A qualitative study evaluating experiences of a lifestyle intervention in men with prostate cancer undergoing androgen suppression therapy

Trials

John M Saxton²  Derek J Rosario⁵  Helen Crank¹  Veronica Nanton⁴  Ratna Sohanpal³  Liam Bourke³ 

[1] Centre for Sport and Exercise Science, Department of Health and Wellbeing, Sheffield Hallam University, Sheffield, S10 2BP, UK;School of Allied Health Professions, University of East Anglia, Norwich, NR4 7TJ, UK;Department of Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, E1 2AB, UK;Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK;Academic Urology Unit, Department of Oncology, Royal Hallamshire Hospital, University of Sheffield, Sheffield, S11 7FE, UK

关键词: Patient evaluation;    Rehabilitation;    Diet;    Exercise;    Androgen suppression;    Prostate cancer;   

Others  :  1095208
DOI  :  10.1186/1745-6215-13-208

 received in 2012-07-17, accepted in 2012-10-24,  发布年份 2012

【 摘 要 】

Background

The severe iatrogenic hypogonadal state induced by medical castration used for treatment of prostate cancer is associated with adverse effects including fatigue, increased fracture risk, and a decrease in skeletal muscle function, which negatively impact quality of life. We have previously reported beneficial changes in healthy lifestyle behaviors, physical function and fatigue as a result of a novel combined exercise and dietary advice intervention (a lifestyle intervention) in men with prostate cancer on androgen suppression therapy (AST). The aim of this research was to conduct a qualitative evaluation of the lifestyle intervention in these men with advanced prostate cancer receiving androgen suppression therapy (AST).

Methods

Twelve men with prostate cancer on AST took part in three focus groups in a UK higher education institution following the 12 week intervention. Sessions lasted between 45 and 60 minutes in duration. All discussions were audio-taped and transcribed. A framework analysis approach was applied to the focus group data. An initial coding framework was developed from a priori issues listed in the topic guide and extended and refined following initial familiarization with the focus group transcripts. Line by line indexing of the transcripts was undertaken iteratively to allow for the incorporation of new codes. Coded sections of text were grouped together (charted) into themes and subthemes prior to a further process of comparison and interpretation.

Results

None of the participants involved in the trial were provided with information on how lifestyle changes might be beneficial to men with prostate cancer during the course of their standard medical treatment. We present novel findings that this intervention was considered beneficial for reducing anxiety around treatment and fear of disease progression. Men were supportive of the benefits of the intervention over conventional cancer survival discussion group arrangements as it facilitated peer support in addition to physical rehabilitation.

Conclusions

The benefits of lifestyle changes in men with prostate cancer are not well appreciated by care providers despite a range of benefits becoming apparent. Strategies to implement exercise and dietary interventions in standard care should be further evaluated.

