Clinical Edge

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Self-Management in Long-Term Prostate Cancer

Publish date:

In a cohort of veterans who were long-term survivors of prostate cancer, a personally tailored, automated telephone symptom management intervention allowed for more confident symptom self-management and reduced symptom burden. 556 prostate cancer survivors who were experiencing symptom burden >1 year after treatment were recruited for the trial across 4 Veterans Affairs sites. Participants were randomly assigned to intervention (n=278) or usual care (n=278) groups. Researchers compared differences in the primary (symptom burden) and secondary outcomes using intent-to-treat analyses. Domain-specific changes in symptom burden from baseline to 5 and 12 months were compared among the intervention group according to the primary symptom focus area of participants. Among the findings:

  • Most study participants (mean age 67 years) were married, white, retired, and underwent radiation therapy.
  • There were no baseline differences in urinary, bowel, sexual, or hormonal domain Expanded Prostate Cancer Index Composite (EPIC) scores across groups.
  • Higher EPIC scores were noted in the intervention arm in all domain areas at 5 months, although differences were not statistically significant.
  • No differences were found in secondary outcomes.

Citation:

Skolarus TA, Metreger T, Wittmann D, et al. Self-management in long-term prostate cancer survivors: A randomized, controlled trial. [Published online ahead of print March 29, 2019]. J Clin Oncol. doi:10.1200/JCO.18.01770.

Commentary:

While advances in prostate cancer treatments often result in improvements in long-term survival, the flip side are the often-bothersome nature of accompanying side effects. How to address these symptoms in a large population of survivors remains a significant need. Recent studies have demonstrated that introduction of protocols for patient interaction through various means (such as telephone, email, or text) may have promise in helping reduce symptom burden. Skolarus et al. describe a potential next step in helping prostate cancer survivors. While the endpoint was not met, their conclusion that intervention focused on individual symptoms merits further evaluation. —Mark A. Klein, MD

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