Assessing the Feasibility of a Self-Management Intervention for Individuals With Advanced Prostate Cancer and...

Many older adults with cancer have at least one comorbidity. Type II diabetes mellitus (T2DM) is a common comorbidity among patients with prostate cancer (PC) and represents an important consideration in this population. Comorbid T2DM can negatively impact cancer-specific outcomes for patients, suggesting the need for better glycemic management, especially for patients on active cancer treatment. The goal of this modified Diabetes Self-Management Education Services (mDSMES) pilot study was to provide patients with the opportunity to learn methods of diabetes self-management, including how to manage their glucose levels, improve their understanding and utilization of medication to promote improvements in health, and optimize PC treatment outcomes.

Men with comorbid T2DM and advanced-stage PC receiving androgen deprivation therapy were recruited from the cancer center and randomized to an individualized pharmacy and nutrition education and counseling intervention or a non-interventional observational group. Diabetes knowledge was assessed with a validated tool. Feasibility and acceptability were assessed through adherence and questionnaire. Laboratory assessments included serum HbA1c measurement.

Among the 803 screened, 177 had T2DM, 50 were eligible, and 28 were consented and randomized. 22 men completed the study. Results show feasibility with > 75% engagement and an average acceptability questionnaire score of 37.3/56. Knowledge test scores increased among mDSMES intervention participants, and HbA1c decreased in all participants, with a continuing trend in mDSMES intervention participants not seen in SOC participants.

The pilot clinical trial was feasible and acceptable, and participants gained insight and were effectively educated about T2DM self-care. A positive residual effect on HbA1c was indicated. Next steps involve refining the intervention based on provider and participant feedback and expanding it to a larger segment of the comorbid T2DM-PC population.