Prostate cancer (PCa) patients may suffer a host of adverse effects of the disease or its treatments. The role of physiotherapy in PCa rehabilitation in dealing with these problems is less understood. This study aims to qualitatively and quantitatively assess the existing literature on PCa survivors that studies the role of various physiotherapy rehabilitation strategies in managing problems like cancer-related fatigue (CRF), urinary incontinence (UI), sexual dysfunction (SD), and quality of life (QoL).
Objectives
To review and quantitatively assess the existing body of literature on the role of physiotherapy strategies and their impact on CRF, UI, SD, and QoL in PCa survivors.
Methods
A digital search was conducted in PubMed, CINAHL, Google Scholar, PEDro, and Cochrane databases between October 2013 and October 2023. Studies meeting the eligibility criteria were evaluated using the PEDro scale followed by descriptive synthesis. The meta-analysis was done using the software Stata version 16. 29 studies were included in this review. 28 were RCTs and 1 was a pre- and post-interventional study. 28 studies were evaluated for risk of bias. Only 10 studies were included for meta-analysis due to insufficient data.
Results
The results showed significant trends favoring intervention groups regarding CRF (theta = 1.83, z = 2.16; p = 0.03), UI (Theta = −0.60, z = −5.05; p = 0.0000), and QoL (theta = 0.335, z = 2.75; p = 0.01) of PCa survivors. However, non-significant trends favoring the intervention groups regarding SD (theta = 0.36, z = 1.25; p = 0.21) were seen.
Conclusion
The study highlights that physiotherapy interventions can reduce CRF, UI, and SD and thereby help to improve health-related QoL of PCa survivors.
RawlaP. Epidemiology of prostate cancer. World J Oncol2019; 10(2): 63–89.
2.
SekhoachaMRietKMotloungP, et al.Prostate cancer review: genetics, diagnosis, treatment options, and alternative approaches. Molecules2022; 27(17): 5730.
3.
LeporeSJHelgesonVSEtonDT, et al.Improving quality of life in men with prostate cancer: a randomized controlled trial of group education interventions. Health Psychol2003; 22(5): 443–452.
4.
BadenMLuLDrummondFJ, et al.Pain, fatigue and depression symptom cluster in survivors of prostate cancer. Support Care Cancer2020; 28(10): 4813–4824.
5.
PyszoraABudzyńskiJWójcikA, et al.Physiotherapy programme reduces fatigue in patients with advanced cancer receiving palliative care: randomized controlled trial. Support Care Cancer2017; 25(9): 2899–2908.
6.
MirzaMGrieblingTLKazerMW. Erectile dysfunction and urinary incontinence after prostate cancer treatment. Semin Oncol Nurs2011; 27(4): 278–289.
The relevance of the procedures related to the physiotherapy in the interventions in patients with prostate cancer: Short review with practice approach - PMC[Internet]. [cited 2024 Apr 23]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4092084/
9.
CormiePNewtonRUTaaffeDR, et al.Exercise therapy for sexual dysfunction after prostate cancer. Nat Rev Urol2013; 10(12): 731–736.
10.
DonnellyCMLowe-StrongARankinJP, et al.Physiotherapy management of cancer-related fatigue: a survey of UK current practice. Support Care Cancer2010; 18(7): 817–825.
11.
The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. The BMJ[Internet]. [cited 2024 Apr 23]. Available from: https://www.bmj.com/content/372/bmj.n71
BourkeLGilbertSHooperR, et al.Lifestyle changes for improving disease-specific quality of life in sedentary men on long-term androgen-deprivation therapy for advanced prostate cancer: a randomised controlled trial. Eur Urol2014; 65(5): 865–872.
14.
CormiePNewtonRUTaaffeDR, et al.Exercise maintains sexual activity in men undergoing androgen suppression for prostate cancer: a randomized controlled trial. Prostate Cancer Prostatic Dis2013; 16(2): 170–175.
15.
BuffartLMGalvãoDAChinapawMJ, et al.Mediators of the resistance and aerobic exercise intervention effect on physical and general health in men undergoing androgen deprivation therapy for prostate cancer. Cancer2014; 120(2): 294–301.
16.
CormiePGalvãoDASpryN, et al.Can supervised exercise prevent treatment toxicity in patients with prostate cancer initiating androgen‐deprivation therapy: a randomised controlled trial. BJU Int2015; 115(2): 256–266.
17.
NilsenTSRaastadTSkovlundE, et al.Effects of strength training on body composition, physical functioning, and quality of life in prostate cancer patients during androgen deprivation therapy. Acta Oncol2015; 54(10): 1805–1813.
18.
BuffartLMNewtonRUChinapawMJ, et al.The effect, moderators, and mediators of resistance and aerobic exercise on health-related quality of life in older long-term survivors of prostate cancer. Cancer2015.
19.
HojanKKwiatkowska-BorowczykELeporowskaE, et al.Physical exercise for functional capacity, blood immune function, fatigue, and quality of life in high-risk prostate cancer patients during radiotherapy: a prospective, randomized clinical study. Eur J Phys Rehabil Med2016; 52(4): 489–501.
20.
HojanKKwiatkowska-BorowczykELeporowskaE, et al.Inflammation, cardiometabolic markers, and functional changes in men with prostate cancer. A randomized controlled trial of a 12-month exercise program. Pol Arch Intern Med2017; 127(1): 25–35.
21.
