A Novel Patient-reported Outcome Measure for Patients With Prostate Cancer Receiving Radionuclide Therapy: FACT-RNT - Lisa Gudenkauf
March 22, 2023
Lisa Gudenkauf joins Phillip Koo to discuss her work on developing a patient-reported outcome measure (PRO) called FACT-RNT that targets symptoms and toxicities specific to radionuclide therapy. She notes that dry mouth is a significant issue, but other symptoms that may be missed that aren't being assessed quite as much are things like feeling isolated from your family after you've had treatment. . Dr. Gudenkauf emphasizes the importance of giving patients a voice and a standardized way to report symptoms and notes that caregivers' perspectives can also be valuable. The development of FACT-RNT involved input from patients, caregivers, and clinicians.
Biographies:
Lisa Marie Gudenkauf, PhD, Clinical Psychologist, Moffit Cancer Center, Tampa, FL
Phillip J. Koo, MD, FACS Division Chief of Diagnostic Imaging at the Banner MD Anderson Cancer Center in Arizona.
Biographies:
Lisa Marie Gudenkauf, PhD, Clinical Psychologist, Moffit Cancer Center, Tampa, FL
Phillip J. Koo, MD, FACS Division Chief of Diagnostic Imaging at the Banner MD Anderson Cancer Center in Arizona.
Read the Full Video Transcript
Phillip Koo: Hi. We're here today with Lisa Gudenkauf from Moffitt Cancer Center, who was someone who I just saw as I walked through the poster session at GU ASCO this year. So before we get into the work that you've been doing, can you tell us a little bit about yourself?
Lisa Gudenkauf: Yeah, absolutely. I'm a clinical health psychologist by training, so I've worked with patients in the clinical setting, but now I'm a researcher at Moffitt Cancer Center.
Phillip Koo: Great. So I saw your poster today talking about patient-reported outcomes in patients who receive radionuclide therapies. Can you tell us a little bit more about that project? What was sort of the impetus of it and where you see it going?
Lisa Gudenkauf: Absolutely. Well, we know that radionuclide therapy is really taking off, and we have clinical trials where we want to be tracking toxicity symptoms. We want to know what's happening for patients as they go through the radionuclide treatment, but we don't have standardized assessments that are specific to radionuclide therapy. So we wanted to produce a PRO measure, a patient-reported outcome measure, that could really target those specific symptoms and toxicities.
Phillip Koo: Great. So in your experience, having worked with a lot of these patients who've received these therapies, what are the types of symptoms or side effects that you see are most troublesome for these patients?
Lisa Gudenkauf: Yeah. We know from even the clinical trials and from clinical practice that things like dry mouth are a really big issue for radionuclide therapy, but the things that we may miss that aren't being assessed quite as much are things like feeling isolated from your family after you've had treatment and you need to stay away. So I think we wanted to really cover the broad spectrum of specific symptomatology that can be treatment-limiting, but also quality of life issues that affect functioning and really impact their day-to-day living.
Phillip Koo: Great. So in men, we often think or hear about how men underreport a lot of these symptoms.
Lisa Gudenkauf: Yeah.
Phillip Koo: Is that real? And are there any tips or tricks that you have for the providers out there to make sure they're getting the complete picture?
Lisa Gudenkauf: Yeah. It's a great question you asked because actually we came at this from the perspective that clinicians often underestimate patient symptoms. So giving patients a voice and giving them an opportunity at every time they have an administration of radionuclide therapy to really report where they're at and to track those more subtle changes over time.
Having a standardized assessment could give them that voice and give them an opportunity to report perhaps at a more realistic level of what they're dealing with. Also, when we developed this, we took into account caregivers' perspectives, clinicians' perspectives, and patients. We wanted all stakeholders to have a say in what they observed for symptoms. So perhaps if a patient underreported, then a caregiver may have been able to speak to that. So we really took into consideration everyone's perspective.
Phillip Koo: Great. So this tool that's developed is called FACT-RNT?
Lisa Gudenkauf: Yes.
Phillip Koo: I believe it's published now in the January issue of the Journal of Nuclear Medicine.
Lisa Gudenkauf: Yes.
Phillip Koo: All right, great. Any last comments or thoughts you have for the listener out there as we enter in this new world of radionuclide therapies?
