Adult urologyLifestyle and health-related quality of life of men with prostate cancer managed with active surveillance
Section snippets
Material and methods
A total of 93 men with biopsy-documented prostate cancer undergoing active surveillance, with prostate-specific antigen levels of 4 to 10 ng/mL and Gleason scores less than 7, were randomly assigned to a lifestyle intervention (n = 44) or usual-care control group (n = 49). These men then accepted an invitation to participate in the Prostate Cancer Lifestyle Trial. 18, 19 A randomized consent design was used to limit the amount of lifestyle information control participants received to reduce the
Participant Characteristics at Baseline
As shown in Table I, the experimental groups were similar in age, employment status, marital status, education, ethnicity, BMI, prostate-specific antigen level, and QOL at baseline. The control group scored somewhat higher on the lifestyle index compared with the intervention group.
Between-Group Differences in 12-Month Changes
Patients in the intervention group made significant improvements in lifestyle compared with the control group from baseline to 12 months. However, no significant differences between groups were found in the
Comment
The results of this study suggest that following a healthy lifestyle is positively related to QOL in men with early-stage prostate cancer choosing active surveillance. Specifically, a healthier lifestyle was associated with greater physical and mental HR-QOL and sexual function at study entry. Furthermore, intervention participants who made significant improvements in lifestyle during the 12-month period also reported improved physical HR-QOL and reduced perceived stress. Because some of the
Conclusions
The results of this study suggest that men with early-stage prostate cancer choosing active surveillance may improve their QOL by adopting healthy lifestyle practices. Future studies should examine further the effect of lifestyle changes in men choosing active surveillance, because this group of patients may increase proportionately with time owing to stage migration and receive less professional healthcare than those who seek conventional treatment. The current trial results suggest that men
Acknowledgment
To Representatives Nancy Pelosi and John Murtha and Senators Arlen Specter and Ted Stevens; and to Dennis Malone, Monika Sieverding, Monika Bullinger, and Michael Sumner for their contributions to the study.
References (29)
- et al.
Prostate cancer radiation dose responseresults of the M.D. Anderson phase III randomized trial
Int J Radiat Oncol Biol Phys
(2002) - et al.
Patient-reported urinary continence and sexual function after anatomic radical prostatectomy
Urology
(2000) - et al.
Population-based study of long-term survival in patients with clinically localised prostate cancer
Lancet
(1997) - et al.
Expectant management of nonpalpable prostate cancer with curative intentpreliminary results
J Urol
(2002) - et al.
Feasibility studywatchful waiting for localized low to intermediate grade prostate carcinoma with selective delayed intervention based on prostate specific antigen, histological and/or clinical progression
J Urol
(2002) - et al.
Changes in health-related quality of life in the first year after treatment for prostate cancerresults from CaPSURE
Urology
(1999) - et al.
Quality of life after a diagnosis of prostate cancer among men of lower socioeconomic statusresults from the Veterans Affairs Cancer of the Prostate Outcomes Study
Urology
(2003) - et al.
The impact of cancer treatment on quality of life outcomes for patients with localized prostate cancer
J Urol
(2001) - et al.
Dietary trial in prostate cancerearly experience and implications for clinical trial design
Urology
(2001) - et al.
Intensive lifestyle changes may affect the progression of prostate cancer
J Urol
(2005)
Nutritional adequacy of a very-low fat vegan diet
J Am Diet Assoc
Watchful waiting and health related quality of life for patients with localized prostate cancerdata from CaPSURE
J Urol
Urinary and sexual function after radical prostatectomy for clinically localized prostate cancerthe Prostate Cancer Outcomes Study
JAMA
Patient-reported impotence and incontinence after nerve-sparing radical prostatectomy
J Natl Cancer Inst
Cited by (109)
Diet and Health-related Quality of Life Among Men on Active Surveillance for Early-stage Prostate Cancer: The Men's Eating and Living Study (Cancer and Leukemia Group 70807 [Alliance])
2022, European Urology FocusCitation Excerpt :There were no significant differences in anxiety between Black/African American and other patients. Increased vegetable intake was not associated with differential changes in PRO scores in any of the domains compared with the control group, an observation consistent with a small RCT of an intervention combining vegan diet, exercise, and stress management [31]. A likely explanation is that lifestyle-focused interventions, such as diet, will not offer meaningful benefits for prostate cancer–associated HRQoL since these patients already experienced a high sense of well-being.
Effects of Exercise on Sexual Dysfunction in Patients With Prostate Cancer – A Systematic Review
2021, Journal of Sexual MedicineCitation Excerpt :8 studies (34%) used the specific sexual function questionnaires IIEF-1527,34 and IIEF-5,28,41–44,46 while twelve (52%) studies used questionnaires that included a sexual function subscale.26,27,29,31,33,35–40,45 These are the EORTC QLQ-PR25,26,27,29,31,33,35 the EPIC,27 the EPIC-26,37,40 the UCLA-PCI36,38,45 and the IIS.39 All questionnaires are validated questionnaires.48–54
Unmarried men have worse oncologic outcomes after radical cystectomy for nonmetastatic urothelial bladder cancer
2020, Urologic Oncology: Seminars and Original InvestigationsContemporary analysis of the effect of marital status on survival of prostate cancer patients across all stages: A population-based study
2019, Urologic Oncology: Seminars and Original InvestigationsLow risk prostate cancer and an opportunity lost: More activity required in active surveillance
2018, Medical Journal of Australia
Major support for this study was provided by grants from the Department of Defense Uniformed Services University (USU grant MDA905-99-1-0003) by way of the Henry M. Jackson Foundation (grant 600-06971000-236), the Prostate Cancer Foundation, and National Institutes of Health grant 5P50CA089520-02 UCSF Prostate Cancer Specialized Program of Research Excellence (SPORE). Additional support was provided by the Department of Defense (grant W81XWH-05-1-0375-P0001) and the following foundations: Ellison, Fisher, Gallin, Highmark Blue Cross Blue Shield, Koch, Resnick, Wachner, Walton Family, and Wynn.