Background
cancer, Prostate cancer, prostate cancer, breast cancer
BREAST CANCER, CANCER, DISEASE, PROSTATE CANCER, PROSTATE CANCER
Prostate cancer is the commonest cancer in UK men, with a rising incidence now reaching around 52,000 per year (Androgen deprivation therapy (ADT) is prescribed to almost half of all men that have been diagnosed with prostate cancer [Although ADT is an effective treatment, with virtually all men with advanced disease showing an initial clinical response, it is associated with troublesome side effects. Up to 80% of men undergoing ADT suffer from HFNS [Current UK practice for management of ADT induced HFNS is rather inconsistent, reflecting the lack of positive and methodologically sound data on which to make recommendations.Currently, there are few validated safe and effective treatments for men with HFNS [A recent systematic review to determine best practice for managing ADT induced HFNS identified fifteen studies. Eight were of pharmacologic interventions and the remainder for complementary and alternative medicine. It concluded that evidence is insufficient to support even the limited current intervention options [Cognitive behavioural therapy has been found effective in the management of HFNS. Our previous study (MENOS4) in women with breast cancer demonstrated that breast cancer nurse delivered group CBT was both an effective and safe intervention for reducing HFNS symptoms. This multicentre RCT of 130 patients compared group CBT to TAU. The study showed a 46% (6.9–3.7) reduction in the primary endpoint of mean HFNS problem rating score at 26 weeks post randomisation in the CBT arm compared to a 15% (6.5–5.5) reduction in the TAU arm (adjusted mean difference − 1.96, 95% CI − 3.68 to − 0.23, We have also adapted our approach to CBT intervention for men undergoing prostate cancer hormonal therapy. MANCAN was a single centre RCT of 68 patients which compared guided self-help CBT to TAU which showed that self-help CBT, delivered by a clinical psychologist, significantly reduced the impact of HFNS at 6 weeks post-randomisation (primary endpoint, adjusted mean difference: − 1.33, 95% CI − 2.07 to − 0.58; MANCAN2 will advance this program of work by determining whether ADT-induced HFNS in men with prostate cancer can be impacted by a guided self-help CBT intervention (delivered virtually, face to face or hybrid). Critically, this will be undertaken by the existing prostate cancer CNS team within a multicentre study. The emphasis on this existing team, compared to a requirement for clinical psychology involvement, if successful, should facilitate translation through to implementation in routine practice.