Peppone, Luke J.

11625 Background: Improving body image and self-esteem are top ASCO priorities in the survivorship care of men with prostate cancer (PCa). Body image and global self-esteem, influenced by physical self-worth, are negatively affected by PCa treatment. We investigate whether exercise can improve physical self-worth in men treated for PCa and if improving self-worth is associated with changes in quality of life (QoL) and mental health. Methods: We performed a secondary analysis of a phase II randomized controlled trial comparing the effects of Exercise for Cancer Patients(EXCAP), a structured, 6-week, home-based exercise intervention, to usual care (UC) in men with non-metastatic PCa receiving radiation or Androgen Deprivation Therapy (ADT). The Physical Self-Perception Profile (PSPP), a valid 30-item questionnaire where higher scores indicate greater physical self-worth, was assessed at pre- and post-intervention. Changes between arms were compared using ANCOVA. Spearman correlations were calculated for pre/post-intervention change scores for PSPP and QoL, depression, and anxiety as measured by the Functional Assessment of Cancer Therapy (FACT), Center of Epidemiologic Studies Depression (CES-D) scale, and State-Trait Anxiety Inventory (STAI), respectively. Results: Fifty-eight men were randomized; average age was 67.1 years. Physical self-worth at baseline moderated the effect of the intervention. Compared to UC, EXCAP improved physical self-worth in those with baseline PSPP scores above the median (p < 0.04). Exercisers with baseline PSPP scores in the top quartile demonstrated a more significant improvement over UC (p < 0.01). Improvements in physical self-worth were associated with improved QoL (r = 0.29, p = 0.04), depression (r = -0.28, p = 0.04) and anxiety (r = -0.30, p = 0.03). Conclusions: Exercise significantly improves physical self-worth in men with PCa on radiation or ADT, and greater physical self-worth is associated with improved QoL, depression and anxiety. Those with higher baseline physical self-worth derived the most benefit from exercise. Exercise should be prescribed to boost self-esteem and body image in men receiving radiation or ADT for PCa. Clinical trial information: NCT00815672.

Abstract As the number of cancer survivors expands, the need for cancer control and survivorship research becomes increasingly important. The National Cancer Institute (NCI) Cooperative Groups may offer a viable platform to perform such research. Observational, preventive, and behavioral research can often be performed within the cooperative group setting, especially if resources needed for evaluation are fairly simple, if protocols are easily implemented within the typical clinical setting, and if interventions are well standardized. Some protocols are better suited to cooperative groups than are others, and there are advantages and disadvantages to conducting survivorship research within the cooperative group setting. Behavioral researchers currently involved in cooperative groups, as well as program staff within the NCI, can serve as sources of information for those wishing to pursue symptom management and survivorship studies within the clinical trial setting. The structure of the cooperative groups is currently changing, but going forward, survivorship is bound to be a topic of interest and one that perhaps may be more easily addressed using the proposed more centralized structure. Cancer Epidemiol Biomarkers Prev; 20(5); 1050–5. ©2011 AACR.