Managing the Late Effects of Cancer: Developing a Self-Management Intervention for the Late Effects of Different Treatment Modalities for Breast, Prostate and Bowel Cancers

This is an innovative project within the important area of cancer survivorship. The student will join a small expert team within the Institute of Applied Health Sciences which has good links with NHS Grampian and UCAN (Urological Cancer Charity). Dr Sara Jane MacLennan is a health psychologist with a long standing interest in the health psychology of cancer. Dr Peter Murchie is a clinical consultant within Academic Primary Care with an established track record in the management of cancer in primary care.

This PhD will investigate how to best support people managing the late effects of cancer after they have completed their primary cancer treatment.

The morbidity associated with breast, prostate and bowel cancers can be significant ranging from the psychological and social impact of diagnosis and the side effects of treatment to pain and fatigue and the social, psychological and economic costs associated with loss of livelihood (Bradley et al, 2002; Chirikos et al, 2002) and impaired quality of life (Schmidt et al, 2012). Cancer survivorship is the area focused on enabling individuals to make as full a return to normal life as possible from point of diagnosis onwards until end of life (Macmillan Cancer Support, 2008). This includes issues related to diagnosis, treatment, the promotion and maintenance of recovery, side effects and late effects of treatment, quality of life and psychosocial wellbeing, engagement in work, dealing with advanced disease and secondary cancers and information and support needs.

Despite progress in terms of cancer survivorship research, substantial gaps still exist in our understanding of the timing of and the impact (both physical and psychosocial) on the individual of the late effects of different treatment modalities for breast, prostate and bowel cancers. This holds implications for the design and delivery of care after treatment. There is a need to better understand how:

(1) individuals manage the cognitive, behavioural and emotional response; and how

(2) we can support the development of knowledge, skills and confidence (self-efficacy) to facilitate return to as full a normal life as possible.

Given the ever greater constraint on resources within primary and secondary care, self-management interventions could offer a way of meeting the information, education and support needs of those experiencing late effects. However, we need to better understand the particular needs of this patient group.

Research aim:

(1) To understand the impact of the late effects of different modalities of primary treatment for breast, prostate and bowel cancers;

(2) To understand the information, education and support needs of those managing the late effects of different modalities of primary treatment for breast, prostate and bowel cancers; and

(3) To develop and pilot a self-management intervention to meet these needs.

Following an initial systematic review of the literature, the PhD student will conduct a series of interviews and/or Delphi or questionnaire surveys with patients, significant others and relevant health and care providers within primary and secondary care. Through study 1, the student will focus on understanding which patients experience late effects of different treatment modalities for breast, prostate and bowel cancers, what are these late effects and when do they occur in the cancer care and aftercare pathway. The student will also investigate how individuals and family members have tried to manage these (cognitive, behavioural and emotional response), what support they have received, what information, education and support needs have remained unmet and the views of these groups on how the current system could be improved. Through study 2, the student will seek to understand what data is routinely collected about late effects within primary and secondary care, how needs are identified and what information, education and support is currently provided by health care professionals. They will also explore what are the unmet needs and barriers within the current system and how this could be improved. The work conducted will provide a foundation for the development of future self-management interventions.

Application Procedure:

Please select ’Degree of Doctor of Philosophy in Applied Health Sciences’ from the list of programme options in the University of Aberdeen’s online postgraduate applicant portal to ensure that your application is passed to the correct school for processing. Then manually enter the name of the supervisor(s), project title and funder (Elphinstone) in the space provided.

This award is available to high-achieving students. Candidates should have (or expect to achieve) a minimum of a First Class Honours degree in a relevant subject. Applicants with a minimum of a 2.1 Honours degree may be considered provided they have a Distinction at Masters level.