Psychological and physical therapy can improve quality of life

This article examined the use of a physical and psychosocial rehabilitation program to improve urinary dysfunction and patient quality of life following radiotherapy for the treatment of prostate cancer.

Advances in prostate cancer treatments, including radiotherapy and hormonal therapies, have significantly increased the long-term survival of prostate cancer patients. However, these treatments may also significantly damage quality of life (QoL). Many adverse effects can occur even years following treatment, and since men are now living longer following diagnosis, a new focus has been given to improving the QoL of these patients. For instance, urinary symptoms such as incontinence and a frequent urge to urinate are experienced by many patients following radiotherapy.

Pelvic floor exercises, which tone the muscles of the pelvic floor, have been shown to be effective at treating incontinence. The current study examined whether a multidisciplinary rehabilitation program, including pelvic floor exercises coupled with psychological and social support, could improve both urinary symptoms and overall patient QoL.

This study included 209 men, diagnosed with prostate cancer, and who underwent hormonal and radiotherapy treatments. Men were randomly assigned to an intervention group or a usual care control group. Both groups were offered one physician visit four weeks after the end of radiation treatment. Men in the intervention group were offered four further counseling sessions over 20 weeks with nurses and physical therapists specially trained to help in the rehabilitation of prostate cancer patients. Nurses discussed adverse effects with patients, and offered help with lifestyle changes, including smoking cessation, drinking habits, diet, fitness and any sexual or psychological problems. Physical therapists offered training in pelvic floor exercises. Improvements in urinary symptoms and QoL were measured in both groups using scored patient-answered questionnaires.

Psychosocial and physical rehabilitation were found to improved urinary symptoms by 5.8 points compared to men in the control group. Overall physical QoL was also improved by 3.6 points in the intervention group compared to the control group. Patients with the worse urinary symptoms prior to intervention showed the largest improvements after intervention. Although significant changes were found between groups regarding both symptoms and QoL, no measureable difference was found in pelvic floor strength.

This study concluded that psychosocial and physical interventions improve urinary symptoms and patient quality of life following radiotherapy.

Since each patient in the intervention group received counseling from both nurses and physical therapists, it is impossible to determine which of the interventions was most influential.

Consult with your physician regarding physical therapy, psychosocial rehabilitation and other possible interventions to improve quality of life following radiotherapy.