期刊论文详细信息
BMC Cancer
Improving sexual health in men with prostate cancer: randomised controlled trial of exercise and psychosexual therapies
Prue Cormie4  Suzanne K Chambers6  Robert U Newton4  Robert A Gardiner6  Nigel Spry5  Dennis R Taaffe2  David Joseph5  M Akhlil Hamid7  Peter Chong1  David Hughes8  Kyra Hamilton3  Daniel A Galvão4 
[1] Lake Macquarie Urology, Newcastle, New South Wales, Australia
[2] School of Environmental and Life Sciences, University of Newcastle, Ourimbah, Australia
[3] Griffith Health Institute, Griffith University, Southport, Australia
[4] Edith Cowan University Health and Wellness Institute, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia
[5] Faculty of Medicine, University of Western Australia, Nedlands, Australia
[6] Centre for Clinical Research, The University of Queensland, Brisbane, Australia
[7] Department of Urology, Royal Perth Hospital, Perth, Western Australia, Australia
[8] Bangalow Community Health Centre, Bangalow, New South Wales, Australia
关键词: Self-management;    Psychosexual support;    Aerobic exercise;    Resistance training;    Exercise;    Erectile dysfunction;    Sexual health;    Prostate cancer;   
Others  :  858957
DOI  :  10.1186/1471-2407-14-199
 received in 2013-11-04, accepted in 2014-02-28,  发布年份 2014
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【 摘 要 】

Background

Despite being a critical survivorship care issue, there is a clear gap in current knowledge of the optimal treatment of sexual dysfunction in men with prostate cancer. There is sound theoretical rationale and emerging evidence that exercise may be an innovative therapy to counteract sexual dysfunction in men with prostate cancer. Furthermore, despite the multidimensional aetiology of sexual dysfunction, there is a paucity of research investigating the efficacy of integrated treatment models. Therefore, the purpose of this study is to: 1) examine the efficacy of exercise as a therapy to aid in the management of sexual dysfunction in men with prostate cancer; 2) determine if combining exercise and brief psychosexual intervention results in more pronounced improvements in sexual health; and 3) assess if any benefit of exercise and psychosexual intervention on sexual dysfunction is sustained long term.

Methods/Design

A three-arm, multi-site randomised controlled trial involving 240 prostate cancer survivors will be implemented. Participants will be randomised to: 1) ‘Exercise’ intervention; 2) ‘Exercise + Psychosexual’ intervention; or 3) ‘Usual Care’. The Exercise group will receive a 6-month, group based, supervised resistance and aerobic exercise intervention. The Exercise + Psychosexual group will receive the same exercise intervention plus a brief psychosexual self-management intervention that addresses psychological and sexual well-being. The Usual Care group will maintain standard care for 6 months. Measurements for primary and secondary endpoints will take place at baseline, 6 months (post-intervention) and 1 year follow-up. The primary endpoint is sexual health and secondary endpoints include key factors associated with sexual health in men with prostate cancer.

Discussion

Sexual dysfunction is one of the most prevalent and distressing consequences of prostate cancer. Despite this, very little is known about the management of sexual dysfunction and current health care services do not adequately meet sexual health needs of survivors. This project will examine the potential role of exercise in the management of sexual dysfunction and evaluate a potential best-practice management approach by integrating pharmacological, physiological and psychological treatment modalities to address the complex and multifaceted aetiology of sexual dysfunction following cancer.

Trial registration

Australian New Zealand Clinical Trials Registry ACTRN12613001179729.