Trial registration

Current Controlled Trials ISRCTN88605738

【 授权许可】

   
2012 Bourke et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Maddams J, Brewster D, Gavin A, Steward J, Elliott J, Utley M, Moller H: Cancer prevalence in the United Kingdom: estimates for 2008. Br J Cancer 2009, 101:541-547.
• [2]Loblaw DA, Virgo KS, Nam R, Somerfield MR, Ben-Josef E, Mendelson DS, Middleton R, Sharp SA, Smith TJ, Talcott J, Taplin M, Vogelzang NJ, Wade JL 3rd, Bennett CL, Scher HI: American Society of Clinical Oncology: Initial hormonal management of androgen-sensitive metastatic, recurrent, or progressive prostate cancer: 2007 update of an American Society of Clinical Oncology practice guideline. J Clin Oncol 2007, 25:1596-1605.
• [3]Meng MV, Grossfeld GD, Sadetsky N, Mehta SS, Lubeck DP, Carroll PR: Contemporary patterns of androgen deprivation therapy use for newly diagnosed prostate cancer. Urology 2002, 60(Suppl 1):7-11. discussion 11–12
• [4]Schroder FH, Kurth KH, Fossa SD, Hoekstra W, Karthaus PP, De Prijck L, Collette L: Early versus delayed endocrine treatment of T2-T3 pN1-3 M0 prostate cancer without local treatment of the primary tumour: final results of European Organisation for the Research and Treatment of Cancer protocol 30846 after 13 years of follow-up (a randomised controlled trial). Eur Urol 2009, 55:14-22.
• [5]Stone P, Hardy J, Huddart R, A’Hern R, Richards M: Fatigue in patients with prostate cancer receiving hormone therapy. Eur J Cancer 2000, 36:1134-1141.
• [6]Basaria S, Lieb J 2nd, Tang AM, DeWeese T, Carducci M, Eisenberger M, Dobs AS: Long-term effects of androgen deprivation therapy in prostate cancer patients. Clin Endocrinol (Oxf) 2002, 56:779-786.
• [7]Shahinian VB, Kuo YF, Freeman JL, Goodwin JS: Risk of fracture after androgen deprivation for prostate cancer. N Engl J Med 2005, 352:154-164.
• [8]Smith MR, Lee WC, Brandman J, Wang Q, Botteman M, Pashos CL: Gonadotropin-releasing hormone agonists and fracture risk: a claims-based cohort study of men with nonmetastatic prostate cancer. J Clin Oncol 2005, 23:7897-7903.
• [9]Dacal K, Sereika SM, Greenspan SL: Quality of life in prostate cancer patients taking androgen deprivation therapy. J Am Geriatr Soc 2006, 54:85-90.
• [10]Richards M, Corner J, Maher J: The National Cancer Survivorship Initiative: new and emerging evidence on the ongoing needs of cancer survivors. Br J Cancer 2011, 105(Suppl 1):S1-S4.
• [11]Bourke L, Doll H, Crank H, Daley A, Rosario DJ, Saxton J: Lifestyle intervention in men with advanced prostate cancer receiving androgen suppression therapy: a feasibility study. Cancer Epidemiol Biomarkers Prev 2011, 20:647-657.
• [12]Richardson A, Addington-Hall J, Amir Z, Foster C, Stark D, Armes J, Brearley SG, Hodges L, Hook J, Jarrett N, Stamataki Z, Scott I, Walker J, Ziegler L, Sharpe M: Knowledge, ignorance and priorities for research in key areas of cancer survivorship: findings from a scoping review. Br J Cancer 2011, 105(Suppl 1):S82-S94.
• [13]Thomas L, MacMillan J, McColl E, Hale C, Bond S: Comparison of focus group and individual interview methodology in examining patient satisfaction with nursing care. Social Sciences in Health 1995, 1:206-219.
• [14]Ritchie J, Spencer L: Qualitative Data Analysis for Applied Policy Research. London: Routledge; 1994.
• [15]Seale C: Researching Society and Culture. 3rd edition. London: Sage; 2012.
• [16]Simard S, Savard J, Ivers H: Fear of cancer recurrence: specific profiles and nature of intrusive thoughts. J Cancer Surviv 2010, 4:361-371.
• [17]Crist JV, Grunfeld EA: Factors reported to influence fear of recurrence in cancer patients: a systematic review. Psychooncology 2012,  .
• [18]Llewellyn CD, Weinman J, McGurk M, Humphris G: Can we predict which head and neck cancer survivors develop fears of recurrence? J Psychosom Res 2008, 65:525-532.
• [19]Bellizzi KM, Latini DM, Cowan JE, DuChane J, Carroll PR: Fear of recurrence, symptom burden, and health-related quality of life in men with prostate cancer. Urology 2008, 72:1269-1273.
• [20]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, 21:1653-1659.
• [21]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, 28:340-347.
• [22]Baker F, Denniston M, Smith T, West MM: Adult cancer survivors: how are they faring? Cancer 2005, 104(11 Suppl):2565-2576.
• [23]Koch L, Jansen L, Brenner H, Arndt V: Fear of recurrence and disease progression in long-term (≥5 years) cancer survivors-a systematic review of quantitative studies. Psychooncology 2012,  .
• [24]Lee-Jones C, Humphris G, Dixon R, Hatcher MB: Fear of cancer recurrence–a literature review and proposed cognitive formulation to explain exacerbation of recurrence fears. Psychooncology 1997, 6:95-105.
• [25]American College of Sports Medicine: American College of Sports Medicine position stand: progression models in resistance training for healthy adults. Med Sci Sports Exerc 2009, 41:687-708.
• [26]Daley AJ, Mutrie N, Crank H, Coleman R, Saxton J: Exercise therapy in women who have had breast cancer: design of the Sheffield women’s exercise and well-being project. Health Educ Res 2004, 19:686-697.
• [27]Berman H, Ford-Gilboe M, Campbell JC: Combining stories and numbers: a methodologic approach for a critical nursing science. ANS Adv Nurs Sci 1998, 21:1-15.
• [28]Rehse B, Pukrop R: Effects of psychosocial interventions on quality of life in adult cancer patients: meta analysis of 37 published controlled outcome studies. Patient Educ Couns 2003, 50:179-186.
• [29]Emslie C, Whyte F, Campbell A, Mutrie N, Lee L, Ritchie D, Kearney N: ‘I wouldn’t have been interested in just sitting round a table talking about cancer'; exploring the experiences of women with breast cancer in a group exercise trial. Health Educ Res 2007, 22:827-838.
• [30]Midtgaard J, Rorth M, Stelter R, Adamsen L: The group matters: an explorative study of group cohesion and quality of life in cancer patients participating in physical exercise intervention during treatment. Eur J Cancer Care 2006, 15:25-33.
• [31]Gray R, Fitch M, Davis C, Phillips C: Breast cancer and prostate cancer self-help groups: reflections on differences. Psychooncology 1996, 5:137-142.
• [32]Adamsen L, Rasmussen JM: Sociological perspectives on self-help groups: reflections on conceptualization and social processes. J Adv Nurs 2001, 35:909-917.
• [33]Emslie C, Browne S, Macleod U, Rozmovits L, Mitchell E, Ziebland S: ‘Getting through’ not ‘going under’: a qualitative study of gender and spousal support after diagnosis with colorectal cancer. Soc Sci Med 2009, 68:1169-1175.
• [34]Kenfield SA, Stampfer MJ, Giovannucci E, Chan JM: Physical activity and survival after prostate cancer diagnosis in the health professionals follow-up study. J Clin Oncol 2011, 29:726-732.
• [35]Richman EL, Kenfield SA, Stampfer MJ, Paciorek A, Carroll PR, Chan JM: Physical activity after diagnosis and risk of prostate cancer progression: data from the cancer of the prostate strategic urologic research endeavor. Cancer Res 2011, 71:3889-3895.