Osteoporosis risk and interest in strength training in men receiving androgen ablation therapy for locally advanced prostate cancer

Abstract

Purpose The overall purpose of this preliminary study to a clinical trial is to explore the feasibility of recruiting men receiving androgen ablation therapy (AAT) for locally advanced prostate cancer to a future strength training study for the prevention of osteoporosis. The threefold specific purpose of this comparative and correlational study is to (a) describe the prevalence of risk factors for osteoporosis, (b) compare functional status and symptom distress between those interested and not interested in a future strength training study, and (c) examine relationships among self-efficacy for strength training, functional status, symptom distress, years since cancer diagnosis, and cumulative dose of AAT in this at-risk population. Method Data were obtained from 40 Caucasian men (mean age = 75.8 years) with locally advanced prostate cancer, capable of self-care, and receiving AAT. The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaires (QLQ) EORTC QLQ-C30 and EORTC QLQ-PR25 (prostate cancer specific) were used to measure functional status and symptom distress. A 6-item, investigator-developed questionnaire was used to measure self-efficacy for learning and overcoming barriers to strength training. Conclusions The majority of these men had multiple risk factors for osteoporosis, in addition to receiving AAT, and had not completed bone mineral density (BMD) testing. A high percentage (67.5%) expressed interest in a future strength training protocol for osteoporosis prevention; functional status and symptom distress did not appear to influence this interest. Several aspects of functional status and symptom distress were significantly related to self-efficacy for learning and overcoming barriers to strength training. Years since cancer diagnosis and cumulative dose of AAT were not significantly related to self-efficacy for strength training, but age was related. This study informs a planned future experimental study by establishing the recruitment potential and the decreased likelihood of symptom distress interfering with self-efficacy for participation in strength training. Implications for practice Advanced practice nurses should complete assessments for osteoporosis risk factors, monitor height loss, order BMD testing and bone enhancing medications, and discuss lifestyle modifications including strength training to improve bone health in men receiving AAT for prostate cancer.