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Supportive Care / Symptom Management (Prevention of Cancer Morbidity)

Projects and Investigators

Targeted, Tailored and Timely (T3) Symptom Management for Prostate Cancer

Program Description

This exploratory study addresses the lack of systematic and structured symptom management targeted to men receiving radiation therapy ( androgen deprivation therapy) for prostate cancer. Because there is not a systematic and regular assessment of symptoms, they may go undetected. Patients may not report problems due to embarrassment, perceived busyness of providers, or lack of recognition that interventions are available to help. There is a lack of systematic educational programs to teach patients the self-care strategies that they can employ to manage their symptoms. As treatment ends, access to symptom management dwindles at the time when it is needed the most. This lack of access is compounded for older men who may have limited transportation and for those who reside in small towns or rural communities where resources are lacking. The long term goal of this research is to develop the most effective ways of improving quality of life for the increasing number of cancer survivors. The overall aims of this pilot study are (1) to test the feasibility and (2) to establish the initial efficacy and estimate the effect size of providing a systematic, structured, evidence- based symptom management intervention for older adult men with prostate cancer. T3 symptom management is an innovative approach which is targeted to the symptoms experienced by men with prostate cancer, tailored to the man's preferred learning method, and timed to when the symptoms are most likely to occur. The "T3" intervention provides a model to reach older adult prostate survivors, including men from rural communities, as they are completing radiation therapy. The targeted symptoms fatigue, insomnia, pain, urinary and bowel problems, hot flashes, depression and anxiety, This pilot study is an exploratory clinical trial which uses an experimental "patient preference" design with repeated measures in which two study groups will be compared in a 2:1 ratio: (1) the T3 symptom management intervention in which patients choose one of three preferred learning methods (n=72) or (2) usual care (n=36). One hundred and eight men (age 60 and older) who are completing radiation therapy ( androgen deprivation therapy) for prostate cancer and experiencing either a moderate level of symptom distress will be recruited to participate in the study from 2 settings in Utah and Arizona. It is anticipated that 40% of the participants (n=43) will reside in rural communities. All intervention and data collection methods will be delivered via computer (self-directed group only), mail, or telephone thus making them accessible to both rural and urban men with prostate cancer. One in 6 men will develop prostate cancer. This exploratory study addresses the lack of systematic and structured symptom management targeted to men receiving radiation therapy ( androgen deprivation therapy) for prostate cancer. Because there is not a systematic and regular assessment of symptoms, they may go undetected. Patients may not report problems due to embarrassment, perceived busyness of providers, or lack of recognition that interventions are available to help. This program can contribute to increasing knowledge about how to improve quality of life for men with prostate cancer by testing an innovative approach that targets troublesome symptoms and allows men to choose how they want to learn.