Androgen-deprivation therapy and metabolic syndrome in men with prostate cancer.

PURPOSE/OBJECTIVES: To examine the trajectory of changes in body composition and metabolic profile in men who receive androgen-deprivation therapy (ADT) for prostate cancer. DESIGN: Prospective longitudinal design with repeated measures. SETTING: Urban medical center in the southwestern United States. SAMPLE: 55 men starting radiation therapy for prostate cancer. METHODS: Changes in the parameters of metabolic syndrome were estimated with ADT (n=31) and non-ADT (n=24) groups by repeated-measures analysis of variance implemented by general linear mixed-effects models. Models included interactions between groups and follow-up time to test differences between the groups. MAIN RESEARCH VARIABLES: Body composition and metabolic variables. FINDINGS: The ADT group demonstrated a transient increase in waist circumference at the nine-month time point and significant changes in measures of insulin resistance were noted at the three month point. Values for diastolic and systolic blood pressure, plasma glucose, high-density lipoprotein, and triglycerides were not altered for either group. Differences in metabolic variables or measures of body composition did not differ significantly between the groups. CONCLUSIONS: The findings demonstrate the development of insulin resistance in men receiving ADT as early as three months after starting ADT. IMPLICATIONS FOR NURSING: Addressing survivorship concerns can lead to the development of nursing interventions designed to reduce adverse effects associated with ADT.

Exercise preferences among men with prostate cancer receiving androgen-deprivation therapy.

PURPOSE/OBJECTIVES: To investigate acceptability of and preferences for physical activity participation in men receiving androgen-deprivation therapy (ADT) for prostate cancer, to identify influencing clinical and demographic factors, and to determine the percentage meeting national exercise guidelines. DESIGN: Cross-sectional, descriptive. SETTING: Ambulatory care clinic of a large medical center. SAMPLE: 135 men receiving ADT. METHODS: A structured interview with a systematic procedure was used to elicit preferences for physical activity. MAIN RESEARCH VARIABLES: Exercise preferences and acceptability; evidence-based exercise intervention. FINDINGS: Participants expressed high levels of acceptability of and willingness to participate in aerobic (64% and 79%) and muscle-strengthening (79% and 81%) programs. Preferences were expressed for muscle-strengthening activities performed at home, either alone or in the company of a family member. Flexible, spontaneous, and self-paced programs were preferred. Significant associations were identified for distance, age, obesity, duration of ADT, and meeting American College of Sports Medicine (ACSM) and American Heart Association (AHA) guidelines. Nineteen percent of the study population met the guidelines for weekly physical activity. CONCLUSIONS: High levels of expressed acceptance of and willingness to participate in physical activity programs as well as the small number of participants meeting ACSM and AHA guidelines suggest feasibility of and support the need for the development of exercise programs in this population. IMPLICATIONS FOR NURSING: Incorporating patient preferences and evidence-based practice is integral to providing high-quality patient-centered care and is the foundation for appropriate intervention programs. Insight from this study will facilitate the design of programs that better reflect actual preferences of prostate cancer survivors. KNOWLEDGE TRANSLATION: ADT-induced changes in body composition are believed to contribute to a reduction in insulin sensitivity and dyslipidemia that contribute to increased cardiovascular risk profile. Exercise has the potential to mitigate the harmful effects of ADT.

Implications of treatment on body image and quality of life.

OBJECTIVES: To describe the changes in body image secondary to the treatment of prostate cancer, and to provide a review of the literature regarding body image assessment and its relationship to quality of life (QOL) among men with prostate cancer. DATA SOURCES: Review of current and classic literature. CONCLUSION: There is strong evidence for the existence of a relationship between body image perception and QOL in men with prostate cancer. IMPLICATIONS FOR NURSING PRACTICE: Understanding the effect of body image changes on QOL will allow us to develop targeted interventions designed to improve the QOL of survivors of prostate cancer.

Body image and quality of life in men with prostate cancer.

Each of the successful treatment options for men with prostate cancer is accompanied by its unique side effect profile. However, treatment with androgen deprivation therapy (ADT) and the resulting castrate level of testosterone lead to profound changes in one's physical appearance. The goal of this descriptive study was to describe the relationship between changes in body image and quality of life (QOL) among prostate cancer survivors based upon whether or not treatment was with ADT. A convenience sample of 132 men (aged > or =60 years) with prostate cancer were recruited from the oncology and urology outpatient departments at an urban Veterans Affairs Medical Center. The participants completed 2 established questionnaires, the Body Image Scale and the Quality of Life Index-Cancer Version. Descriptive and inferential statistics were used in the analysis. There was no difference in QOL based on ADT. There was a significant negative correlation between body image dissatisfaction and QOL. The findings add to our knowledge regarding body image and QOL among men with prostate cancer, provide a foundation for future research endeavors, and support the development of evidence-based interventions to mitigate body image dissatisfaction.

Body image perceptions in men with prostate cancer.

PURPOSE/OBJECTIVES: To describe changes in body image among men with prostate cancer who were either prescribed androgen-deprivation therapy (ADT) or were ADT naive and to explore the relationship of age, duration of therapy, and body mass index with body image perception. DESIGN: Exploratory and descriptive. SETTING: Ambulatory care clinic of a large urban Veterans Affairs medical center. SAMPLE: 132 men 60 years of age or older with prostate cancer recruited from the oncology and urology outpatient departments. METHODS: Participants completed a demographic survey and the Body Image Scale (BIS), an instrument developed to measure changes in body image. Descriptive and inferential statistics were used to explore body image dissatisfaction. MAIN RESEARCH VARIABLES: Body image and ADT. FINDINGS: A significant difference in body image dissatisfaction existed between men who had received ADT and men who were ADT naive. No relationship was identified between age and body image dissatisfaction or between duration of therapy and body image dissatisfaction. A significant positive relationship was found between body mass index and body image dissatisfaction for the sample overall. CONCLUSIONS: A greater degree of body image dissatisfaction existed in the men who received ADT as compared to those who were ADT naive. IMPLICATIONS FOR NURSING: Patients receiving ADT for prostate cancer may be at greater risk of body image dissatisfaction. The psychometric performance of the BIS lends support to its continued use in this population.