Abstract
Abstract
Approximately half of all men treated for prostate cancer (PCa) will undergo androgen deprivation therapy (ADT). Although ADT can substantially slow the progress of PCa and allow men with metastatic disease to live otherwise free of cancer symptoms, ADT is associated with many bothersome side effects which contribute to diminished quality of life (e.g. hot flashes, fatigue, sexual dysfunction). ADT also increases the likelihood that patients will develop significant health risks such as osteoporosis, cardiovascular disease, obesity, and insulin resistance, which can hasten the deaths of PCa patients.
Our previous qualitative study demonstrated that patients feel inadequately prepared to cope with the life changing effects of ADT. Thus, we surveyed patients who had recently begun ADT and found significant deficits in their knowledge of ADT side effects. We concluded that their lack of knowledge might partially explain patients’ difficulty in coping with side effects; patients uninformed about side effects do not engage in behaviors to prevent or reduce the risk of adverse effects. We also determined there are great inconsistencies across sources of information on ADT; therefore, we created an educational workbook to teach men what to expect when on ADT and how to manage side effects.
Eligible patients (104) and their partners (53) were randomly assigned to receive the educational workbook or usual care. Participants were assessed, throughout their first 6 months on ADT, on side effect knowledge, experience and bother, sexual activity, mood, relational intimacy, and use of ADT side effect management strategies. The educational intervention was found to be both feasible and acceptable; however, there were no significant group differences on outcome measures. Despite improvements in side effect knowledge, patients demonstrated declines in sexual function and relational intimacy, as well as increased bother associated with ADT side effects. While participants reported the workbook to be helpful, the intervention was not sufficient to result in improved outcomes. The intervention may show promise for partners as marginally significant group differences were observed on a measure of relational intimacy. Suggestions for improving efforts to reduce the suffering of men on ADT are offered.
