Gjerset, G. M., Fosså, S. D., Dahl, A. A., Loge, J. H., Ensby, T., & Thorsen, L. (2011). Effects of a 1-week inpatient course including information, physical activity, and group sessions for prostate cancer patients. Journal of Cancer Education, 26, 754–760.

To explore the effects of a prostate-specific program on physical activity, fatigue, mental distress, and quality of life (QOL).

Courses were conducted by a multidisciplinary team, including lectures, physical activity, and group sessions, lasting for six days. Activity was performed in groups of six to nine patients twice daily, including water gymnastics, walking, Nordic walking, resistance training, pelvic floor training, stretching, and relaxation for 60 to 90 minutes. Group sessions met for one hour daily and were led by a nurse with experience in group counseling. Lectures involved presentation of medical facts, treatment modalities, late effects, and social and other benefits of physical activity. Study measurements were obtained at baseline and at three-month follow-up.

• Sixty-eight patients (100% male) were included, and 51 completed the entire program. 
• Mean age was 67.4 years (range 48.5–81.2).
• All patients had prostate cancer.
• Of the patients, 14% had metastatic disease, 43% had undergone surgery and radiotherapy, 20% had received radiotherapy, and 16% had received hormonal therapy.
• Median time since diagnosis was 18.2 months.
• Most patients were retired, 50% had completed college education, and 86% were married or cohabitating.

• Single site
• Inpatient
• Norway

Patients were undergoing the active treatment phase of care.

This was a prospective, observational study.

• Godin Leisure-Time Exercise Questionnaire
• Fatigue Questionnaire (physical score range 0–21; mental score range 0–12)
• Memorial Anxiety Scale for Prostate Cancer (MAX-PC)
• Hospital Anxiety and Depression Scale (HADS)
• European Organization for Research and Treatment of Cancer Quality of Life (EORTC QLC-C30 QOL) scale

Total fatigue scores declined from 16.1 to 14.0 (p = 0.001), and physical fatigue declined from 11.1 to 9.2 (p = 0.001). Those who did not complete the entire program had higher baseline fatigue scores. Anxiety results were mixed:  anxiety declined on the prostate specific measure (p = 0.001), but there was no change on the HADS scale. QOL measures did not change significantly.

Although there was a significant reduction in fatigue, the degree of change was small (2 of 33 points possible). The study did not provide strong support for the effectiveness of this program.

• The study had a small sample size, with less than 100 patients.
• No control or comparison group was used.
• The sample was highly variable in terms of the age range, and the rehabilitative needs of younger patients who may have undergone curative surgery can be expected to be different than those of older patients; this was not analyzed.
• Use of an inpatient setting for six days for this type of program can be expected to be expensive.
• Time from surgery to study entry varied, and final measures were three months after the program, with no interim assessment; it is not clear what the best timing of such interventions are in the disease trajectory.
• There was no information regarding continued activity prior to the final study measures being obtained.

The results suggested a small effect of this type of program on fatigue and no significant impact on overall anxiety or QOL.