evidence suggests that non‐metropolitan patients are less likely to survive CRC for five years compared to patients living in metropolitan areas, yet there was limited evidence to suggest geographical disparity in stage of diagnosis. Conclusions: While five‐year survival disparities are apparent, these patterns appear to vary as a function of specific region and health jurisdiction, cancer type and year/s of data collection. Future research should examine current data using consistent and robust methods of reporting survival and classifying geographical location. The impact of population‐level screening programmes on survival and stage at diagnosis also needs to be thoroughly explored. [ABSTRACT FROM AUTHOR]

General practitioners (GPs) are often the first point of contact adolescents and young adults (AYAs, aged 10–29) with cancer have with the health system, and they are well‐placed to coordinate their complex medical and psychosocial care. This study is the first to report characteristics of patients, GPs and cancers involved in AYA cancer management consultations in Australia, using data from a nationally representative sample of 972,100 patient‐GP encounters in 2006–2016. AYA cancers were managed in 212 encounters, equating to approximately 137 per 100,000 AYA consultations. This rate was higher in older AYAs (25–29 years) and those who held a concession card. Approximately 30% of cancers managed were classified as "new", with GPs primarily providing counselling, education, and referrals to specialist care, imaging and pathology. This suggests that GPs are involved in the ongoing care of AYAs with cancer from diagnosis, in conjunction with other healthcare professionals. This is an encouraging indication of the potential for integrated multidisciplinary care extending from active treatment into survivorship; however, further work is needed to explore the changing role of GPs across the cancer trajectory. [ABSTRACT FROM AUTHOR]