Late effects of pelvic radiation treatment (EAGLE study) [Abstract]

Background: Radiotherapy treatment for prostate cancer can cause severe long –term bowel problems, including limiting travel, work or socialising. Around half of patients suffer from late effects, appearing more than six months after radiotherapy. These symptoms often remain unmonitored in follow up care, despite the existence of effective treatment if referred to gastroenterology departments. This study focuses on the early identification and treatment of neglected late effect symptoms. Methods: Novel healthcare interventions are often difficult to embed in local clinical settings. Implementation research methodology will be used to evaluate experiences of a multi-component intervention aimed at prompting referrals to an enhanced gastroenterology service, making real time adjustments as needed, with the ultimate aim of successfully embedding the intervention into practice across the UK. The intervention, introduced in three UK centres, comprises a brief, standardised clinical assessment of relevant symptoms and rapid referral to a gastroenterological service, with staff trained to use a validated investigation and treatment algorithm. Evaluation of the intervention and its acceptability within local practices will be conducted using longitudinal mixed methods research. All prostate cancer patients attending follow up clinics, meeting the eligibility criteria will be invited to be screened (n = 300) and offered a referral to gastroenterology if appropriate. A cost effectiveness analysis of health-related quality of life and resource utilisation data will be undertaken and contrasts made between participants and a comparison group. Results: Interim results will focus on interview data from healthcare professionals and how they are working locally to embed practice, sharing learning points with other locations whilst working towards a sustainable service. Conclusions: This study evaluates the effectiveness of an enhanced assessment and treatment service spanning oncology and gastroenterology services in improving the outcome of men with prostate cancer after radiotherapy. Successful implementation will act as examples of best practice for a network of centres of excellence in this area