National implementation shared-care trial to benefit men with prostate cancer
A QUT-led national implementation trial of a new cancer follow-up care model survivors aims to improve outcomes for men with prostate cancer and create capacity in acute cancer centres by maximising the involvement of general practices in survivorship care.
Professor in Cancer Nursing, Ray Chan from the QUT Cancer and Palliative Care Outcomes Centre will lead a four-year $1.62 million MOSES Trial, a shared-care MOdel for proStatE cancer Survivors, funded by the Medical Research Future Fund (MRFF).
“Due to the improved survival in prostate cancer, men with prostate cancer are now living longer and require good supportive care as well as life-long routine surveillance to make sure the cancer hasn’t come back or metastasized to another organ.” Professor Chan said.
“Because it's so treatable, numbers continue to grow. In the current care model, we keep adding new patients into the system but we're not discharging them fast enough to community care when they finish cancer treatment.
“We need to create capacity in acute cancer centres to see new patients.”
Prostate cancer is the most common cancer among Australian men. It has 95 per cent 5-year relative survival rate and there are 211,000 men in Australia currently living with the disease. Last year, there were 16,741 new diagnoses.
About 890 men will participate in the MOSES Trial, which will implement and evaluate an integrated model of follow-up care shared between six acute cancer care centres and more than 800 general practices across Queensland, South Australia and Victoria.
The national implementation trial follows a pilot PROCARE trial of 88 patients in 2017, which found no difference in men adherence to their prostate-specific antigen (PSA) testing recommendations compared to usual care, and they were very satisfied with the care they received.
It also follows the success of a large body of research program developing and testing a shared-care model for people with breast cancer and lymphoma.
Professor Chan said his research group was targeting the most common cancers including prostate cancer, breast cancer and lymphoma to create a momentum for system-wide uptake.
“General Practitioners (GPs) may only treat a few patients a year, so we need to facilitate shared care in a way that one day it will become usual practice like how they are delivering antenatal share-care,” he said.
“This is a next logical step to create volume and momentum in shared care for cancer survivors.”
QUT will partner with the Prostate Cancer Foundation of Australia (PCFA) Prostate Cancer Specialist Nurses, who will have a vital role in coordinating care and linking patients with their GPs and practice nurses.
The implementation trial will include men with early-stage prostate cancer, as well as men with advanced prostate cancer who have needs that GPs are well positioned to address, such as side effects of androgen deprivation therapy (ADT) including cardiovascular problems, hot flushes, low energy, and weight gain.
“Ultimately, this research will transform how care is delivered to thousands of men with prostate cancer,” Professor Chan said.
Renowned cancer nurse researcher Distinguished Professor Patsy Yates and specialist urologist Dr Ian Vela, who has joint appointments with QUT and Metro South Health, are also among the chief investigators.
Funding formed part of the MRFF Primary Health Care Research (PHCR) Initiative - 2020 Primary Health Care Research Grants.
The MOSES trial is a collaboration between QUT, University of Melbourne, Prostate Cancer Foundation of Australia, Flinders University, The Council of the Queensland Institute of Medical Research, and Peter MacCallum Cancer Centre.
- Professor Raymond Chan, QUT
- Professor Patsy Yates, QUT
- Dr Ian Vela, QUT
- Dr Nicolas Hart, QUT
- Lee Jones, QUT
- Professor Jeffrey Dunn, University of Southern Queensland
- Professor Jon Emery, University of Melbourne
- Professor Bogda Koczwara, Flinders University
- Associate Professor Louisa Gordon, The Council of the Queensland Institute of Medical Research
- Professor Michael Jefford, Peter MacCallum Cancer Centre.