BACKGROUND. Advice to rest and take things easy if patients become fatigued during radiotherapy may be detrimental. Aerobic walking improves physical functioning and has been an intervention for chemotherapy-related fatigue. A prospective, randomized, controlled trial was performed to determine whether aerobic exercise would reduce the incidence of fatigue and prevent deterioration in physical functioning during radiotherapy for localized prostate carcinoma. METHODS. Sixty-six men were randomized before they received radical radiotherapy for localized prostate carcinoma, with 33 men randomized to an exercise group and 33 men randomized to a control group. Outcome measures were fatigue and distance walked in a modified shuttle test before and after radiotherapy. RESULTS. There were no significant between group differences noted with regard to fatigue scores at baseline (P ϭ 0.55) or after 4 weeks of radiotherapy (P ϭ 0.18). Men in the control group had significant increases in fatigue scores from baseline to the end of radiotherapy (P ϭ 0.013), with no significant increases observed in the exercise group (P ϭ 0.203). A nonsignificant reduction (2.4%) in shuttle test distance at the end of radiotherapy was observed in the control group; however, in the exercise group, there was a significant increase (13.2%) in distance walked (P ϭ 0.0003). CONCLUSIONS. Men who followed advice to rest and take things easy if they became fatigued demonstrated a slight deterioration in physical functioning and a significant increase in fatigue at the end of radiotherapy. Home-based, moderateintensity walking produced a significant improvement in physical functioning with no significant increase in fatigue. Improved physical functioning may be necessary to combat radiation fatigue. Cancer 2004;101:550-7.

We retrospectively analysed acute radiation toxicity data for patients who had participated in a randomised controlled study in our centre in order to assess the impact of aerobic exercise on acute rectal and bladder morbidity during treatment. Data from 65 of 66 patients were analysed: 33 allocated into a control group (standard advice) and 33 into an exercise group (aerobic walking for 30 min at least three times per week) during 4 weeks of external beam radiotherapy; one patient in the exercise group withdrew after randomisation before starting radiotherapy. There was a trend towards less severe acute rectal toxicity in the exercise group with a statistically significant difference in mean toxicity scores over the 4 weeks of radiotherapy (P=0.004), with no significant difference in bladder toxicity scores between the two groups (P=0.123). The lack of an association for severity of bladder toxicity could be attributed to the confounding effect of lower urinary tract symptoms from their prostate cancer. Keeping active and being asked to adhere to a well-defined exercise schedule appears to reduce the severity of rectal toxicity during radiotherapy to the prostate.

This study evaluated the effects of a personal-disclosure mutual-sharing (PDMS) intervention on team cohesion and communication among 21 male professional soccer players from a top division club within the United Kingdom (UK) before an important match in the latter stages of a domestic cup competition. Data from the Group Environment Questionnaire (GEQ) and the British Scale for Effective Communication in Team Sports (BRSECTS) showed no statistically significant changes in cohesion or positive and negative communication from pre to postintervention (i.e., pretest to posttest); yet the team performed above their expectations in the important match only to lose in a penalty shoot-out. Social validation data further revealed that most players felt the intervention was worthwhile and benefitted the team by enhancing closeness, understanding of teammates, and communication. We discuss strategies and guidance for sport psychologists considering a PDMS intervention in the context of professional sport teams. Future research directions considering the effects of PDMS with other professional and youth UK sports, collective efficacy, and social identity is outlined.

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Currently, 250 000 men are affected by prostate cancer in the UK. Clinical guidance is crucial for nurses involved in the care delivery for men with advanced prostate cancer and for their families to maximize their quality and quantity of life. It is essential that nurses understand how prostate cancer is diagnosed, can recognize signs of disease progression, are familiar with disease management, and can educate patients and manage any symptoms appropriately and effectively. Therefore, the aim of this paper is to review current evidence‐based guidelines in relation to care delivery for men with metastatic prostate cancer in order to optimize best supportive care. A literature review was conducted in a range of electronic databases (DARE, Cochrane, MEDLINE, BNI, PsychINFO, EMBASE and CIHAHL) to identify studies employing qualitative and/or quantitative methods. National (UK) and European clinical guidelines were also reviewed. Methodological evaluation was conducted and the evidence‐based recommendations were integrated in a narrative synthesis. Supportive care is a person‐centred approach to the provision of the necessary services for those living with or affected by cancer to meet their informational, spiritual, emotional, social or physical needs during diagnosis, treatment or follow‐up phases including issues of health promotion, survivorship, palliation and bereavement. A multidisciplinary and proactive approach to the management of men with metastatic prostate cancer ensures safe and effective supportive care delivery. Nurses involved in the care delivery for this patient group need to be aware of the complex physical and psychological supportive care needs, and evidence‐based management care plans to ensure a personalized and tailored support to optimize quality of life.

1983 -87 (Sharp et al., 1993b, largely due to the introduction of platinum-based chemotherapy (Ellis and Sikora, 1987). The complete excision of residual masses following chemotherapy is now accepted practice with more experinced surgeons in this area more likely to perform adequate resection (Ewing et al., 1987;Hendry et al., 1987;Whillis et al., 1991). It has also been suggested that results of therapy for this diease in Scotland are better in centres where a large number of patients are seen (Harding et al., 1993). In Scotland there are five oncology centres, patients with NSGCT being treated in them all. The audit was designed to assess if there was any variation in the success of therapy across the country for this usually curable cancer.This audit, and those reported in the accompanying two papers (Clarke et al., 1995;Howard et al., 1995) were part of a Scottish National Audit assessing the appropriateness and variation in manag t strategies and success of therapy for testicular NSGCIT. The (Clarke et al., 1995). New registrations not referred to oncology centres were excluded from the survival analysis as their diagnosis had not been validated.The end of the follow-up period was defined as 31 December 1992 and survival time was caculated from date of diagnosis until death, or the end of follow-up. Actuarial survival curves based on Kaplan-Mewer estimates were described and the log rank chi-square test for differences in survival rates alculated. These data are summarised by means of the 5 year survival rates with associated standard error. Deaths from causes other than the disease or its treatment, as assessed by the reviewer in this study, were censored.As numbers of patients in some health boards were small these were grouped crudely according to population density to investigate area of residence at diagnosis of cancer. A priori the following groupings were defined (1)

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