Purpose: This is a secondary analysis examining a six-month home-based Prostate Cancer-Patient Empowerment Program (PC-PEP) on patient-reported urinary, bowel, sexual, and hormonal function in men with curative prostate cancer (PC) against standard of care. Methods: In a crossover clinical trial, 128 men scheduled for PC surgery (n = 62) or radiotherapy with/without hormones (n = 66) were randomized to PC-PEP (n = 66) or waitlist-control and received the standard of care for 6 months, and then PC-PEP to the end of the year. PC-PEP included daily emails with video instructions, aerobic and strength training, dietary guidance, stress management, and social support, with an initial PFMT nurse consultation. Over 6 months, participants in the PC-PEP received optional text alerts (up to three times daily) reminding them to follow the PFMT video program, encompassing relaxation, quick-twitch, and endurance exercises; compliance was assessed weekly. Participants completed baseline, 6, and 12-month International Prostate Symptom Score (IPSS) and Expanded Prostate Cancer Index Composite (EPIC) questionnaires. Results: At 6 months, men in the PC-PEP reported improved urinary bother (IPSS, p = 0.004), continence (EPIC, p < 0.001), and irritation/obstruction function (p = 0.008) compared to controls, with sustained urinary continence benefits at 12 months (p = 0.002). Surgery patients in the waitlist-control group had 3.5 (95% CI: 1.2, 10, p = 0.024) times and 2.3 (95% CI: 0.82, 6.7, p = 0.11) times higher odds of moderate to severe urinary problems compared to PC-PEP at 6 and 12 months, respectively. Conclusions: PC-PEP significantly improves lower urinary tract symptoms, affirming its suitability for clinical integration alongside established mental health benefits in men with curative prostate cancer.
Cancers. 2024 Feb 27*** epublish ***
Tarek Lawen, Gabriela Ilie, Ross Mason, Ricardo Rendon, Jesse Spooner, Emmi Champion, Jessica Davis, Cody MacDonald, Michael J Kucharczyk, Nikhilesh Patil, David Bowes, Greg Bailly, David Bell, Joseph Lawen, Derek Wilke, George Kephart, Robert David Harold Rutledge
Department of Urology, Dalhousie University, Halifax, NS B3H 4R2, Canada., Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS B3H 4R2, Canada., Department of Oncology, Queens University, Kingston, ON K7L 3N6, Canada., Department of Radiation Oncology, Dalhousie University, Halifax, NS B3H 4R2, Canada.