Self-management after prostate cancer treatment: evaluating the feasibility of providing a cognitive and behavioural programme for lower urinary tract symptoms

Objective: • To test the feasibility of a self-management intervention to help men cope with lower urinary tract symptoms as a result of radiotherapy for prostate cancer.

Patients and methods: • A quasi-experimental design was used incorporating a pre-post-test evaluation. In total, a population of 71 men were screened for moderate to severe urinary symptoms 3 months or longer post-radiotherapy. Of these mean, 22 were recruited into the intervention from an eligible population of 43 symptomatic men. • Urinary symptoms were measured before the intervention and again after 4 months of follow-up through International Prostate Symptom Scores (IPSS) and bladder diaries. • Health-related quality of life was measured in relation to cancer per se and prostate cancer specifically, and confidence to cope was measured by a self-efficacy questionnaire. • The self-management intervention comprised pelvic floor muscle exercises, bladder retraining, patient education and problem solving and coping strategies

Results: • Lower urinary tract symptoms, as measured by the IPSS, showed a significant improvement, with a median score change of 5 (P < 0.005). • This was supported by objective changes in median bladder void volume of +7.5 mL (P < 0.05) and the median number of daily voids of -1 (P < 0.005). • In addition, decreases in emotional distress and problems associated with urinary function suggest that the intervention had a positive impact on health-related quality of life.

Conclusions: • The provision of such an intervention was feasible within the clinical setting and provided benefits for men. • Symptom change vs those of normative recovery values for IPSS showed an intervention effect. • This intervention could be applied in routine practice and further testing is required in a randomized controlled trial.