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New Web-Based Platform Addresses Quality of Life After Treatment for Prostate Cancer Survivors
PHILADELPHIA (July 23, 2021) – Although it improved certain aspects of adaptive coping among prostate cancer survivors, a small randomized, controlled trial found use of PROGRESS, a web-based intervention developed at Fox Chase Cancer Center, did not fully address coping and psychosocial demands.
Prostate cancer is one of the most prevalent cancers in men. Poor physical functioning and negative psychological outcomes are often reported by survivors after treatment.
Suzanne M. Miller, PhD, a professor in the Cancer Prevention and Control Program, was the study’s lead author, and Erin K. Tagai, PhD, MPH, a postdoctoral fellow in Miller’s lab, was first author. Alexander Kutikov, MD, chief of the Division of Urology and Urologic Oncology, and biostatistician Elizabeth Handorf, PhD, an associate professor, were also authors.
Given the size of the population diagnosed with prostate cancer, it’s important to assess symptoms and the long-term effects of treatment, Miller said. “We want to provide the best, most patient-centered care while minimizing patients’ regret about their treatment decisions,” she added.
Another reason for the study was to find ways to enhance patient care without overloading healthcare professionals who have to help patient address various psychosocial issues, Tagai said.
“We are always concerned about all of the aspects of a patient,” including the physical and psychological, Miller said. “Sexual and urinary dysfunction are not pleasant or easy to deal with. That’s why we are always asking, ‘How can we use our skills to further enhance patient care?’”
Miller said that when patients weigh treatment options, they also want to know what is involved in the process of transitioning to survivorship. During and after treatment for prostate cancer, “dynamics change, especially with a partner. At Fox Chase, we are sensitive to the psychosocial aspects of decision making.”
Anyone enrolled in the study was personally introduced to PROGRESS by staff and received support while participating. Slightly older participants, who may have more time, used PROGRESS more than younger men, Miller said. PROGRESS stands for Prostate Cancer Online Guide & Resources for Electronic Survivorship Service.
In intent-to-treat analyses, patients in the randomized intervention group had improved diversion coping such as the healthy redirection of worrying thoughts about their cancer. This same group had more difficulty with marital communication.
As-treated analyses found patients “reported fewer practical concerns but had worse positive coping” compared to patients who opted not to use PROGRESS at all.
PROGRESS usage among those randomized to the intervention group was just 38.7%. “We expected more men to engage,” Miller said.
This points to the need, she added, for additional research to better understand the gaps in intervention delivery and poor improvement across all domains of functional quality of life and adaptive coping.
“It’s not just the cure we care about,” Miller said. “It’s the quality of life for the patient and his partner.” Miller said future studies would likely engage spouses and partners in addition to patients. Gender does figure in to usage and responses, she added.
“Once you have a program like PROGRESS the challenge is getting it into the health delivery system so that it can truly help patients,” Tagai said. “Prostate cancer patients report a lot of anxiety while coping with uncertainty. We want to minimize unnecessary psychological side effects.”
Miller described the design of PROGRESS as very careful, very deliberate, very collaborative and “very novel.” Clinicians, researchers, and former patients were all part of the development team. Still, it was “a best guess” based on the science available, said Miller.
The study, “Improved Cancer Coping From a Web-Based Intervention for Prostate Cancer Survivors: A Randomized Controlled Trial,” was published in Psychooncology.
Fox Chase Cancer Center (Fox Chase), which includes the Institute for Cancer Research and the American Oncologic Hospital and is a part of Temple Health, is one of the leading comprehensive cancer centers in the United States. Founded in 1904 in Philadelphia as one of the nation’s first cancer hospitals, Fox Chase was also among the first institutions to be designated a National Cancer Institute Comprehensive Cancer Center in 1974. Fox Chase is also one of just 10 members of the Alliance of Dedicated Cancer Centers. Fox Chase researchers have won the highest awards in their fields, including two Nobel Prizes. Fox Chase physicians are also routinely recognized in national rankings, and the Center’s nursing program has received the Magnet recognition for excellence six consecutive times. Today, Fox Chase conducts a broad array of nationally competitive basic, translational, and clinical research, with special programs in cancer prevention, detection, survivorship, and community outreach. It is the policy of Fox Chase Cancer Center that there shall be no exclusion from, or participation in, and no one denied the benefits of, the delivery of quality medical care on the basis of race, ethnicity, religion, sexual orientation, gender, gender identity/expression, disability, age, ancestry, color, national origin, physical ability, level of education, or source of payment.
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