Non‐Medical Interventions to Improve Functional Outcomes for Men Undergoing Radiotherapy for Prostate Cancer: A Systematic Review

Purpose This study aimed to identify and evaluate non‐medical interventions (exercise, psychosocial, diet and nutrition, or a combination thereof) to improve functional outcomes (fatigue, mental wellbeing, sexual function, bowel function and urinary function) in men undergoing prostate cancer radiotherapy. Methods An electronic search of six databases (CINAHL, Embase, Emcare, Medline via Ovid, Scopus and The Cochrane Library) was conducted for studies published in English from 1990 onwards. Randomised controlled trials (RCTs) and quasiexperimental studies regarding non‐medical interventions delivered before, during or after radiotherapy for prostate cancer to improve functional outcomes were included in this review. Two‐stage screening (title/abstract and full text) was conducted against predefined inclusion and exclusion criteria. Data were extracted using a standardised form, and risk of bias was assessed using Joanna Briggs Institute critical appraisal tools. Results Twenty‐five RCTs and seven quasiexperimental studies met the eligibility criteria. Aerobic and resistance exercises showed promising results in improving fatigue, while multidisciplinary rehabilitation showed promise in improving urinary function. However, inconsistent findings prevented definitive conclusions about the effect of exercise on other functional outcomes. Additionally, the impact of psychosocial and dietary interventions on functional outcomes remains inconclusive due to the limited number of studies, small sample sizes, non‐randomised study design and study quality. Conclusion There is a lack of strong evidence supporting the effectiveness of non‐medical interventions in improving functional outcomes after prostate cancer radiotherapy, except for aerobic and resistance exercises for fatigue and multidisciplinary rehabilitation for urinary function. More rigorous RCTs are needed to address this evidence gap. Implications for Cancer Survivors Engaging in aerobic and/or resistance exercise can likely reduce fatigue, and multidisciplinary rehabilitation may improve urinary function in prostate cancer patients who receive radiotherapy.