Cardiovascular health and physical activity levels of prostate cancer patients improve following successful interventions by community pharmacies, new research in the British Medical Journal reports.

In the first study of its kind, researchers from the University of Surrey, funded by the Movember Foundation in partnership with Prostate Cancer UK, developed and tested the feasibility of community pharmacies delivering programmes to improve levels of physical activity and diet of men with prostate cancer and those who have successfully completed treatment for the disease. NICE recommends that men with prostate cancer follow a 12-week exercise programme to reduce symptoms after treatment and improve overall wellbeing, but this is hard to support in a hospital setting.

Nine community pharmacy teams in the south of England were trained to deliver health assessments and lifestyle prescriptions to men with prostate cancer or those who had undergone treatment. Pharmacy teams checked the weight, BMI, blood cholesterol and blood pressure of 116 men and assessed their upper-limb strength (grip strength), lower-limb strength (chair sit to stand) and overall fitness. To help improve strength and fitness levels, a computer algorithm developed by the research team used this assessment data to generate a personalised lifestyle prescription, including exercise and dietary advice, for the participants. In support of the lifestyle changes, pharmacy teams made regular phone calls to assist participants and offer guidance.

After a three-month period, participants were invited back to the pharmacy to assess progress. Moderate and vigorous physical activity levels amongst the group were found to have increased significantly by 34 minutes over three months. A reduction in weight by 1kg on average was observed amongst participants, with BMI down by 0.3kg/m2 and cholesterol decreasing by 0.4mmol/l. Grip strength increased on average by 0.2kg (meaning that men were stronger in their arms) and more chair sit to stands reflected better leg strength. These results indicate that support offered by community pharmacies can make a real difference in improving the physical fitness and wellbeing of men.

Sara Faithfull, Professor of Cancer Nursing Practice at the University of Surrey, said: “Exercise and diet have been shown to reduce symptoms of prostate cancer treatment and lessen chances of cardiovascular disease. It is understandable that men who have successfully beaten cancer are reluctant to embark on an exercise regime by themselves, so they need help to know what to do and how much is required to make a difference.”

“Community pharmacies can make a really positive impact to this issue by providing valuable guidance and support for increasing activity levels and ensuring more informed dietary decisions are made. It is encouraging to see a measurable improvement over only three months, but we need to examine further how this could be effective in the longer term.”

Heather Blake, Director of Support and Influencing from Prostate Cancer UK said: “We know that regular exercise and a healthy diet can help some men manage many of the side effects of prostate cancer treatments, as well as improving their mental health and wellbeing.

“We are therefore pleased that this study shows that community pharmacies can support men with prostate cancer to improve their physical activity and cardiovascular health. We now need to determine how this improvement can be sustained over longer periods of time.”

Owen Sharp, CEO of the Movember Foundation said: “We know that some men who have been through prostate cancer treatment are at a higher risk of developing heart disease.

“This study shows that with the right support from community pharmacists, men can be empowered to take charge of their condition which has a positive impact on both their quality of life and overall health.”

Dr Agnieszka Lemanska, Lecturer in Integrated Care at the University of Surrey, said: “Community pharmacies are well placed in many respects to help facilitate lifestyle changes amongst patients. The potential benefits of lifestyle interventions in living with and beyond prostate cancer include decreased disease reoccurrence as well as improvements in quality of life, energy levels and physical function.”

http://dx.doi.org/10.1136/bmjopen-2018-025114

Source: University of Surrey,
Full bibliographic information

Community pharmacy lifestyle intervention to increase physical activity and improve cardiovascular health of men with prostate cancer: a phase II feasibility study; Agnieszka Lemanska, Karen Poole, Bruce A Griffin, Ralph Manders, John M Saxton, Lauren Turner, Joe Wainwright, Sara Faithfull; BMJ Open; June 2019