Skip to main content

Advertisement

Log in

Psychosocial and physical outcomes of in- and outpatient rehabilitation in prostate cancer patients treated with radical prostatectomy

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

A radical prostatectomy might lead to an impaired quality of life. Aim of the study was to analyse the impact of inpatient and outpatient rehabilitation on psychosocial and physical outcomes in patients after surgery.

Methods

Six hundred nineteen inpatients and 95 outpatients, treated for localized prostate cancer by prostatectomy, completed the Hospital Anxiety and Depression Scale (HADS) and two quality-of-life questionnaires (EORTC QLQ-C30 and EORTC QLQ-PR25) at the beginning and end of rehabilitation as well as 12 months after rehabilitation. Data were analysed by using t-tests, chi2 - tests and analyses of variance with repeated measures.

Results

Compared to a population sample, patients reported a significantly worse quality of life (EORTC QLQ-C30) and more anxiety (HADS) at the beginning of rehabilitation. Physical, role and social functioning increased significantly over time for in- and outpatients. Patients still reported lower emotional functioning (EORTC QLQ-C30), anxiety (HADS) and prostate cancer-specific physical symptoms (EORTC QLQ-PR25) 1 year after rehabilitation, although symptom levels decreased significantly over time. The setting did not have an independent significant effect in the multivariate model.

Conclusions

In- and outpatients reported an increased quality of life 1 year after rehabilitation with respect to their physical constitution and their reintegration into social life. Nonetheless, both groups still struggled with problems due to surgery. The results indicated that both settings seem to be supportive in the recovery process but that patients seem to require additional support with aftercare for treating surgery-related problems as well as emotional discomfort.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Robert Koch - Institut & Gesellschaft der epidemiologischen Krebsregister in Deutschland e. V. (2013) Krebs in Deutschland 2009/2010. Eine gemeinsame Veröffentlichung des Robert Koch-Instituts und der Gesellschaft der epidemiologischen Krebsregister in Deutschland e. V., Berlin

  2. GLOBOCAN (IARC) (2014) Section of Cancer Information, 2012. Available at: http://globocan.iarc.fr/Default.aspx [retrieved: 13.07.2015]

  3. Heidenreich A, Bolla M, Joniau S, Mason MD, Matveev V, Mottet N, Schmid H-P, van der Kwast TH, Wiegel T, Zattoni F (2010) Guidelines on prostate cancer. European Association of Urology. Available at: http://uroweb.org/wp-content/uploads/Prostate-Cancer-2010-June-17th.pdf [retrieved: 13.07.2015]

  4. Hellbom M, Bergelt C, Bergenmar M, Gijsen B, Loge JH, Rautalathi M, Smaradottir A, Johansen C (2011) Cancer rehabilitation: a Nordic and European perspective. Acta Oncol 50:179–186

    Article  PubMed  Google Scholar 

  5. Alfano CM, Ganz PA, Rowland JH, Hahn EE (2012) Cancer survivorship and cancer rehabilitation: revitalizing the link. J Clin Oncol 30:904–906

    Article  PubMed  Google Scholar 

  6. Deutsche Rentenversicherung Bund (2014) Abgeschlossene Leistungen zur Rehabilitation. Rentenversicherung in Zeitreihen: 223–240

  7. Bundesarbeitsgemeinschaft für Rehabilitation (2004) Rahmenempfehlungen zur ambulanten onkologischen Rehabiliation vom 22. Januar 2004. Bundesarbeitsgemeinschaft für Rehabilitation (BAR), Frankfurt a. M

  8. Hartmann U, Kluge A, Ring C, Reuss-Borst M (2006) Improvement of anxiety and depression in women with breast cancer during inpatient oncological rehabilitation-results of a prospective study. Rehabilitation (Stuttg) 45:88–94

    Article  CAS  Google Scholar 

  9. Dombo O, Otto U (2005) Quality of life after radical urologic pelvic surgery and impact of inpatient rehabilitation. Urologe A 44:11–28

