The Relationship of Physical Activity with Age, Anxiety, Physical and Mental Health and the Symptoms Experienced in Men with Early Prostate Cancer Prior to Therapy
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Prostate cancer (PC) is a significant public health problem, affecting 1 out of 8 men in their lifetime. With the advent of early detection and improved therapies, the number of prostate cancer survivors is increasing, with an estimated 2.5 million prostate cancer survivors currently living in the United States. Research shows that physical activity (PA) maintains function in the elderly. Evidence also shows that PA decreases anxiety, urinary, bowel and sexual dysfunction symptoms in non-cancer populations. PA in prostate cancer survivors improves general quality of life (QOL) and fatigue, but the relationship between PA and genitourinary and bowel symptoms in PC survivors is unknown. These symptoms may be life-changing. Seventy percent of cancer survivors do not meet recommended levels of PA. Low levels of PA in elderly patients increase risk for symptoms and decreased function during treatment. A review of the literature, presented in the first manuscript, reveals that PA positively affects general QOL of PC survivors. Evidence also supports PA as an effective intervention for decreasing fatigue with some preliminary findings showing attenuation of other symptoms such as pain and depression. While fitness improved with PA, it is not clear if increased fitness plays a role in symptom mitigation, or if body composition changes impact patient outcomes. The potential contribution of diet is also unknown. Little evidence exists regarding PA and dietary interventions on urinary, bowel or sexual dysfunctional symptoms. Accurate measurement of PA, diet and body composition, lacking in most studies, is critical to better understand how PA and dietary interventions control genitourinary and bowel symptoms experienced by PC survivors. The second manuscript addresses the topic of PA and body composition measurement. The third manuscript is the research study of this dissertation conducted to determine the relationships among PA, age, co-morbidities, anxiety, mental and physical health and symptoms, particularly those related to genitourinary and bowel dysfunction, experienced by men with PC prior to therapy. The study design is a correlational/cross sectional secondary analysis of de-identified data from self-reported instruments of 258 men with early stage PC prior to initiation of therapy. Study findings showed urinary, bowel and sexual dysfunction symptoms experienced by men at time of diagnosis were similar to men of similar age without prostate cancer, indicating age as the dominant predictor of symptoms. This dissertation provides a foundation for a program of research of PA interventions for managing urinary, bowel and sexual dysfunction symptoms in PC survivors. The study identified potential mechanisms of symptoms in early stage PC that warrant further testing. Symptoms related to sexual dysfunction may be especially amenable to PA.