Canadian Cancer Survivor Network Survey for Patient & Caregiver Input on Apalutamide

Introduction & Filtering Questions

The purpose of the survey is to provide the Canadian Cancer Survivor Network (CCSN) with insights and perspectives about living with and managing prostate cancer from patients and caregivers in order to complete a patient evidence submission for apalutamide, a new medication for metastatic castrate-sensitive prostate cancer (mCSPC).

The survey will remain open until October 23, 2019.

The pan-Canadian Oncology Drug Review invites patient groups like CCSN to prepare and send in submissions so that patients and caregivers like you can be heard. Please join us and have your voice included in this important submission process.

If you do not have metastatic castrate-sensitive prostate cancer (mCSPC), but believe that you would benefit from this treatment, please complete the survey.

Thank you for your participation.

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* 1. Are you a resident of Canada?

Yes

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* 2. If you are a resident of Canada, what province or territory do you reside in?

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* 3. If you are not a resident of Canada, what country are you from?

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* 4. What gender do you identify as?

Male

Female

Other

Prefer not to say

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* 5. What methods were used to diagnose prostate cancer?

Incidental finding / Physical exam by family doctor

PSA testing

Reporting of symptoms and/or discomforts

Rectal exam

Blood work

Biopsy

A combination of any of the above

Does not apply

Other (please specify)

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* 6. Are you a prostate cancer patient or a caregiver?

Patient - I have taken or am taking apalutamide

Patient - I have never taken apalutamide

Caregiver