Osteoporosis risk and interest in strength training in men receiving androgen ablation therapy for locally advanced prostate cancer

Identifying the self-management behaviours performed by prostate cancer survivors: a systematic review of the evidence

Purpose

Prostate cancer survivors are keen to engage as active partners in the management of their condition but have voiced a number of unmet support needs that make effective self-management problematic. Identifying self-management behaviours and evaluating how self-management changes over time may provide valuable insights into how men can be better supported to self-manage. Our systematic review aimed to identify the self-management behaviours for prostate cancer survivors and to evaluate whether these change over time.

Methods

Using the PRISMA statement we performed a systematic review of studies that identified the self-management behaviours of prostate cancer survivors. Databases searched included: DARE, CDSR, Medline, CINAHL, PsycINFO and ASSIA. Studies were classified by levels of evidence and quality assessment.

Results

111 publications were retrieved from the search and 5 publications were included. Men performed a variety of self-management behaviours for psychological and physical problems. Only one study assessed changes in self-management behaviours over time and was limited to men treated by radiotherapy.

Conclusion

Despite the recent political drive for cancer survivors to self-manage, this review has demonstrated the evidence base is under-developed and a wide range of research is needed to address the unmet supportive care needs of prostate cancer survivors. Practically, this review has identified that Dodd’s Self-Care Log was found to have the strongest psychometric properties for additional research in this area.

Exercise guidelines for adults with cancer: a vital role in survivorship

Cancer survivors face many challenges as a result of their cancer diagnosis and treatment, most importantly the maintenance of physical well-being. Nurses and other health professionals strive to address the needs of cancer survivors, including providing appropriate health-promotion information for a physically active lifestyle. Cancer survivors are at greater risk for recurrence and for developing second cancers because of treatment effects, unhealthy lifestyle behaviors, or risk factors that contributed to the first cancer. In light of those concerns, guide-lines aimed at understanding and preventing secondary disease, recurrence, and the late and long-term effects of treatment are essential.

Body composition, physical fitness, functional performance, quality of life, and fatigue benefits of exercise for prostate cancer patients: a systematic review

CONTEXT

Prostate cancer patients, especially those on androgen deprivation therapy (ADT), experience many symptoms that make it difficult to maintain their independence and quality of life. Because ADT acts by means of reducing testosterone production, exercise may offset many of the ADT side effects and those of the cancer itself.

OBJECTIVES

This systematic review of the literature evaluates whether exercise could reduce symptoms and improve quality of life for prostate cancer patients.

METHODS

Using relevant databases and key words, 12 training studies were found meeting the inclusion and exclusion criteria.

RESULTS

Grade A level evidence was observed for the benefits of exercise in improving muscular endurance, aerobic endurance, and overall quality of life, as well as reducing fatigue in prostate cancer patients. Grade B evidence also suggested that exercise may improve prostate cancer patients' muscle mass, muscular strength, functional performance (walking and sit to stand speed), as well as health-related, social and physical quality of life. These effects appeared greater for group-rather than home-based-exercise, especially if these programs included resistance training.

CONCLUSION

It is recommended that most prostate cancer patients be encouraged to exercise regularly by their clinicians and significant others. Where possible, this exercise should be group-based and include some resistance training. Future research in this area should directly compare group- and home-based, as well as resistance, aerobic, and combined resistance and aerobic training to better elucidate the most effective forms of exercise for this population and what factors affect initiation and adherence to such programs.

3-D conformal treatment of prostate cancer to 74 Gy vs. high-dose-rate brachytherapy boost: a cross-sectional quality-of-life survey

The effects of two modalities of dose-escalated radiotherapy on health-related quality of life (HRQOL) were compared. Forty-one consecutive patients were treated with a 3-D conformal (3-DC) boost to 74 Gy, and 43 with high-dose rate (HDR) brachytherapy boost (2x9 Gy), following 3-D conformal treatment to 46 Gy. Median age was 70 years in both groups, median initial PSA was 7.9 microg/l in 3-DC boost patients and 8.1 microg/l in HDR boost patients. Stage was <or=T2 in 66% and 67% and Gleason score was >or=7 in 52% and 47%, respectively. HRQOL was assessed cross-sectionally using EORTC QLQ-C30 and organ-specific PR25 modules 3--32 (median 19) and 4--25 (median 14) months after treatment, respectively. Questionnaires were completed by 93% and 97% of patients, respectively. Diarrhea and insomnia scores were significantly increased in both groups. In the PR25 module, scores of 3-DC boost and HDR boost patients for urinary, bowel and treatment-related symptoms were similar. Among responders, 34% of 3-DC boost patients and 86% of HDR boost patients had severe erectile problems. Dose escalation in prostate cancer by either 3-DC boost to 74 Gy or HDR brachytherapy boost appears to result in similar HRQOL profiles.

A systematic review of physical activity in prostate cancer survivors: outcomes, prevalence, and determinants

INTRODUCTION

We reviewed physical activity (PA) studies in prostate cancer (PC) survivors investigating (a) the effects of PA on health outcomes, (b) the prevalence of PA, and (c) the determinants of PA.

MATERIALS AND METHODS

A systematic search of the literature identified nine studies on the outcomes of PA, six studies on the prevalence of PA, and four studies on the determinants of PA in PC survivors.

RESULTS

Results showed promising effects of PA on muscular fitness, physical functioning, fatigue, and health-related quality of life. The prevalence of PA varied widely from <30% to >70%, depending on the type of measure used. PA in PC survivors was predicted by motivational variables such as intentions, perceived behavioral control, and subjective norms.

CONCLUSION

Although preliminary research is promising, there remains a significant amount of research to be done on the role of PA in PC survivors. Moreover, future research would benefit from larger samples using randomized controlled trial methodology.

Physical activity correlates and barriers in head and neck cancer patients

PURPOSE

Our study purpose was to determine physical activity correlates and barriers among head and neck cancer patients.

MATERIALS AND METHODS

Fifty-nine (response rate = 91%) head and neck cancer patients from an academic oncology clinic enrolled in a cross-sectional study utilizing chart review and self-administered questionnaire.

RESULTS

The majority were men (83%) and white (92%) with mean age of 58 +/- 12.8 years and mean months since diagnosis of 18.6 +/- 51.9. The strongest bivariate correlates of physical activity included enjoyment (r = 0.41; p = 0.002), symptom index (r = -0.36; p = 0.006), alcohol use (r = 0.36; p = 0.007), task self-efficacy (r = 0.33; p = 0.013), perceived barriers (r = -0.27; p = 0.047), and comorbidity score (r = -0.27; p = 0.042). Stepwise regression demonstrated independent associations with physical activity for enjoyment (beta = 0.38; p = 0.002) and symptom index (beta = -0.33; p = 0.006; R (2) = 0.28). The most prevalent barriers significantly associated with physical activity included dry mouth or throat (r = -0.32; p = 0.016), fatigue (r = -0.27; p = 0.043), drainage in mouth or throat (r = -0.41; p = 0.002), difficulty eating (r = -0.32; p = 0.015), shortness of breath (r = -0.30; p = 0.024), and muscle weakness (r = -0.29; p = 0.033).

CONCLUSIONS

Our results showed that the strongest independent correlates of physical activity were social cognitive (i.e., enjoyment) and treatment-related (i.e., symptom index). Treatment-related activity barriers were frequent and significantly associated with reduced activity. Efforts to enhance exercise adherence in head and neck cancer patients should focus on optimizing enjoyment and managing treatment-related barriers.