A 12-week Supervised Physical Activity And Behavioural Counselling Program On Prostate Cancer Survivor's Sexual Health

PURPOSE: Sexual dysfunction is one of the most common, distressing, and persistent long-term effects of prostate cancer treatment. However, physical activity (PA) interventions may improve sexual health (SH), particularly if incorporating social (spousal) support. This secondary analysis examines changes in SH after a supervised PA program plus standard exercise counseling (SPA+EC) versus a SPA plus motivationally-enhanced behavioral counseling (SPA+BC) in prostate cancer survivors (PCS). METHODS: This study was a pilot two-armed, randomized controlled trial (RCT). Twenty-three PCS were randomized to a 12-week SPA+EC group (n = 12) or a SPA+BC group (n = 11). The goal of both arms was to gradually meet the guidelines of 150 min/wk of moderate-to-vigorous PA. All PCS had supervised PA sessions that tapered to a home-based program. The SPA+BC group received additional behavioral counseling based on the Multi-Process Action Control Framework including social support (e.g., PA goal setting and action planning with their spouse). The SPA+EC group received PA training counseling (i.e., intensity, safety). PCS completed a battery of questionnaires including the International Index of Erectile Function at baseline and post-intervention (i.e., 12 weeks). Five domains of sexual health were computed: erectile function (EF), orgasmic function (OF), sexual desire (SD), intercourse satisfaction (IS), and overall satisfaction (OS). Separate ANCOVAs examined changes in domains between groups. RESULTS: PCS (N=23; Mage = 66.1 ± 6.8, Myears = 8.3±5.8 since diagnosis; 91% localized cancer). Adherence to the supervised PA sessions were 100% for both groups (12 sessions). Adherence to the home-based sessions was 70% and 92% in the SPA + EC and SPA + BC groups, respectively. Across all five domains, only OS (Mdiff= 0.28, p=0.73, ηp2=0.01) favoured the SPA+BC group. EF (Mdiff= -0.23, p=0.91, ηp2= 0.00), OF (Mdiff= -0.58, p= 0.58, ηp2= 0.02), SD (Mdiff= -0.39, p=0.049, ηp2=0.03), and IS (Mdiff= -1.11, p=0.45, ηp2=0.03) did not result in additional improvements between groups. CONCLUSIONS: Preliminary evidence suggests that eliciting social support with spousal support increases PA and positively impacts overall satisfaction. Larger RCTs powered to examine the role of spousal support on sexual function in PCS are needed. Campus Research Board Award [#RB16051] from the University of Illinois