【 授权许可】

   
2014 Cormie et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Australian Institute of Health and Welfare & Australasian Association of Cancer Registries 2012: Cancer in Australia: an overview. In Cancer series no. 74. Cat. no. CAN 70. Canberra: AIHW; 2012.
  • [2]Sanda MG, Dunn RL, Michalski J, Sandler HM, Northouse L, Hembroff L, Lin X, Greenfield TK, Litwin MS, Saigal CS, Arul M, Eric K, Adam K, Pisters LL, Deborah K, Irving K, David W, Jay C, Nikhil S, Wei JT: Quality of life and satisfaction with outcome among prostate-cancer survivors. N Engl J Med 2008, 358(12):1250-1261.
  • [3]Bober SL, Varela VS: Sexuality in adult cancer survivors: challenges and intervention. J Clin Oncol 2012, 30(30):3712-3719.
  • [4]Sadovsky R, Basson R, Krychman M, Morales AM, Schover L, Wang R, Incrocci L: Cancer and sexual problems. J Sex Med 2010, 7(1 Pt 2):349-373.
  • [5]Resnick MJ, Koyama T, Fan KH, Albertsen PC, Goodman M, Hamilton AS, Hoffman RM, Potosky AL, Stanford JL, Stroup AM, Lawrence Van Horn R, Penson DF: Long-term functional outcomes after treatment for localized prostate cancer. N Engl J Med 2013, 368(5):436-445.
  • [6]Stanford JL, Feng Z, Hamilton AS, Gilliland FD, Stephenson RA, Eley JW, Albertsen PC, Harlan LC, Potosky AL: Urinary and sexual function after radical prostatectomy for clinically localized prostate cancer: the Prostate Cancer Outcomes Study. JAMA 2000, 283(3):354-360.
  • [7]Spry NA, Kristjanson L, Hooton B, Hayden L, Neerhut G, Gurney H, Corica T, Korbel E, Weinstein S, McCaul K: Adverse effects to quality of life arising from treatment can recover with intermittent androgen suppression in men with prostate cancer. Eur J Cancer 2006, 42(8):1083-1092.
  • [8]Hamilton AS, Stanford JL, Gilliland FD, Albertsen PC, Stephenson RA, Hoffman RM, Eley JW, Harlan LC, Potosky AL: Health outcomes after external-beam radiation therapy for clinically localized prostate cancer: results from the Prostate Cancer Outcomes Study. J Clin Oncol 2001, 19(9):2517-2526.
  • [9]Parker WR, Wang R, He C, Wood DP Jr: Five year expanded prostate cancer index composite-based quality of life outcomes after prostatectomy for localized prostate cancer. BJU Int 2011, 107(4):585-590.
  • [10]Higano CS: Sexuality and intimacy after definitive treatment and subsequent androgen deprivation therapy for prostate cancer. J Clin Oncol 2012, 30(30):3720-3725.
  • [11]Ng E, Woo HH, Turner S, Leong E, Jackson M, Spry N: The influence of testosterone suppression and recovery on sexual function in men with prostate cancer: observations from a prospective study in men undergoing intermittent androgen suppression. J Urol 2012, 187(6):2162-2167.
  • [12]Elliott S, Latini DM, Walker LM, Wassersug R, Robinson JW: Androgen deprivation therapy for prostate cancer: recommendations to improve patient and partner quality of life. J Sex Med 2010, 7(9):2996-3010.
  • [13]Reese JB: Coping with sexual concerns after cancer. Curr Opin Oncol 2011, 23(4):313-321.
  • [14]Penson DF, Latini DM, Lubeck DP, Wallace K, Henning JM, Lue TOM: Is quality if life different for Men with erectile dysfunction and prostate cancer compared to Men with erectile dysfunction due to other causes? results from the ExCEED data base. J Urol 2003, 169(4):1458-1461.
  • [15]Singer PA, Tasch ES, Stocking C, Rubin S, Siegler M, Weichselbaum R: Sex or survival: trade-offs between quality and quantity of life. J Clin Oncol 1991, 9(2):328-334.
  • [16]Smith DP, Supramaniam R, King MT, Ward J, Berry M, Armstrong BK: Age, health, and education determine supportive care needs of men younger than 70 years with prostate cancer. J Clin Oncol 2007, 25(18):2560-2566.
