CLASP Cancer: Life Affirming Survivorship support in Primary care

Roughly 2.5 million people in the UK are cancer ‘survivors’ – meaning people who have finished primary treatment, whether or not they are cured. The number is rising to an estimated 4 million by 2030.

Recent national surveys suggest that 47% of survivors live with either moderately bad or very bad fear of the cancer coming back. Distress is common (37% report anxiety or depression, 31% mood swings), as is fatigue (43%) and sleep problems (43%). Almost 30% take no exercise at all.

Studies show that lifestyle changes (healthy eating and more physical activity) and support for improving psychological wellbeing (particularly coping with tiredness and emotional distress) could improve quality of life for cancer survivors. However, we need simple, efficient and effective ways to help, which we could widely and easily put into practice. Our research will explore using the internet as an intervention to support change in the way GP practices offer support to patients. It has several steps:

We will review past research to inform how we approach development of the intervention, and to identify particular types of support that have a good chance of working.

We will then adapt internet applications that have already been developed for patients with other conditions to improve lifestyle (healthy eating and physical activity) and wellbeing (coping with distress and fatigue).

The internet applications will be adapted for primary care for patients living with or in remission from colorectal, breast and prostate cancer.

We will then carry out a small study of around 100 patients in 5-10 general practices to make sure the intervention is likely to work and be acceptable to patients and health professionals.

Following this we will carry out a larger study of 2500 patients. In this study we will randomise patients to one of three groups (so patients will have an equal chance of being in any one of the three groups):

1) Control. Patients will receive brief advice about lifestyle and wellbeing with written materials;

2) Web only. As in (1 above) but with support from a practice nurse to use an Internet based Lifestyle and Wellbeing Package called Renewed

3) Web with flexible nurse support. As in (2 above) but with extra guidance and support to increase the likely patient use of the self-help intervention. This will be provided flexibly by practice nurses to participants who request it. We will follow up patients in all groups over 1 year to see if their quality of life improves and to talk to them about what part of the intervention worked well for them and what could have worked better for them.

Programme Manager: Jane Barnett

Duration: Jan 1st 2016- 31st March 2022

Contact: Jane Barnett jab6@soton.ac.uk