Self-management after prostate cancer treatment: evaluating the feasibility of providing a cognitive and behavioural programme for lower urinary tract symptoms
Article first published online: 13 OCT 2010
© 2010 THE AUTHORS. BJU INTERNATIONAL © 2010 BJU INTERNATIONAL
Volume 107, Issue 5, pages 783–790, March 2011
How to Cite
Faithfull, S., Cockle-Hearne, J. and Khoo, V. (2011), Self-management after prostate cancer treatment: evaluating the feasibility of providing a cognitive and behavioural programme for lower urinary tract symptoms. BJU International, 107: 783–790. doi: 10.1111/j.1464-410X.2010.09588.x
- Issue published online: 28 FEB 2011
- Article first published online: 13 OCT 2010
- Accepted for publication 1 April 2010
- prostate cancer;
Study Type – Therapy (case series)
Level of Evidence 4
What’s known on the subject? and What does the study add?
Self-management intervention has been shown to be effective for lower urinary tract symptoms (LUTS) in benign prostate disease.
The evidence base for self-management of LUTS after treatment for prostate cancer is small and characterised by heterogeneous samples in terms of disease stage, treatment profiles, timings and intervention content.
This pilot study provides data suggesting that a narrowly targeted, cognitive and behavioural self-management intervention can improve LUTS in men who have had radiotherapy treatment for prostate cancer.
The intervention could be applied in routine practice and further testing in an adequately powered randomized controlled trial is required.
• To test the feasibility of a self-management intervention to help men cope with lower urinary tract symptoms as a result of radiotherapy for prostate cancer.
PATIENTS AND METHODS
• A quasi-experimental design was used incorporating a pre-post-test evaluation. In total, a population of 71 men were screened for moderate to severe urinary symptoms 3 months or longer post-radiotherapy. Of these mean, 22 were recruited into the intervention from an eligible population of 43 symptomatic men.
• Urinary symptoms were measured before the intervention and again after 4 months of follow-up through International Prostate Symptom Scores (IPSS) and bladder diaries.
• Health-related quality of life was measured in relation to cancer per se and prostate cancer specifically, and confidence to cope was measured by a self-efficacy questionnaire.
• The self-management intervention comprised pelvic floor muscle exercises, bladder retraining, patient education and problem solving and coping strategies
• Lower urinary tract symptoms, as measured by the IPSS, showed a significant improvement, with a median score change of 5 (P < 0.005).
• This was supported by objective changes in median bladder void volume of +7.5 mL (P < 0.05) and the median number of daily voids of −1 (P < 0.005).
• In addition, decreases in emotional distress and problems associated with urinary function suggest that the intervention had a positive impact on health-related quality of life.
• The provision of such an intervention was feasible within the clinical setting and provided benefits for men.
• Symptom change vs those of normative recovery values for IPSS showed an intervention effect.
• This intervention could be applied in routine practice and further testing is required in a randomized controlled trial.