  • [17]Miles CL, Candy B, Jones L, Williams R, Tookman A, King M: Interventions for sexual dysfunction following treatments for cancer. Cochrane Database Syst Rev 2007., 4CD005540
  • [18]Magheli A, Burnett AL: Erectile dysfunction following prostatectomy: prevention and treatment. Nat Rev Urol 2009, 6(8):415-427.
  • [19]Galvao DA, Taaffe DR, Spry N, Newton RU: Physical activity and genitourinary cancer survivorship. Recent Results Cancer Res 2011, 186:217-236.
  • [20]Galvao DA, Taaffe DR, Spry N, Joseph D, Newton RU: Combined resistance and aerobic exercise program reverses muscle loss in men undergoing androgen suppression therapy for prostate cancer without bone metastases: a randomized controlled trial. J Clin Oncol 2010, 28(2):340-347.
  • [21]Galvao DA, Taaffe DR, Spry N, Newton RU: Exercise can prevent and even reverse adverse effects of androgen suppression treatment in men with prostate cancer. Prostate Cancer Prostatic Dis 2007, 10(4):340-346.
  • [22]Galvão DA, Spry N, Denham J, Taaffe DR, Cormie P, Joseph D, Lamb DS, Newton RU: A multicenter year-long randomized controlled trial of exercise training targeting physical functioning in men with prostate cancer previously treated with androgen suppression and radiation from TROG 03.04 RADAR. Eur Urol 2013. 3 Oct [Epub ahead of print]
  • [23]Cormie P, Newton RU, Spry N, Joseph D, Taaffe DR, Galvao DA: Safety and efficacy of resistance exercise in prostate cancer patients with bone metastases. Prostate Cancer Prostatic Dis 2013. Aug 6 [Epub ahead of print]
  • [24]Segal RJ, Reid RD, Courneya KS, Malone SC, Parliament MB, Scott CG, Venner PM, Quinney HA, Jones LW, D'Angelo ME, Wells GA: Resistance exercise in men receiving androgen deprivation therapy for prostate cancer. J Clin Oncol 2003, 21(9):1653-1659.
  • [25]Segal RJ, Reid RD, Courneya KS, Sigal RJ, Kenny GP, Prud'Homme DG, Malone SC, Wells GA, Scott CG, Slovinec D'Angelo ME: Randomized controlled trial of resistance or aerobic exercise in men receiving radiation therapy for prostate cancer. J Clin Oncol 2009, 27(3):344-351.
  • [26]Cormie P, Newton RU, Taaffe DR, Spry N, Joseph D, Akhlil Hamid M, Galvao DA: Exercise maintains sexual activity in men undergoing androgen suppression for prostate cancer: a randomized controlled trial. Prostate Cancer Prostatic Dis 2013, 16(2):170-175.
  • [27]Cormie P, Newton RU, Taaffe DR, Spry N, Galvão DA: Exercise therapy for sexual dysfunction after prostate cancer. Nat Rev Urol 2013. 8 October [Epub ahead of print]
  • [28]Chambers SK, Pinnock C, Lepore SJ, Hughes S, O'Connell DL: A systematic review of psychosocial interventions for men with prostate cancer and their partners. Patient Educ Couns 2011, 85(2):e75-88.
  • [29]Faller H, Schuler M, Richard M, Heckl U, Weis J, Kuffner R: Effects of psycho-oncologic interventions on emotional distress and quality of life in adult patients with cancer: systematic review and meta-analysis. J Clin Oncol 2013, 31(6):782-793.
  • [30]Linden W, Girgis A: Psychological treatment outcomes for cancer patients: what do meta-analyses tell us about distress reduction? Psychooncology 2012, 21(4):343-350.
  • [31]Chambers SK, Ferguson M, Gardiner RA, Aitken J, Occhipinti S: Intervening to improve psychological outcomes for men with prostate cancer. Psychooncology 2013, 22(5):1025-1034.
  • [32]Canada AL, Neese LE, Sui D, Schover LR: Pilot intervention to enhance sexual rehabilitation for couples after treatment for localized prostate carcinoma. Cancer 2005, 104(12):2689-2700.