    Article  CAS  PubMed  Google Scholar 

  10. Weis J, Moser TM, Fachinger D, Bartsch HH (2002) Zielorientierte Evaluation von Maßnahmen der stationären onkologischen Rehabilitation. In: Bengel J, Jäckel WH (eds) Zielorientierte Evaluation in der Rehabilitation. Rehabilitationswissenschaftlicher Forschungsverbund Freiburg/Bad Säckingen. Roderer, Regensburg

  11. Koch U, Gundelach C, Tiemann F, Mehnert A (2000) Partial inpatient oncologic rehabilitation-results of a model project. Rehabilitation (Stuttg) 39:363–372

    Article  CAS  Google Scholar 

  12. Lehmann C, Bergelt C, Welk H-J, Hagen-Aukamp C, Berger D, Koch U (2008) Do outpatient and inpatient rehabilitation programs differ in applied interventions and success? An analysis of medical discharge summaries. Phys Rehab Kur Med 18:59–68

    Article  Google Scholar 

  13. Silver JK, Baima J, Mayer RS (2013) Impairment-driven cancer rehabilitation: an essential component of quality care and survivorship. CA Cancer J Clin 63:295–317

    Article  PubMed  Google Scholar 

  14. Silver JK, Baima J, Newman R, Galantino ML, Shockney LD (2013) Cancer rehabilitation may improve function in survivors and decrease the economic burden of cancer to individuals and society. Work 46:455–472

    PubMed  Google Scholar 

  15. Oldervoll LM, Kaasa S, Hjermstad MJ, Lund JA, Loge JH (2004) Physical exercise results in the improved subjective well-being of a few or is effective rehabilitation for all cancer patients? Eur J Cancer 40:951–962

    Article  CAS  PubMed  Google Scholar 

  16. Stubblefield MD, Schmitz KH, Ness KK (2013) Physical functioning and rehabilitation for the cancer survivor. Semin Oncol 40:784–795

    Article  PubMed  Google Scholar 

  17. Holley S, Borger D (2001) Energy for living with cancer: preliminary findings of a cancer rehabilitation group intervention study. Oncol Nurs Forum 28:1393–1396

    CAS  PubMed  Google Scholar 

  18. Strasser F, Sweeney C, Willey J, Benisch-Tolley S, Palmer JL, Bruera E (2004) Impact of a half-day multidisciplinary symptom control and palliative care outpatient clinic in a comprehensive cancer center on recommendations, symptom intensity, and patient satisfaction: a retrospective descriptive study. J Pain Symptom Manag 27:481–491

    Article  Google Scholar 

  19. Stubblefield MD, Hubbard G, Cheville A, Koch U, Schmitz KH, Dalton SO (2013) Current perspectives and emerging issues on cancer rehabilitation. Cancer 119:2170–2178

    Article  PubMed  Google Scholar 

  20. Winkler J, Stolzenberg H (1999) [Social class index in the Federal Health Survey.] Gesundheitswesen 61(Sonderheft 2):S178–183

    PubMed  Google Scholar 

  21. Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC et al (1993) The European organization for research and treatment of cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376

    Article  CAS  PubMed  Google Scholar 

  22. van Andel G, Bottomley A, Fossa SD, Efficace F, Coens C, Guerif S, Kynaston H, Gontero P, Thalmann G, Akdas A, D’Haese S, Aaronson NK (2008) An international field study of the EORTC QLQ-PR25: a questionnaire for assessing the health-related quality of life of patients with prostate cancer. Eur J Cancer 44:2418–2424

    Article  PubMed  Google Scholar 

  23. Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67:361–70

    Article  CAS  PubMed  Google Scholar 

  24. Schwarz R, Hinz A (2001) Reference data for the quality of life questionnaire EORTC QLQ-C30 in the general German population. Eur J Cancer 37:1345–1351

