Understanding Experiences and Needs of Patients With Prostate Cancer Across Asia-Pacific: A Cross-Sectional Mixed-Methods Study

Abstract

Purpose: To understand the impact of prostate cancer (PC) and identify gaps in existing care from patients, caregivers, and physicians in Australia, Japan, Mainland China, South Korea, and Taiwan. Materials and Methods: This study comprised qualitative interviews among patient-caregiver pairs and quantitative surveys among patients (high-risk localized [HRLPC] or metastatic castration-resistant [mCRPC]) and physicians. Thematic interpretation from qualitative interviews, to facilitate the quantitative survey development, was guided by the Psycho-Onco Emotional Anxiety (POEM) Framework and COM-B (Capability, Opportunity, Motivation-Behavior) model. Results: Patients reported experiencing high anxiety about fear of cancer recurrence (HRLPC: 83.3%; mCRPC: 88.9%), which increased along the course of their illness (68.8%; 48.1%). More mCRPC (40.7%) than HRLPC (20.8%) patients perceived delays in cancer diagnosis, with reasons related to time between consultation and diagnosis, belief that symptoms were not severe, prostate-specific antigen testing not a routine, or unaware of symptoms. More mCRPC (25.9%) than HRLPC (8.3%) were confused about treatment options, consistent with physicians' clinical observations. More mCRPC than HRLPC patients felt their physicians did not clearly explain potential treatment benefits, risks, and side effects or inform new therapies. Physicians (39.4%-49.5%) reported having insufficient consultation time to talk to patients. Despite majority of physicians (>80%) encouraging patients to make treatment decisions, 77.8% to 83.3% of patients relied on their doctors. Conclusions: Challenges to current PC care included gaps in knowledge, patient-physician communication, shared decision-making, and psychosocial support which are interrelated. There is a need for multidisciplinary efforts to boost patient awareness and psychosocial support to enhance the quality of comprehensive PC care.