Prostate cancer is well documented as a major issue in men’s health. Most recent figures indicate that one in eight Queensland men are at risk of developing prostate cancer in their lifetime. At present in Queensland, there is little information available on how men are diagnosed and treated for prostate cancer and how their diagnosis and treatment impacts on their lives. 

The VCRCC is working in collaboration with urologists in Brisbane (and surrounds), Townsville and Mackay and with the Royal Brisbane, Princess Alexandra, Mater (Brisbane), Greenslopes Private, QEII, Ipswich, Redlands, Redcliffe, Townsville and Mackay Base Hospitals to recruit over 1000 men with prostate cancer from across Queensland to take part in the ProsCan program (Patterns of care and health-related outcomes for men newly diagnosed with prostate cancer in Queensland). The study will follow men with prostate cancer for five years to document their patterns of care and better understand the resulting impact on their health and quality of life.

ProsCan is being conducted in collaboration with the Northern Section of the Urological Society of Australia and New Zealand, Queensland University of Technology and Griffith University and is the first Australian large-scale study to track men with prostate cancer from the point of diagnosis and to follow them over time.

Staff involved: Suzanne Chambers, Joanne Aitken, Megan Ferguson, Tanuja Barker, Lorraine Caesar, Jan Howell, Sharlene Miller, Marina Tomasella, Elizabeth Goadby, Naomi Daveson.

Collaborators: David Nicol (Princess Alexandra Hospital), Frank Gardiner (Royal Brisbane and Women’s Hospital, University of Queensland), Spence Broughton (Community Representative), Stefano Occhipinti (Griffith University), Louisa Gordon (QIMR), The Northern Section of the Urological Society of Australia and New Zealand.

Contact: Megan Ferguson

Over the past few years, Cancer Council Queensland has undertaken a program of research on the supportive care needs and quality of life outcomes of men with prostate cancer. This research has indicated a need for easily accessible psychosocial interventions targeting support for decision making about medical treatments and helping men to think about their cancer in more positive ways, as well as practical advice on coping with treatment effects.

All men in the ProsCan program who are diagnosed with localised prostate cancer are offered the opportunity to take part in a randomised controlled trial of a new support program for men diagnosed with prostate cancer. The intervention is a telephone-based psychosocial support program, designed to be flexible in order to meet the specific needs of the individual man. The program focuses on providing men with support for treatment decision making, coping, and stress management, as well as information and support around managing treatment side-effects. The ProsCan intervention employs a unique nurse counsellor model and is the first targeted support intervention of this kind in Australia. Over 700 men are taking part in this component of the ProsCan Project.

The intervention component of ProsCan is being conducted in collaboration with the Northern Section of the Urological Society of Australia and New Zealand, and Griffith University and is the first study internationally to assess this type of supportive care intervention.

If the telephone service is found to be successful, it may provide a model for effective delivery of cancer support services that could be used across Queensland to provide support to patients with other types of cancer.

Staff involved: Suzanne Chambers, Megan Ferguson, Sylvia Milner, Brigid Hanley, Samantha Clutton, Tanuja Barker, Marina Tomasella, Lorraine Caesar, Jan Howell,Sharlene Miller, Elizabeth Goadby, Naomi Daveson, Joanne Aitken.

Collaborators: David Nicol (Princess Alexandra Hospital), Frank Gardiner (Royal Brisbane and Women’s Hospital, University of Queensland), Spence Broughton (Community Representative), Stefano Occhipinti (Griffith University), Louisa Gordon (QIMR), The Northern Section of the Urological Society of Australia and New Zealand.

Funded by: National Health and Medical Research Council and Cancer Council Queensland.

Contact: Megan Ferguson

The most substantial long term morbidity from prostate cancer is sexual dysfunction with consequent adverse changes in couple and intimate relationships. Research to date has not identified an effective way to improve sexual and psychosocial adjustment for both men with prostate cancer and their partners. As well, the efficacy and cost effectiveness of peer counselling as opposed to professional models of service delivery has not yet been empirically tested.

ProsCan for Couples is a randomised control trial of a couples based intervention that targets the specific challenges couples experience at diagnosis of localised prostate cancer and after radical prostatectomy. Intervention components include psycho-education; cognitive behavioural strategies; couple relationship education focussed on relationship enhancement and helping the couple to conjointly manage the stresses of cancer diagnosis and treatment; and specific psychosexual education and sexual communication.

