Quality Of Life Of Prostate Cancer Men Undergoing Pre-surgical Exercise Prior To Prostatectomy.

Abstract

Exercise interventions in prostatectomy patients have generally focused on the post-surgical period and enhancement of pelvic floor musculature to reduce incontinence. However, quality of life (QOL) and psychological distress are also impacted in the pre- and post-surgical period in this patient group. PURPOSE: To evaluate the efficacy of exercise undertaken before surgery to enhance pre- and post-surgical QOL and psychological distress in men scheduled for prostatectomy. METHODS: Twenty-three men with localised prostate cancer (50-73 years) scheduled for surgery were randomised to exercise (EX = 13) or usual care (UC = 10). EX underwent 6 weeks of pre-surgical exercise (resistance and aerobic) thrice weekly. Self-reported QOL was assessed using the EORTC QLQ-C30) and psychological distress using the Brief Symptom Inventory-18 (BSI-18) which includes anxiety, somatization, depression, and the global severity index (GSI). Measures were undertaken at baseline, pre-surgery, within 2 weeks post-surgery and 6 weeks post-surgery. Data were assessed for normality and analysed using two-way repeated-measures ANOVA. RESULTS: There were no differences between groups at baseline. Following exercise, there was a significant interaction (p < 0.05) for somatization with somatization increasing in EX 2 week’s post- surgery and returning to pre-training values 6 weeks post-surgery, with no change in anxiety, depression or the GSI. There was a significant time effect (p < 0.05) for global health, physical, role, cognitive and social function, as well as for fatigue, pain, insomnia, appetite loss and diarrhoea, with QOL generally improving over the study period. CONCLUSION: A pre-surgical exercise program improves components of quality of life prior to surgery, however, EX patients group had higher symptoms after surgery but then did return to pre-training level at 6 weeks post-surgery. Pre-surgery exercise may have a role in managing quality of life and psychological distress in this patient cohort.