Lisa Gudenkauf: Well, it's an exciting world, and I think we want to make sure that throughout as we move forward, we don't lose the patient voice and we don't forget to assess very thoroughly and in a standardized way. In each of these clinical trials and in clinical practice, we want to be able to compare how the different radionuclide therapies affect patients directly, and we want to hear from them directly.
Phillip Koo: Great. That's a great message for all of us, and I think for those physicians out there treating these patients, whether you're a medical oncologist or urologist and nuclear medicine physician, whatever background you might be, I think these are important things that we need to monitor. So thank you very much for bringing this to our attention, and we look forward to hearing more about FACT-RNT in the future.
Lisa Gudenkauf: Thank you so much for this opportunity. I appreciate it.
Phillip Koo: Okay.
Phillip Koo: Hi. We're here today with Lisa Gudenkauf from Moffitt Cancer Center, who was someone who I just saw as I walked through the poster session at GU ASCO this year. So before we get into the work that you've been doing, can you tell us a little bit about yourself?
Lisa Gudenkauf: Yeah, absolutely. I'm a clinical health psychologist by training, so I've worked with patients in the clinical setting, but now I'm a researcher at Moffitt Cancer Center.
Phillip Koo: Great. So I saw your poster today talking about patient-reported outcomes in patients who receive radionuclide therapies. Can you tell us a little bit more about that project? What was sort of the impetus of it and where you see it going?
Lisa Gudenkauf: Absolutely. Well, we know that radionuclide therapy is really taking off, and we have clinical trials where we want to be tracking toxicity symptoms. We want to know what's happening for patients as they go through the radionuclide treatment, but we don't have standardized assessments that are specific to radionuclide therapy. So we wanted to produce a PRO measure, a patient-reported outcome measure, that could really target those specific symptoms and toxicities.
Phillip Koo: Great. So in your experience, having worked with a lot of these patients who've received these therapies, what are the types of symptoms or side effects that you see are most troublesome for these patients?
Lisa Gudenkauf: Yeah. We know from even the clinical trials and from clinical practice that things like dry mouth are a really big issue for radionuclide therapy, but the things that we may miss that aren't being assessed quite as much are things like feeling isolated from your family after you've had treatment and you need to stay away. So I think we wanted to really cover the broad spectrum of specific symptomatology that can be treatment-limiting, but also quality of life issues that affect functioning and really impact their day-to-day living.
Phillip Koo: Great. So in men, we often think or hear about how men underreport a lot of these symptoms.
Lisa Gudenkauf: Yeah.
Phillip Koo: Is that real? And are there any tips or tricks that you have for the providers out there to make sure they're getting the complete picture?
Lisa Gudenkauf: Yeah. It's a great question you asked because actually we came at this from the perspective that clinicians often underestimate patient symptoms. So giving patients a voice and giving them an opportunity at every time they have an administration of radionuclide therapy to really report where they're at and to track those more subtle changes over time.
Having a standardized assessment could give them that voice and give them an opportunity to report perhaps at a more realistic level of what they're dealing with. Also, when we developed this, we took into account caregivers' perspectives, clinicians' perspectives, and patients. We wanted all stakeholders to have a say in what they observed for symptoms. So perhaps if a patient underreported, then a caregiver may have been able to speak to that. So we really took into consideration everyone's perspective.
Phillip Koo: Great. So this tool that's developed is called FACT-RNT?
Lisa Gudenkauf: Yes.
Phillip Koo: I believe it's published now in the January issue of the Journal of Nuclear Medicine.
Lisa Gudenkauf: Yes.
Phillip Koo: All right, great. Any last comments or thoughts you have for the listener out there as we enter in this new world of radionuclide therapies?
Lisa Gudenkauf: Well, it's an exciting world, and I think we want to make sure that throughout as we move forward, we don't lose the patient voice and we don't forget to assess very thoroughly and in a standardized way. In each of these clinical trials and in clinical practice, we want to be able to compare how the different radionuclide therapies affect patients directly, and we want to hear from them directly.
Phillip Koo: Great. That's a great message for all of us, and I think for those physicians out there treating these patients, whether you're a medical oncologist or urologist and nuclear medicine physician, whatever background you might be, I think these are important things that we need to monitor. So thank you very much for bringing this to our attention, and we look forward to hearing more about FACT-RNT in the future.
Lisa Gudenkauf: Thank you so much for this opportunity. I appreciate it.
Phillip Koo: Okay.