Six-Month Prostate Cancer Empowerment Program (PC-PEP) Improves Urinary Function: A Randomized Trial

Area of Science:

• Oncology
• Urology
• Health Psychology

Background:

• Curative treatments for prostate cancer (PC) often lead to significant urinary, bowel, sexual, and hormonal dysfunctions.
• Patient-reported outcomes are crucial for evaluating the effectiveness of interventions in managing these side effects.
• A home-based empowerment program may offer a scalable solution for improving quality of life post-treatment.

Purpose of the Study:

• To evaluate the impact of a six-month home-based Prostate Cancer-Patient Empowerment Program (PC-PEP) on patient-reported outcomes.
• To assess the program's effects on urinary, bowel, sexual, and hormonal function in men with curative prostate cancer (PC) compared to standard care.
• To determine the long-term benefits of PC-PEP at 12 months post-intervention.

Main Methods:

• A secondary analysis of a crossover clinical trial involving 128 men with PC undergoing surgery or radiotherapy.
• Randomization to either the PC-PEP intervention group or a waitlist-control group, followed by a crossover.
• PC-PEP included daily emails, video-guided exercises (aerobic, strength, PFMT), dietary guidance, stress management, and social support.
• International Prostate Symptom Score (IPSS) and Expanded Prostate Cancer Index Composite (EPIC) questionnaires were used for assessments at baseline, 6, and 12 months.

Main Results:

• At 6 months, PC-PEP participants reported significantly improved urinary bother (IPSS, p = 0.004) and continence (EPIC, p < 0.001) compared to controls.
• Sustained improvements in urinary continence were observed at 12 months (p = 0.002).
• Surgery patients in the control group had higher odds of moderate to severe urinary problems at 6 and 12 months compared to PC-PEP participants.

Conclusions:

• The Prostate Cancer-Patient Empowerment Program (PC-PEP) effectively improves lower urinary tract symptoms in men with curative prostate cancer.
• PC-PEP demonstrates suitability for clinical integration to manage urinary dysfunction post-treatment.
• The program's benefits extend beyond physical symptoms, potentially including established mental health advantages.