Program boosts life for prostate cancer patients

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An intervention run by specialist nurses and aided by an interactive computer program may help improve men’s quality of life after Prostate cancer treatment, a new study suggests.

Researchers found that monthly visits with an oncology nurse helped men and their partners get through common post-treatment problems such as sexual dysfunction and worry about cancer recurrence.

The nurses helped patients identify their concerns through the interactive computer program, and figure out what to do about them. Such systematic assessment of patients’ quality of life is not the norm after cancer treatment, said Dr. R. Brian Giesler, the lead author of the study.

Though many doctors and nurses try to address these concerns, it’s typically done in an “unstructured” way, and under the time constraints of the healthcare system, Dr. R. Brian Giesler told.

But if quality-of-life issues, like sexual function, urinary symptoms and Anxiety over cancer recurrence, aren’t addressed early, Giesler noted, they could grow and take firmer hold much like cancer does.

Giesler, who was at Indiana University in Indianapolis at the time of the study, is now a professor of psychology at Butler University. He and his colleagues report their findings in the journal Cancer.

The study included 99 Prostate cancer patients who were randomly assigned to receive either the nurse-led intervention or standard care following treatment for their cancer.

In the former group, patients and their wives or partners made six monthly visits to an oncology nurse, who used the computer program to help determine whether the men had any of several quality-of-life problems. The program also offered potential solutions to each problem.

Overall, sexual dysfunction was the most common problem—affecting 23 percent of patients—followed by urinary symptoms and relationship strain. When a problem was identified, the nurse and patient would settle on a strategy to deal with it.

For example, for sexual dysfunction that might mean improving couple’s communication skills or getting information about Viagra.

Over the next year, patients in this group made greater improvements in sexual function and anxiety than men receiving standard care. Urinary symptoms also improved for some, but only those without a high level of Depression at the study’s outset.

Prostate cancer patients who are significantly depressed may need to focus on Depression treatment before they are ready to tackle other issues, according to Giesler.

Still, the program did help many men, and Giesler attributed part of the success to the “structured and consistent” way it identified, addressed and monitored patients’ problems over time.

The computer program used in the study was adapted from earlier ones that two of the researchers developed. It’s not ready for general use, Giesler said, but one of the goals is to create more user-friendly versions that can be widely adopted.

SOURCE: Cancer, August 15, 2005. 

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