  • [33]Schover LR, Canada AL, Yuan Y, Sui D, Neese L, Jenkins R, Rhodes MM: A randomized trial of internet-based versus traditional sexual counseling for couples after localized prostate cancer treatment. Cancer 2012, 118(2):500-509.
  • [34]Schover LR, Fouladi RT, Warneke CL, Neese L, Klein EA, Zippe C, Kupelian PA: The use of treatments for erectile dysfunction among survivors of prostate carcinoma. Cancer 2002, 95(11):2397-2407.
  • [35]Stephenson RA, Mori M, Hsieh YC, Beer TM, Stanford JL, Gilliland FD, Hoffman RM, Potosky AL: Treatment of erectile dysfunction following therapy for clinically localized prostate cancer: patient reported use and outcomes from the Surveillance, Epidemiology, and End Results Prostate Cancer Outcomes Study. J Urol 2005, 174(2):646-650. discussion 650
  • [36]Tal R, Jacks LM, Elkin E, Mulhall JP: Penile implant utilization following treatment for prostate cancer: analysis of the SEER-Medicare database. J Sex Med 2011, 8(6):1797-1804.
  • [37]Addis ME, Mahalik JR: Men, masculinity, and the contexts of help seeking. Am Psychol 2003, 58(1):5-14.
  • [38]Galdas PM, Cheater F, Marshall P: Men and health help-seeking behaviour: literature review. J Adv Nurs 2005, 49(6):616-623.
  • [39]Smith JA, Braunack-Mayer A, Wittert G: What do we know about men's help-seeking and health service use? Med J Aust 2006, 184(2):81-83.
  • [40]Schulz KF, Altman DG, Moher D: CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. BMC Med 2010, 8:18. BioMed Central Full Text
  • [41]Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A: The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology 1997, 49(6):822-830.
  • [42]Wei JT, Dunn RL, Litwin MS, Sandler HM, Sanda MG: Development and validation of the expanded prostate cancer index composite (EPIC) for comprehensive assessment of health-related quality of life in men with prostate cancer. Urology 2000, 56(6):899-905.
  • [43]van Andel G, Bottomley A, Fossa SD, Efficace F, Coens C, Guerif S, Kynaston H, Gontero P, Thalmann G, Akdas A, D'Haese S, Aaronson NK: An international field study of the EORTC QLQ-PR25: a questionnaire for assessing the health-related quality of life of patients with prostate cancer. Eur J Cancer 2008, 44(16):2418-2424.
  • [44]Swindle R, Cameron A, Rosen R: A 15-item short form of the psychological and interpersonal relationship scales. Int J Impot Res 2006, 18(1):82-88.
  • [45]Libman E, Rothenberg I, Fichten CS, Amsel R: The SSES-E: a measure of sexual self-efficacy in erectile functioning. J Sex Marital Ther 1985, 11(4):233-247.
  • [46]Clark JA, Bokhour BG, Inui TS, Silliman RA, Talcott JA: Measuring patients' perceptions of the outcomes of treatment for early prostate cancer. Med Care 2003, 41(8):923-936.
  • [47]Spence JT, Helmreich RL: Masculinity and femininity: their psychological dimensions, correlates, and antecedents. Austin, Texas: University of Texas Press; 1978.
  • [48]Chambers SK, Schover L, Halford K, Clutton S, Ferguson M, Gordon L, Gardiner RA, Occhipinti S, Dunn J: ProsCan for couples: randomised controlled trial of a couples-based sexuality intervention for men with localised prostate cancer who receive radical prostatectomy. BMC Cancer 2008, 8(1):226. BioMed Central Full Text
  • [49]Sharpley C, Cross D: A psychometric evaluation of the Spanier Dyadic Adjustment Scale. J Marriage Fam 1982, 44:739-741.
  • [50]Bonevski B, Sanson-Fisher R, Girgis A, Burton L, Cook P, Boyes A: Evaluation of an instrument to assess the needs of patients with cancer. Supportive Care Review Group. Cancer 2000, 88(1):217-225.
