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How Are Patients With Prostate Cancer Managing Androgen Deprivation Therapy Side Effects?
Erik Wibowo1, Richard J Wassersug2, John W Robinson3
1University of Otago, Dunedin, New Zealand.
Background:
Androgen deprivation therapy (ADT) for prostate cancer has numerous side effects. Clinical guidelines for side effect management exist; however, these are not always integrated into routine practice. What remains undocumented and therefore the objective of this study, is to describe patients' willingness to employ established strategies.
Patients And Methods:
Study participants were 91 men who had attended an educational program (ie, attend a class plus read a book), designed to prepare patients for managing ADT side effects. Three months later, patients completed the ADT Management Strategies Inventory, to determine use of strategies. Descriptive analyses were conducted.
Results:
At the time of class attendance, the average ADT duration was 133 days. Patient preferences for a variety of strategies for each side effect are presented. Highlights include: a high degree (> 65%) of patients using or willing to use exercise to manage medical risks and physical side effects. Forty percent of patients continued to engage in non-penetrative sexual activities, despite reduced sexual desire and erectile dysfunction.
Conclusions:
When educated about options, patients are willing to use a wide array of ADT management strategies. Consequently, health care providers should ensure that patients know about side effects and how to manage them. Exercise appears to be the single best strategy to encourage, because it is helpful in managing many side effects (eg, weight gain, muscle weakening, fatigue) and reducing medical risks of ADT (eg, cardiovascular disease, type II diabetes, and osteoporosis). A general trend was patient's preference for behavioral and lifestyle strategies over pharmacologic interventions.
Insights
Patients undergoing androgen deprivation therapy (ADT) are willing to use various strategies to manage side effects when educated. Exercise is particularly effective for managing multiple ADT side effects and reducing health risks.
Area of Science:
- Oncology
- Urology
- Patient Care
Background:
- Androgen deprivation therapy (ADT) for prostate cancer causes significant side effects.
- Clinical guidelines for managing ADT side effects are not consistently implemented in practice.
- Patient willingness to use established management strategies for ADT side effects is largely undocumented.
Purpose of the Study:
- To describe prostate cancer patients' willingness to use established strategies for managing ADT side effects.
- To assess patient engagement with ADT side effect management after an educational intervention.
Main Methods:
- 91 men who attended an educational program on managing ADT side effects were studied.
- The ADT Management Strategies Inventory was used to assess strategy use three months post-intervention.
- Descriptive analyses were performed on patient data.
Main Results:
- Over 65% of patients were using or willing to use exercise for medical risks and physical side effects.
- Despite sexual dysfunction, 40% of patients continued non-penetrative sexual activities.
- Patient preferences for various management strategies were documented.
Conclusions:
- Patients are willing to adopt a range of ADT management strategies when informed of their options.
- Healthcare providers should educate patients about ADT side effects and management.
- Exercise is a key strategy for managing multiple ADT side effects and associated health risks, with a patient preference for lifestyle interventions over pharmacologic ones.
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