VillumsenBRJorgensenMGFrystykJ, et al.Home-based exergaming was safe and significantly improved 6-min walking distance in prostate cancer patients: a single-blinded randomized controlled trial. BJU Int2019.
22.
NdjaveraWOrangeSTO’DohertyAF, et al.Exercise-induced attenuation of treatment side-effects in patients with newly diagnosed prostate cancer beginning androgen-deprivation therapy: a randomised controlled trial. BJU Int2020; 125(1): 28–37.
23.
AshtonREAningJJTewGA, et al.Supported progressive resistance exercise training to counter the adverse side effects of robot-assisted radical prostatectomy: a randomised controlled trial. Support Care Cancer2021; 29(8): 4595–4605.
24.
HarrisonMRDavisPGKhouriMG, et al.A randomized controlled trial comparing changes in fitness with or without supervised exercise in patients initiated on enzalutamide and androgen deprivation therapy for non-metastatic castration-sensitive prostate cancer (EXTEND). Prostate Cancer Prostatic Dis2022; 25(1): 58–64.
25.
MoonCGallegosAMSheikhB, et al.Pilot study on the impact of a home-based exercise program on inflammatory cytokines and quality of life in men with prostate cancer under active surveillance. Cancer Control2022.
26.
BrownMMurphyMHMcAneneyH, et al.Feasibility of home-based exercise training during adjuvant treatment for metastatic castrate-resistant prostate cancer patients treated with an androgen receptor pathway inhibitor (EXACT). Support Care Cancer2023; 31(7): 442.
27.
GalvãoDATaaffeDRChambersSK, et al.Exercise intervention and sexual function in advanced prostate cancer: a randomised controlled trial. BMJ Support Palliat Care2022; 12(1): 29–32.
28.
Ben-JosefAMChenJWileytoP, et al.Effect of eischens yoga during radiation therapy on prostate cancer patient symptoms and quality of life: a randomized Phase II trial. Int J Radiat Oncol Biol Phys2017; 98(5): 1036–1044.
29.
CampoRAAgarwalNLaStayoPC, et al.Levels of fatigue and distress in senior prostate cancer survivors enrolled in a 12-week randomized controlled trial of Qigong. J Cancer Surviv2014; 8(1): 60–69.
30.
KaushikDShahPKMukherjeeN, et al.Effects of yoga in men with prostate cancer on quality of life and immune response: a pilot randomized controlled trial. Prostate Cancer Prostatic Dis2022.
31.
Rajkowska-LabonEBakułaSKucharzewskiM, et al.Efficacy of physiotherapy for urinary incontinence following prostate cancer surgery. BioMed Res Int2014; 2014: 1–9.
32.
ZhangAYBodnerDRFuAZ, et al.Effects of patient centered interventions on persistent urinary incontinence after prostate cancer treatment: a randomized, controlled trial. J Urol2015.
33.
ZopfEMBlochWMachtensS, et al.Effects of a 15-month supervised exercise program on physical and psychological outcomes in prostate cancer patients following prostatectomy: the ProRehab study. Integr Cancer Ther2015; 14(5): 409–418.
34.
de Santana e SantosNASaintrainMVRegadasR, et al.Assessment of physical therapy strategies for recovery of urinary continence after prostatectomy. Asian Pac J Cancer Prev2017; 18(1): 81–86. DOI: 10.22034/APJCP.2017.18.1.81.
35.
LaurienzoCEMagnaboscoWJJaburF, et al.Pelvic floor muscle training and electrical stimulation as rehabilitation after radical prostatectomy: a randomized controlled trial. J Phys Ther Sci2018; 30(6): 825–831.
36.
MardaniAPedram RaziSMazaheriR, et al.Effect of the exercise programme on the quality of life of prostate cancer survivors: a randomized controlled trial. Int J Nurs Pract2021; 27(2): e12883.
37.
TantawySAElgoharyHMIAbdelbassetWK, et al.Effect of 4 weeks of whole-body vibration training in treating stress urinary incontinence after prostate cancer surgery: a randomised controlled trial. Physiotherapy2019; 105(3): 338–345.
38.
HeydenreichMPutaCGabrielHH, et al.Does trunk muscle training with an oscillating rod improve urinary incontinence after radical prostatectomy? A prospective randomized controlled trial. Clin Rehabil2020; 34(3): 320–333.
39.
SotoGMDa Cuña CarreraIGutiérrez NietoM, et al.Early 3-month treatment with comprehensive physical therapy program restores continence in urinary incontinence patients after radical prostatectomy: a randomized controlled trial. Neurourol Urodyn2020; 39(5): 1529–1537.
40.
StrojekKWeber-RajekMStrączyńskaA, et al.Randomized-controlled trial examining the effect of pelvic floor muscle training in the treatment of stress urinary incontinence in men after a laparoscopic radical prostatectomy pilot study. J Clin Med2021; 10(13): 2946.
41.
FaithfullSCockle-HearneJLemanskaA, et al.Randomised controlled trial to investigate the effectiveness of the symptom management after radiotherapy (SMaRT) group intervention to ameliorate lower urinary tract symptoms in men treated for prostate cancer. Support Care Cancer2022; 30(4): 3165–3176.
42.
GalvaoDATaaffeDRChambersSK, et al.Exercise intervention and sexual function in advanced prostate cancer: a randomised controlled trial. BMJ Support Palliat Care2022.
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