Non-pharmacological interventions for cancer-related fatigue in men treated for prostate cancer: A systematic review.

Abstract

Cancer-related fatigue is the most common, distressing complaint reported by cancer patients and the most frequently reported long-term side effect of treatment for prostate cancer. Despite this, cancer-related fatigue has not received serious attention from health professionals or researchers, particularly in relation to men with prostate cancer. It is important for healthcare professionals to understand effective non-pharmacological interventions for treating cancer-related fatigue. To synthesize the best available evidence on the effectiveness of non-pharmacological interventions for managing cancer-related fatigue in men with prostate cancer who are undergoing or have completed treatment. This review considered men with prostate cancer (regardless of staging, any previous treatment or co morbidities), aged 18 years and over who were undergoing any treatment, or had completed any treatment for prostate cancer within the previous 12 months.This review considered non-pharmacological interventions, including exercise, diet modification, counselling, education, and cognitive behavioral therapy, using other non-pharmacological interventions or standard care as comparators.Fatigue, as measured by validated tools.This review considered randomized controlled trials and experimental studies. A three-step search strategy was used to find published studies and papers, limited to English language reports, published between 1990 and March 2012. Data was extracted using a standardized extraction tool from the Joanna Briggs Institute. Narrative synthesis of the results of included studies was conducted due to the heterogeneous nature of participant populations, interventions and methodologies encountered that precluded statistical meta-analysis. Eight studies with 600 participants were included in this review. Three interventions were found to be effective for the management of cancer-related fatigue in men with prostate cancer, either undergoing treatment or having completed treatment within the previous twelve months. The available evidence demonstrated the effectiveness of physical activity, both aerobic and resistance exercise, and psychosocial interventions, including education and cognitive behavioral therapy for improving fatigue in men treated for prostate cancer CONCLUSION: The management of cancer-related fatigue in men treated for prostate cancer requires health professionals to provide patients with a range of options. While physical activity has been shown to have the strongest benefit, other non-pharmacological interventions are beneficial and should also be considered as a strategy in treating this debilitating side effect of cancer and its treatment.Health professionals need to be aware of the high likelihood of cancer-related fatigue in men treated for prostate cancer. They also need to have knowledge of a range of effective interventions aimed at reducing cancer-related fatigue in men with prostate cancer and should incorporate those interventions into their patient management.More research should be conducted to evaluate effective non-pharmacological interventions for cancer-related fatigue in men with prostate cancer. Particular focus should be on psychosocial and educational interventions rather than activity-based interventions, as these have been well studied and shown to be effective in men with prostate cancer. Further research is needed in specific prostate cancer populations, including those defined by stage of disease, treatment type and phase of treatment.