The Quality-of-Life Impact of Prostate Cancer Treatments

Singh, Jaspreet; Trabulsi, Edouard J.; Gomella, Leonard G.

doi:10.1007/s11934-010-0103-y

Cited by 30 publications

(40 citation statements)

References 34 publications

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“…Androgen deprivation therapy (ADT) is a basic treatment for PCa patients which can prolong survival rate and reduce disease-related morbidity. [2] However, patients initiating ADT suffer from adverse effects including reducing quality of life, [3] decreasing in physical function, body composition, bone mineral density (BMD) loss, [4,5] and increasing risk of metabolic dysfunction and cardiovascular diseases, [6] and these mental and physical changes in the end will have a bad effect on patient health.…”

Section: Introductionmentioning

confidence: 99%

Exercise overcome adverse effects among prostate cancer patients receiving androgen deprivation therapy

Gao

He²,

Xueyang³

et al. 2017

Medicine

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Background:Prostate cancer (PCa) patients initiating androgen deprivation therapy (ADT) are suffering from adverse effects; exercise has been proposed as a treatment to relieve adverse effects of ADT, available meta-analysis has proved exercise improves quality of life, and therapy caused fatigue; recently, some high-quality trials have been conducted in order to get more assessment; we conduct an updated meta-analysis to evaluate feasibility that exercise relieves adverse effects in PCa patients initiating ADT.Materials and methods:A systematic article search was performed from Cochrane Library, MEDLINE, EMBASE, and PubMed databases up to March 10, 2017. Outcomes included changes in body composition, physical function, bone health and cardiometabolic changes. We conduct subgroup analysis to analyze the duration and type of exercise correlated with the effect and calculated using standard mean difference (SMD) and corresponding 95% confidence intervals (CI).Result:Fifteen studies involving 1135 patients were included in our meta-analysis, and significant positive effects were found in body strength (leg press (SMD: 0.78 (95%CI: 0.57–0.99, P <.00001, I2 = 0%)), chest press (SMD: 0.71 (95%CI: 0.50–0.92, P <.00001, I2 = 0%)), exercise tolerance (VO2 peak SMD: 0.35 (95%CI: 0.04–0.66, P = .03, I2 = 0%) in 6 months and SMD: 0.59 (95%CI: 0.16–1.03, P = .007, I2 = 0% over 6 months)), fatigue (SMD: 0.84 (95%CI: −1.43 to 3.10, P = .85, I2 = 51%) in 6 months and SMD: −9.3 (95%CI: −16.22 to −2.39, P = .0030, I2 = 49%) over 6 months)), ADT-caused obesity (body mass index SMD: −0.33 (95%CI: −0.55 to −0.12, P = .002, I2 = 38% in 6 months and SMD: −0.59 95%CI: −1.02 to 0.17, P = .006, I2 = 25% over 6 months)), and sex function (SMD: 0.66 (95%CI: 0.35–0.97, P <.00001, I2 = 2%). There were no evidence of benefit for cardiometabolic changes and bone health. No systematic difference was observed between resistance exercise training (RET) and aerobic exercise training (AET) in ADT-caused obesity, fatigue, and exercise toleranceConclusion:Exercise can significantly improve the upper and lower muscle strength, increase exercise tolerance, help PCa patients receiving ADT control their body fat mass, BMI, and keep the sex function. ADT-related fatigue is correlated with exercise duration time. No differences were observed in LBM, bone mineral density, and any other metabolic blood markers. Available data show that there is no difference between AET and RET.

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Section: Introductionmentioning

confidence: 99%

Exercise overcome adverse effects among prostate cancer patients receiving androgen deprivation therapy

Gao

He²,

Xueyang³

et al. 2017

Medicine

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“…Men with prostate cancer typically experience adverse effects associated with the disease and its treatment, however, including urinary leakage, bowel urgency, erectile dysfunction [5], fatigue [6], anxiety and depression [7], and diminished health-related quality of life [8]. In addition, those treated with androgen deprivation therapy (ADT) are at increased risk of bone fracture, muscle mass and strength loss, diabetes, obesity, and cardiovascular-related mortality [9, 10].…”