An audiovisual resource supports the intervention that can be delivered with peer or nurse counselling. We will evaluate the efficacy of this intervention in a three arm randomised controlled trial comparing (1) usual care; (2) eight sessions of peer-delivered telephone counselling with the audiovisual resource; (3) eight sessions of oncology nurse-delivered telephone counselling with the audiovisual resource.

ProsCan for Couples is being conducted in collaboration with the Northern Section of the Urological Society of Australia and New Zealand, MD Anderson Cancer Center, and Griffith University and is the first study internationally to assess this type of supportive care intervention.

Staff involved: Suzanne Chambers, Jeff Dunn, Megan Ferguson, Tanuja Barker, Marina Tomasella, Samantha Clutton, Sylvia Milner, Brigid Hanley, Ann Burbidge, Sharlene Miller.
Peer Support Volunteers: Spence Broughton, Robert Burns, Warren Depper, Peter Dornan, Roger Dutton, Chris Gourlay, Mike McHutchison, Robert Stirling, Brendan Smyth, Ron Smith.

Collaborators: Leslie Schover (MD Anderson), Frank Gardiner (Royal Brisbane and Women's Hospital, University of Queensland), Bill McHugh and Spence Broughton (Community Representatives), Kim Halford (University of Queensland), Stefano Occhipinti (Griffith University), John Yaxley (The Northern Section of the Urological Society of Australia and New Zealand), Louisa Gordon (QIMR).

Funded by: Andrology Australia and National Health and Medical Research Council.

Contact: Megan Ferguson

It is well understood that treatment for prostate cancer can result in urinary, sexual and bowel functioning side-effects. These issues not only affect the patient, but can also significantly impact on relationships within the family unit, particularly intimate relationships with a partner. While there is a substantial body of literature examining the psychological distress and outcomes of partners of patients diagnosed with other cancers, the information for partners of men diagnosed with prostate cancer is limited.

The ProsCan Partners Study is examining the psychosocial distress experienced by partners of men diagnosed with prostate cancer. Men who are currently participating in the existing ProsCan research program being conducted by the Cancer Council Queensland will be approached for permission to invite their partner to take part in the ProsCan Partners Study. The project will involve approximately 400 partners and will follow them over several years to assess their ongoing levels of distress and psychosocial outcomes. Recruitment for the ProsCan Partners Study started in 2009.

Information gathered from this study will identify new ways to support partners of men with prostate cancer and improve the services that are available to this group. It will also guide the development of more effective psychological interventions for men and their partners.

Staff involved: Suzanne Chambers, Megan Ferguson, Tanuja Barker, Marina Tomasella, Lorraine Caesar, Jan Howell, Sharlene Miller.

Collaborators: Stefano Occhipinti (Griffith University), Stephen Lepore (Temple University), Frank Gardiner (Royal Brisbane and Women's Hospital, University of Queensland).

Contact: Megan Ferguson

Men with advanced prostate cancer where curative intent is no longer the treatment goal, face distinct challenges. The mainstay of treatment for these men is hormonal ablation and many men experience side-effects related to their treatment. By comparison to men with localised prostate cancer, men with advanced disease can report higher levels of psychological distress, poorer quality of life and greater unmet supportive care needs. The area of greatest unmet need for these men is fear of cancer progression, a reflection of the challenges of living with advanced disease. Hence, for men with advanced prostate cancer targeted support to reduce psychological distress, including depression, and to promote resilience in the face of advancing disease is crucial.

The Living with Advanced Prostate Cancer (LAPC) project is trialling a mindfulness group intervention for men with advanced prostate cancer. The project will examine the acceptability of group-based mindfulness meditation for men with advanced prostate cancer as well as the benefits of this approach in assisting men with advanced disease to adjust to the challenges of diagnosis and treatment.

Outcomes from the LAPC project will include a therapy manual and training outline that can be used immediately as a support intervention by trained staff within Cancer Council Queensland, with the potential to be translated more broadly into other treatment centres. In addition, it is envisaged that the results of this work will be used to develop further multi-disciplinary intervention concepts for this patient group.