    Article  CAS  PubMed  Google Scholar 

  25. Hinz A, Schwarz R (2001) Anxiety and depression in the general population: normal values in the Hospital Anxiety and Depression Scale. Psychother Psychosom Med Psychol 51:193–200

    Article  CAS  PubMed  Google Scholar 

  26. Kjaer TK, Johansen C, Ibfelt E, Christensen J, Rottmann N, Hoybye MT, Ross L, Svendsen M, Dalton SO (2011) Impact of symptom burden on health related quality of life of cancer survivors in a Danish cancer rehabilitation program: a longitudinal study. Acta Oncol 50:223–232

    Article  PubMed  Google Scholar 

  27. Osoba D, Rodrigues G, Myles J, Zee B, Pater J (1998) Interpreting the significance of changes in health-related quality-of-life scores. J Clin Oncol 16:139–144

    CAS  PubMed  Google Scholar 

  28. Litwin MS, Gore JL, Kwan L, Brandeis JM, Lee SP, Withers HR, Reiter RE (2007) Quality of life after surgery, external beam irradiation, or brachytherapy for early-stage prostate cancer. Cancer 109:2239–2247

    Article  PubMed  Google Scholar 

  29. Litwin MS, Hays RD, Fink A, Ganz PA, Leake B, Leach GE, Brook RH (1995) Quality-of-life outcomes in men treated for localized prostate cancer. JAMA 273:129–135

    Article  CAS  PubMed  Google Scholar 

  30. Namiki S, Arai Y (2010) Health-related quality of life in men with localized prostate cancer. Int J Urol 17:125–138

    Article  PubMed  Google Scholar 

  31. Sanda MG, Dunn RL, Michalski J, Sandler HM, Northouse L, Hembroff L, Lin X, Greenfield TK, Litwin MS, Saigal CS, Mahadevan A, Klein E, Kibel A, Pisters LL, Kuban D, Kaplan I, Wood D, Ciezki J, Shah N, Wei JT (2008) Quality of life and satisfaction with outcome among prostate-cancer survivors. N Engl J Med 358:1250–1261

    Article  CAS  PubMed  Google Scholar 

  32. Ferrer M, Suarez JF, Guedea F, Fernandez P, Macias V, Marino A, Hervas A, Herruzo I, Ortiz MJ, Villavicencio H, Craven-Bratle J, Garin O, Aguilo F, Multicentric Spanish Group of Clinically Localized Prostate Cancer (2008) Health-related quality of life 2 years after treatment with radical prostatectomy, prostate brachytherapy, or external beam radiotherapy in patients with clinically localized prostate cancer. Int J Radiat Oncol 72:421–432

    Article  Google Scholar 

  33. Lampert T, Kroll LE, von der Lippe E, Muters S, Stolzenberg H (2013) Socioeconomic status and health. Results of the German health interview and examination survey for adults (DEGS1). Bundesgesundhbl Gesundheitsforsch Gesundheitsschutz 56:814–821

    Article  CAS  Google Scholar 

  34. Gülich M, Jäckel WH (2007) Zugang zur Rehabilitation, Rehabilitationsbedarf/-fähigkeit/-potential/-prognose. In: Morfeld M, Mau W, Jäckel WH, Koch U (eds) Querschnitt Rehabilitation, Physikalische Medizin und Naturheilverfahren. Ein fallorientiertes Lehrbuch. Urban, München, pp. 25–31

Download references

Acknowledgments

This study was funded by the “Nordrhein-Westfalen Association for the Fight Against Cancer, Germany” (Arbeitsgemeinschaft für Krebsbekämpfung im Lande Nordrhein-Westfalen, ARGE).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hilke M. Rath.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rath, H.M., Ullrich, A., Otto, U. et al. Psychosocial and physical outcomes of in- and outpatient rehabilitation in prostate cancer patients treated with radical prostatectomy. Support Care Cancer 24, 2717–2726 (2016). https://doi.org/10.1007/s00520-016-3076-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-016-3076-7

Keywords

Navigation