  • [51]Ware JE Jr, Sherbourne CD: The MOS 36-item short-form health survey (SF-36) I. Conceptual framework and item selection. Med Care 1992, 30(6):473-483.
  • [52]Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC: The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 1993, 85(5):365-376.
  • [53]Zabora J, BrintzenhofeSzoc K, Jacobsen P, Curbow B, Piantadosi S, Hooker C, Owens A, Derogatis L: A new psychosocial screening instrument for use with cancer patients. Psychosomatics 2001, 42(3):241-246.
  • [54]Yellen SB, Cella DF, Webster K, Blendowski C, Kaplan E: Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system. J Pain Symptom Manage 1997, 13(2):63-74.
  • [55]Galvao DA, Spry NA, Taaffe DR, Newton RU, Stanley J, Shannon T, Rowling C, Prince R: Changes in muscle, fat and bone mass after 36 weeks of maximal androgen blockade for prostate cancer. BJU Int 2008, 102(1):44-47.
  • [56]Hopwood P, Fletcher I, Lee A, Al Ghazal S: A body image scale for use with cancer patients. Eur J Cancer 2001, 37:189-197.
  • [57]Newton RU, Taaffe DR, Spry N, Cormie P, Chambers SK, Gardiner RA, Shum DH, Joseph D, Galvao DA: Can exercise ameliorate treatment toxicity during the initial phase of testosterone deprivation in prostate cancer patients? Is this more effective than delayed rehabilitation? BMC Cancer 2012, 12:432. BioMed Central Full Text
  • [58]Plasqui G, Westerterp KR: Physical activity assessment with accelerometers: an evaluation against doubly labeled water. Obesity (Silver Spring) 2007, 15(10):2371-2379.
  • [59]Jacobs DR Jr, Ainsworth BE, Hartman TJ, Leon AS: A simultaneous evaluation of 10 commonly used physical activity questionnaires. Med Sci Sports Exerc 1993, 25(1):81-91.
  • [60]Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvao DA, Pinto BM, Irwin ML, Wolin KY, Segal RJ, Lucia A, Schneider CM, von Gruenigen VE, Schwartz AL, American College of Sports Medicine: American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc 2010, 42(7):1409-1426.
  • [61]Rock CL, Doyle C, Demark-Wahnefried W, Meyerhardt J, Courneya KS, Schwartz AL, Bandera EV, Hamilton KK, Grant B, McCullough M, Tim B, Ted G: Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin 2012, 62(4):242-274.
  • [62]Bennett-Levy J, Richards D, Farrand P: Low Intensity CBT Interventions: A Revolution in Mental Health Services. In Oxford Guide to Low Intensity CBT Interventions. Edited by Bennett-Levy J, Richards D, Farrand P. Oxford: Oxford University Press; 2010:3-18.
  • [63]Barlow J, Wright C, Sheasby J, Turner A, Hainsworth J: Self-management approaches for people with chronic conditions: a review. Patient Educ Couns 2002, 48(2):177-187.
  • [64]Chambers SK: Facing the Tiger A Guide for Men with Prostate Cancer and the People who Love Them. Samford Valley, Australia: Australian Academic Press; 2013.
  • [65]Bellg AJ, Borrelli B, Resnick B, Hecht J, Minicucci DS, Ory M, Ogedegbe G, Orwig D, Ernst D, Czajkowski S: Enhancing treatment fidelity in health behavior change studies: best practices and recommendations from the NIH Behavior Change Consortium. Health Psychol 2004, 23(5):443-451.
  • [66]Klaeson K, Sandell K, Bertero CM: Sexuality in the context of prostate cancer narratives. Qual Health Res 2012, 22(9):1184-1194.
  • [67]Zaider T, Manne S, Nelson C, Mulhall J, Kissane D: Loss of masculine identity, marital affection, and sexual bother in Men with localized prostate cancer. J Sex Med 2012, 9(10):2724-2732.
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