Phillip Koo:

So we recently had two major conferences in the urology space - European Association of Urology, that was held in Madrid, and then American Urology Association, which was in Las Vegas, and lots of data, lots of discussions, lots of great work that was presented. And we're going to try to highlight some of these. So some of these, you know, data presentations or whatnot that benefit patients directly.

So, number one, at AUA this year, there was a large discussion about this caregiver survey that was presented. Can you tell us a little bit more about this survey?

Zachary Klaassen: 

Yeah, absolutely. Before I get into that, I just want to bring one more point up about these meetings. This is, you know, they're urology meetings, and 15 years ago, it was all urologists at these meetings. But now we have urologists, nurse practitioners, radiation oncologists, medical oncologists, nuclear medicine physicians.

And so it's really become multidisciplinary around these meetings as well. Not just those meetings, but certainly upcoming meeting next month or later this month at ASCO, which is the big American Society of Clinical Oncology. So our listeners, I think it's important to understand that this is multi-specialty. Even at these quote unquote “urology meetings.” 

So yeah, I think, Phil, this paper, I happen to be the author on it. I was delighted to be involved with it. And it really is important when you look at caregivers and what their needs are, there's decent amount of literature in breast cancer, and some of the other cancers, but for some reason prostate hasn't had as much looked at in terms of what are the needs? What is the role? What is the stresses? 

All these things that come into play with caregivers, and I'm sure we have several on the line with their patients listening right now. So this study was a 528-caregiver survey; 57 questions given to 538 [editor’s note, 528] caregivers of prostate cancer patients. There's a lot to unpack here, and I know we'll send the link out to this video to sort of look at all of the many nuances and research that was sort of pulled out of this study. 

But some of the highlights were, about half of these caregivers are females. The mean age is about 47, and about two-thirds of the caregivers live with the patients. And when we look at some of the stresses on the caregivers, about 50%, especially in patients with metastatic disease, either had to change their job or quit their job to help with their–with the patient. This may be driving to appointments. This may be activities of daily living, such as getting to the bathroom, cleaning, etc. But it really can be a huge, not only time commitment, but, you know, from a financial standpoint, as well.

You know, looking at some of the other things that were pulled out of this survey, a lot of the caregivers come to these appointments because they want to hear things that the physician, saying that the patient may miss. They want to advocate. What's one of the most interesting points was that the caregiver is 4 times more likely to talk about adverse events taking a medication than the patient is themselves. 

And I think, so, this is really showing that as the patient, we may be shy to talk about it. But the caregiver is going to be right there. And really, you know, telling the healthcare provider what's really going on. I think the other interesting thing is that [the] majority of caregivers and patients have a very beneficial relationship. I think that was important, as well. You know, there's a lot of stress in these relationships. But it's very mutually rewarding, I would say.

And I think the final point on this survey – and again, there's a lot more information than what I'm just talking about right now – but is, how do caregivers want to get their information? Number one is getting to the doctor's appointment. Then there's a big push for social media. So YouTube, Facebook, they're doing their own research. And really, another really important take-home is how to deal with stress and mental health in their own lives, associated with all this stuff going on. So I was delighted to be a part of this study. I think the link will be very helpful for people to look additional stuff we looked at, but you know, sort of a jumping-off point as to where we go from here for sure.

Phillip Koo:

You know, I think those are all great points. And we know it, but being able to sort of identify the impact that it has on, you know, not just the patient. But, you know, the community and the people surrounding the patient really helps us identify ways in which we can then start impacting care more effectively.

So I really appreciate, you know, the time and effort that it took to sort of conduct this survey and then analyze it more scientifically. So then, from your perspective, where do we go next? What's sort of the next step to this to sort of maximize that impact?

Zachary Klaassen:

I think it's, it's all about implementing, getting information and resources to the caregivers. Now, whether this is support groups at cancer centers–I know PCF has some additional resources as well, which I know we'll link to this, too. But also, you know, every little nugget of information is another opportunity to intervene.

You know I talked about that, caregivers are 4 times more likely to discuss adverse events, and so I think, empowering caregivers and having that information, and also understanding that the physicians need to know this, too, they need to ask the caregiver what's going on. So there's a lot of implementation just at the grassroots level of both from the patient, the caregiver, and the healthcare provider to make this all work, because I think there's a lot of interesting and important stuff that came out of this study.