Staff involved: Suzanne Chambers, Samantha Clutton, Sandy Hutchison, Megan Ferguson, Elizabeth Galt, Sylvia Milner.

Collaborators: Elizabeth Foley (Sydney Cancer Centre), Spence Broughton (consumer representative), Frank Gardiner (Royal Brisbane and Women’s Hospital, University of Queensland), Carolyn Salmon (Beyond Blue).

Funded by: Beyond Blue and Cancer Council Queensland.

Contact: Samantha Clutton

Some men with prostate cancer experience worse quality of life (QoL) than others. Biomarkers - the fingerprints of genes that can be assessed via simple blood sampling - could be used to identify those men before treatment. Interventions could then be directed to those men to maintain or improve their QoL.

A number of biological markers are altered in people with cancer and may be associated with QoL. This research will investigate if there are genetic markers associated with QoL in men with prostate cancer. Research into these biological markers could lead to the development of a DNA test that can predict QoL outcomes in men with prostate cancer based on genetic predisposition. This would better enable an individualised approach to care, to maintain or improve QoL through the use of effective pharmacological and psychosocial interventions, in these men throughout and beyond their cancer treatment.

Staff involved: Suzanne Chambers.

Collaborators: Kimberly Hinze (PhD candidate, Queensland University of Technology), Monika Janda, Diana Battistutta (Queensland University of Technology), Amanda Spurdle (QIMR).

Contact: Kimberly Hinze

The first-degree male relatives of men with prostate cancer are at higher risk of developing prostate cancer than are general population men. However, owing to the lack of efficacious early-detection screening practices for prostate cancer the current prostate cancer screening guidelines do not recommend population-based screening for asymptomatic men in Australia. These same screening guidelines apply to the first-degree relatives of men with prostate cancer despite their being at higher risk of developing prostate cancer.

There has been limited research on how the first-degree relatives of men with prostate cancer reconcile their risk information and use their family history to guide their screening decisions. This research will examine the current screening practices of men with a family history of prostate cancer in Queensland and examine prostate cancer risk perceptions and the psychosocial factors associated with family history risk (for example, cancer-specific worry) to help establish how having a family member with prostate cancer affects the decision to participate in prostate cancer screening.

Outcomes from this research with help Cancer Council Queensland to develop evidence-based support and information services and educational materials to assist men with a family history of prostate cancer in understanding their heightened risk of prostate cancer and making appropriate, quality decisions about early detection testing.

PhD candidate: Michelle McDowell (Griffith University).

Supervisors: Stefano Occhipinti (Griffith University), Suzanne Chambers (Cancer Council Queensland).

Contact: Michelle McDowell

Epidemiological research suggests that sun exposure, and subsequently Vitamin D, may protect against cancer risk. Precursor Vitamin D is produced in the skin with sun exposure and is then metabolised to the active form in the body. Although the evidence relating to prostate cancer is still inconclusive, it has been demonstrated that genetic changes to the Vitamin D receptor gene might also affect prostate cancer risk.

This study will explore the influence that sun exposure, Vitamin D and changes in the Vitamin D receptor, have on prostate cancer recurrence and progression. In this study, it is suggested that: increased sun exposure may be associated with lower rates of prostate cancer recurrence and improved survival; that the effect of sun exposure relates to the production of Vitamin D; and that genetic changes to the Vitamin D receptor gene may reduce the risk of prostate cancer. The project will involve men currently taking part in Cancer Council Queensland’s ProsCan Project and Cancer Council New South Wales’ PCOS Project.

Information from this study will identify whether sun exposure reduces prostate cancer recurrence and progression, enabling clinicians and consumers to be better informed about the relationship between sun exposure, Vitamin D and prostate cancer.

This study is a collaboration between Cancer Council Queensland, Cancer Council New South Wales, the University of Sydney and the Queensland University of Technology.

Staff involved: Suzanne Chambers, Megan Ferguson, Tanuja Barker, Jan Howell, Lorraine Caesar, Marina Tomasella. .

Collaborators: Queensland University of Technology, Cancer Council New South Wales, The University of Sydney, Royal Prince Alfred Hospital, The Anzac Research Institute.

Funded by: National Health and Medical Research Council.

Contact: Tanuja Barker