Section: Introductionmentioning

confidence: 99%

Fitness outcomes from a randomised controlled trial of exercise training for men with prostate cancer: the ENGAGE study

et al. 2016

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PurposeThe main purpose of this study was to investigate the effects of a 12-week, clinician-referred, community-based exercise training program with supervised and unsupervised sessions for men with prostate cancer. The secondary purpose was to determine whether androgen deprivation therapy (ADT) modified responses to exercise training.MethodsSecondary analysis was undertaken on data from a multicentre cluster randomised controlled trial in which 15 clinicians were randomly assigned to refer eligible patients to an exercise training intervention (n = 8) or to provide usual care (n = 7). Data from 119 patients (intervention n = 53, control n = 66) were available for this analysis. Outcome measures included fitness and physical function, anthropometrics, resting heart rate, and blood pressure.ResultsCompared to the control condition, men in the intervention significantly improved their 6-min walk distance (M diff = 49.98 m, p adj = 0.001), leg strength (M diff = 21.82 kg, p adj = 0.001), chest strength (M diff = 6.91 kg, p adj = 0.001), 30-s sit-to-stand result (M diff = 3.38 reps, p adj = 0.001), and reach distance (M diff = 4.8 cm, p adj = 0.024). A significant difference (unadjusted for multiplicity) in favour of men in the intervention was also found for resting heart rate (M diff = −3.76 beats/min, p = 0.034). ADT did not modify responses to exercise training.ConclusionsMen with prostate cancer who act upon clinician referrals to community-based exercise training programs can improve their strength, physical functioning, and, potentially, cardiovascular health, irrespective of whether or not they are treated with ADT.Implications for Cancer SurvivorsClinicians should inform men with prostate cancer about the benefits of exercise and refer them to appropriately qualified exercise practitioners and suitable community-based programs.Trial registrationAustralia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12610000609055

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“…All of these treatments are associated with specific side effects resulting in considerable impairment in several health-related quality of life (HRQOL) domains [3,4]. Thus, the inclusion of HRQOL assessment in randomised controlled trials (RCTs) testing different interventions for PCa is crucial for understanding which approach is best from the patient's perspective.…”

Section: Introductionmentioning

confidence: 99%

Patient-reported Outcomes in Randomised Controlled Trials of Prostate Cancer: Methodological Quality and Impact on Clinical Decision Making

et al. 2014

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Context Patient-reported outcomes (PRO) data from randomised controlled trials (RCTs) are increasingly used to inform patient-centred care as well as clinical and health policy decisions. Objective The main objective of this study was to investigate the methodological quality of PRO assessment in RCTs of prostate cancer (PCa) and to estimate the likely impact of these studies on clinical decision making. Evidence acquisition A systematic literature search of studies was undertaken on main electronic databases to retrieve articles published between January 2004 and March 2012. RCTs were evaluated on a predetermined extraction form, including (1) basic trial demographics and clinical and PRO characteristics; (2) level of PRO reporting based on the recently published recommendations by the International Society for Quality of Life Research; and (3) bias, assessed using the Cochrane Risk of Bias tool. Studies were systematically analysed to evaluate their relevance for supporting clinical decision making. Evidence synthesis Sixty-five RCTs enrolling a total of 22 071 patients were evaluated, with 31 (48%) in patients with nonmetastatic disease. When a PRO difference between treatments was found, it related in most cases to symptoms only (n = 29, 58%). Although the extent of missing data was generally documented (72% of RCTs), few reported details on statistical handling of this data (18%) and reasons for dropout (35%). Improvements in key methodological aspects over time were found. Thirteen (20%) RCTs were judged as likely to be robust in informing clinical decision making. Higher-quality PRO studies were generally associated with those RCTs that had higher internal validity. Conclusions Including PRO in RCTs of PCa patients is critical for better evaluating the treatment effectiveness of new therapeutic approaches. Marked improvements in PRO quality reporting over time were found, and it is estimated that at least one-fifth of PRO RCTs have provided sufficient details to allow health policy makers and physicians to make critical appraisals of results. Patient summary In this report, we have investigated the methodological quality of PCa trials that have included a PRO assessment. We conclude that including PRO is critical to better evaluating the treatment effectiveness of new therapeutic approaches from the patient's perspective. Also, at least one-fifth of PRO RCTs in PCa have provided sufficient details to allow health policy makers and physicians to make a critical appraisal of results.

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The Quality-of-Life Impact of Prostate Cancer Treatments

Cited by 30 publications

References 34 publications

Exercise overcome adverse effects among prostate cancer patients receiving androgen deprivation therapy

Exercise overcome adverse effects among prostate cancer patients receiving androgen deprivation therapy

Fitness outcomes from a randomised controlled trial of exercise training for men with prostate cancer: the ENGAGE study

Patient-reported Outcomes in Randomised Controlled Trials of Prostate Cancer: Methodological Quality and Impact on Clinical Decision Making

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