University of Otago, Dunedin, New Zealand.
University of British Columbia, Vancouver, BC, Canada.
Clin Genitourin Cancer. 2019 Jun;17(3):e408-e419. doi: 10.1016/j.clgc.2018.12.006. Epub 2018 Dec 20.
Androgen deprivation therapy (ADT) for prostate cancer has numerous side effects. Clinical guidelines for side effect management exist; however, these are not always integrated into routine practice. What remains undocumented and therefore the objective of this study, is to describe patients' willingness to employ established strategies.
Study participants were 91 men who had attended an educational program (ie, attend a class plus read a book), designed to prepare patients for managing ADT side effects. Three months later, patients completed the ADT Management Strategies Inventory, to determine use of strategies. Descriptive analyses were conducted.
At the time of class attendance, the average ADT duration was 133 days. Patient preferences for a variety of strategies for each side effect are presented. Highlights include: a high degree (> 65%) of patients using or willing to use exercise to manage medical risks and physical side effects. Forty percent of patients continued to engage in non-penetrative sexual activities, despite reduced sexual desire and erectile dysfunction.
When educated about options, patients are willing to use a wide array of ADT management strategies. Consequently, health care providers should ensure that patients know about side effects and how to manage them. Exercise appears to be the single best strategy to encourage, because it is helpful in managing many side effects (eg, weight gain, muscle weakening, fatigue) and reducing medical risks of ADT (eg, cardiovascular disease, type II diabetes, and osteoporosis). A general trend was patient's preference for behavioral and lifestyle strategies over pharmacologic interventions.
前列腺癌的雄激素剥夺疗法(ADT)有许多副作用。虽然存在管理副作用的临床指南,但这些指南并不总是纳入常规实践。本研究旨在描述患者采用既定策略的意愿,而这一点尚未有文献记录。
研究参与者为 91 名参加了教育项目(即参加课程加阅读书籍)的男性,该项目旨在使患者能够管理 ADT 的副作用。三个月后,患者完成了 ADT 管理策略清单,以确定策略的使用情况。进行了描述性分析。
在参加课程时,ADT 的平均持续时间为 133 天。患者对每种副作用的各种策略的偏好如下:超过 65%的患者使用或愿意使用运动来管理医疗风险和身体副作用。尽管性欲和勃起功能障碍降低,仍有 40%的患者继续进行非渗透性行为。
当患者了解了各种选择后,他们愿意采用广泛的 ADT 管理策略。因此,医疗保健提供者应确保患者了解副作用及其管理方法。运动似乎是最值得鼓励的单一策略,因为它有助于管理许多副作用(例如,体重增加、肌肉减弱、疲劳),并降低 ADT 的医疗风险(例如,心血管疾病、二型糖尿病和骨质疏松症)。患者倾向于选择行为和生活方式策略而非药物干预,这是一种普遍趋势。