The following article was originally posted by Dalhousie University Communications and Marketing.
A unique home-based program for men undergoing treatment for prostate cancer can reduce the profound psychological stress, feelings of isolation and anxiety that often develop in the wake of their diagnosis, according to a new study by researchers at Dalhousie University.
A team of scientists and physicians found that prostate cancer patients who participated in the Prostate Cancer Patient Empowerment Program (PC-PEP) had significantly lower rates of anxiety, depression and other forms of psychological distress than those receiving standard care.
“To our knowledge, PC-PEP is the first program in the world to activate the role of the patients in their own care, educate and empower them for six months straight and beyond if they want to remain connected. It includes 70 minutes of daily prescribed activities in all domains of living, that have been evaluated scientifically to result in meaningful improvements in mental health at six and twelve months of follow up,” said Dr. Gabriela Ilie, project lead and Dalhousie University Endowed Soillse Scientist in Prostate Cancer Quality of Life Research.
PC-PEP, developed by Dr. Ilie and Dr. Rob Rutledge, an oncologist and associate professor at Dalhousie, provides online physical, mental and social support over a six-month period to men being treated for prostate cancer as a way to reduce the high rates of treatment side effects and mental health issues.
The study, published in the platinum journal European Urology, examined the effects of the program on two groups of men ranging in age from 50 to 82 years old who were all scheduled for prostate cancer surgery or radiotherapy.
In the randomized clinical trial of 128 Maritime men, 66 participated in the six-month program while another 62 were part of a waitlist group who received the standard of care for six months, but then participated in PC-PEP for the subsequent six months.
The PC-PEP intervention consists of daily e-mails with video instructions providing education, patient activities and healthy living guidance, including information on physical and mental health, dietary recommendations, physical fitness, stress reduction and social connection.
“The six-month program started before prostate surgery or radiation, which helped the men get through and recover more quickly from the treatment side effects like fatigue and urinary leakage. Men in the program took an active role in their health, which also helped them psychologically during this very stressful time,” added Dr. Rutledge.
The study found that at six months, patients in the control group had almost four times higher odds for psychological distress and need for psychological treatment than men who received the PC-PEP intervention.
At 12 months, the waitlist group that received the intervention at six months had higher psychological distress than the group who started the program earlier and completed the program at six months. Although the program is intensive, compliance was exceeded and nine out of 10 patients recommend the program to other men who receive a prostate cancer diagnosis.
“PC-PEP delivered early following diagnosis significantly prevented the burden of psychological distress in men undergoing curative prostate cancer treatment,” the authors state.
Two other manuscripts that are currently being reviewed show that for physical fitness and urinary continence, the program is effective whether delivered early or six months later.
“It makes sense that an intervention of this type is exactly what men need when they receive their diagnosis. Given the role of oxidative stress, which is brought about by life stressors including a significant event such as a cancer diagnosis, it is crucial that we implement programs such as this into the current standard of care of patients.”
The program, developed in 2019 with funding from Research Nova Scotia, was designed with the involvement of patients from the outset and has been expanded throughout Canada and in New Zealand, is being translated into French and is undergoing testing for other forms of cancer.
Dr. Ilie and Dr. Rutledge say PC-PEP is a cost-effective, convenient and a reliable program for a disease that is estimated to affect one in seven men in their lifetime. Unlike most forms of cancer, survival rates for newly diagnosed cases of prostate cancer are very high. Yet, 90 per cent of these patients will likely suffer significant treatment-related side effects which can profoundly affect their quality of life.