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Strategies for living well with hormone-responsive advanced prostate cancer—a qualitative exploration

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Due to recent treatment advances, men are increasingly living longer with advanced prostate cancer (PCa). This study sought to understand men’s experiences of living with and adjusting to advanced hormone-responsive PCa and how this influenced their quality of life (QoL), in order to highlight how support could be optimized.


Participants were recruited through a UK wide survey—the ‘Life After Prostate Cancer Diagnosis’ study. In-depth telephone interviews were conducted with 24 men (aged 46–77 years) with advanced (stage IV) hormone-responsive PCa diagnosed 18–42 months previously. Thematic analysis was undertaken using a framework approach.


Most participants perceived their QoL to be relatively good, which was influenced by the following factors (enablers to ‘living well’ with PCa): a sense of connectedness to others, engagement in meaningful activities, resources (social, cognitive, financial), ability to manage uncertainty, utilization of adjustment strategies and support, communication and information from health professionals. Barriers to ‘living well’ with PCa were often the converse of these factors. These also included more troublesome PCa-related symptoms and stronger perceptions of loss and restriction.


In our study, men living with advanced hormone-responsive PCa often reported a good QoL. Exploring the influences on QoL in men with advanced PCa indicates how future interventions might improve the QoL of men who are struggling. Further research is required to develop and test interventions that enhance QoL for these men.

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Fig. 1

Data availability

The datasets generated and/or analysed in the current study are not available publicly as eligible patients were informed at the time of the survey that their data would be stored securely and confidentially.


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The authors thank all the men who responded to the survey. We thank the Movember Foundation, in partnership with Prostate Cancer UK, for funding the study. We acknowledge the following people for their contribution to the development, setting up and running of the study: Rebecca Mottram, Majorie Allen, Heather Kinnear, Conan Donnelly, Oonagh McSorley, Victoria Cairnduff, Linda Roberts, Adrian Slater, Picker Institute Europe, the LAPCD User Advisory Group and Clinical and Scientific Advisory Group. This study is based in part on information collected and quality assured by the National Cancer Registration and Analysis Service (part of Public Health England), the Northern Ireland Cancer Registry, the Welsh Cancer Intelligence & Surveillance Unit and the Scottish Cancer Registry (part of the Public Health & Intelligence Unit of NHS National Services Scotland).The work of cancer registries uses data provided by patients and collected by health services as part of their care and support.


The Life After Prostate Cancer Diagnosis study was funded by the Movember Foundation, in partnership with Prostate Cancer UK, as part of the Prostate Cancer Outcomes programme, grant number BO26/MO.

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Authors and Affiliations



EW, RW, PW, AG, AG and HB contributed to the study conception and design. Data collection and analysis were performed by LM, JN, CR, JB, RW and EW. The first draft of the manuscript was written by LM, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Eila Watson.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Newcastle/North Tyneside Research Ethics Committee (15/NE/0036), Health Research Authority Confidentiality Advisory Group (15/CAG/0110), NHS Scotland Public Benefit and Privacy Panel (0516–0364), Northern Ireland Research Ethics Office (16/NI/0073)) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Richard Wagland and Eila Watson are joint last authors.

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Matheson, L., Nayoan, J., Rivas, C. et al. Strategies for living well with hormone-responsive advanced prostate cancer—a qualitative exploration. Support Care Cancer 29, 1317–1325 (2021).

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