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6th Annual Scientific Meeting of the Australian and New Zealand Urogenital and Prostate Cancer Trials Group, Redefining Personalised Medicine.

Prue Cormie*, John L. Oliffe, Addie C. Wootten, Daniel A. Galvao, Robert U. Newton and Suzanne K. Chambers Edith Cowan University Health and Wellness Institute, Edith Cowan University, Joondalup, WA, Australia School of Nursing, University of British Columbia, Vancouver, BC, Canada Department of Urology, Royal Melbourne Hospital, Parkville, VIC, Australia Epworth Prostate Centre, Epworth Healthcare, Richmond, VIC, Australia Australian Prostate Cancer Research, East Melbourne, VIC, Australia The University of Hong Kong, Hong Kong, Hong Kong UQ Centre for Clinical Research, University of Queensland, Brisbane, QLD, Australia Griffith Health Institute, Griffith University, Southport, QLD, Australia Cancer Council Queensland, Brisbane, QLD, Australia Prostate Cancer Foundation of Australia, Sydney, Australia

Objective In the past decade, localised prostate cancer (LPC) management has been shifting from three radical treatment options (radical prostatectomy, external beam radiotherapy, or brachytherapy) to also include active surveillance (AS). This study examines men with LPC and partners' experiences of choosing between AS and radical treatments, and their experiences of AS when selected. Methods A qualitative descriptive research design was used. Interviewed participants were men, and partners of men, who either had chosen radical treatment immediately following diagnosis or had been on AS for at least 3 months. AS was the recommended treatment. Transcribed interviews were thematically analysed and inter-rater reliability integrated. Results Twenty-one men and 14 partners participated. Treatment decisions reflected varied reactions to prostate cancer information, regularly described as contradictory, confusing, and stressful. Men and partners commonly misunderstood AS but could describe monitoring procedures. Partners often held the perception that they were also on AS. Men and partners usually coped with AS but were sometimes encumbered by treatment decision-making memories, painful biopsies, ongoing conflicting information, and unanswered medical questions. Radical treatment was selected when cancer progression was feared or medically indicated. Some preferred doctors to select treatments. Conclusions To reduce distress frequently experienced by men diagnosed with LPC and their partners during treatment decision making and ongoing AS monitoring, the following are needed: improved community and medical awareness of AS; consistent information about when radical treatment is required; and consistent, unbiased information on treatment options, prognostic indicators, and side effects. Regularly updated decisional support information/aids incorporating men's values are imperative. Copyright © 2014 John Wiley & Sons, Ltd.

Objective To examine the effectiveness of a cognitive–behavioural therapy (CBT) group intervention to facilitate improved psycho-sexual adjustment to treatment side effects in prostate cancer survivors post-radical prostatectomy. Methods A randomised, wait-list controlled trial was conducted with a total of 60 men who participated in a manualised 8-week cognitive–behavioural group intervention 6 months to 5 years post-radical prostatectomy for localised prostate cancer. Participants completed standardised questionnaires pre-intervention and post-intervention, which assessed mood state, stress, general and prostate cancer anxiety, quality of life and areas of sexual functioning. Results Paired samples t-tests identified a significant improvement in sexual confidence, masculine self-esteem, sexual drive/relationship and a significant decline in sexual behaviour from pre-intervention to post-intervention. Hierarchical regression analyses revealed that after controlling for covariates, participation in the group intervention significantly improved sexual confidence, sexual intimacy, masculine self-esteem and satisfaction with orgasm. Conclusions This group-based CBT intervention for men post-radical prostatectomy for localised prostate cancer shows promising results in terms of improving quality of life. Copyright © 2013 John Wiley & Sons, Ltd.

Aim: To assess the degree of residual urinary and sexual dysfunction experienced by patients treated for localized prostate cancer with radical prostatectomy (RP), external beam radiotherapy (EBRT) or EBRT plus hormone therapy (EBRT/HT) in an Australian sample. Methods: This was a cross-sectional survey of 150 patients who had undergone treatment for localized prostate cancer a mean of 4.93 years prior to the study. It was part of a larger study investigating the psychological adjustment of patients and their partners. Fifty-five patients had undergone RP, 67 patients had undergone EBRT and 28 patients had undergone EBRT/HT for localized prostate cancer. The patients completed the University of California Los Angeles-prostate cancer index to determine the level of residual sexual and urinary dysfunction and bother as well as their socio-demographic characteristics. Results: In the RP group, 34.5% of patients reported urinary leakage every day. Only one RP patient (1.8%) reported this as a significant problem. Inability to achieve an erection was reported by 41.8% of the RP group, 34.3% of the EBRT group and 46.4% of the EBRT/HT group. ancova indicated a significant difference in mean urinary function scores across treatment groups. The RP group showed significantly worse urinary function compared to the other treatment groups; however, this was not perceived to be a significant problem by most of the survivors. Age was significantly associated with sexual function. Conclusion: Patients treated for localized prostate cancer face a high probability of living with long-term residual symptoms. The results of this study suggest that urinary and sexual dysfunction is still evident, even in patients treated more than 4 years ago. The findings are consistent with a growing body of research indicating that patients in the later stages of surviving cancer face significant quality of life issues.

Various conflicting guidelines and recommendations about prostate cancer screening and early detection have left both clinicians and their patients quite confused. At the Prostate Cancer World Congress held in Melbourne in August 2013, a multidisciplinary group of the world's leading experts in this area gathered together and generated this set of consensus statements to bring some clarity to this confusion. The five consensus statements provide clear guidance for clinicians counselling their patients about the early detection of prostate cancer.