Assessing the Impact of the Prostate Cancer Patient Empowerment Program (PC-PEP) on Relationship Satisfaction, Quality of Life, and Support Group Participation: A Randomized Clinical Trial

Abstract

Background/Objectives: The Prostate Cancer Patient Empowerment Program (PC-PEP) is a 6-month, home-based intervention aimed at enhancing mental health in men undergoing curative prostate cancer treatment. This exploratory secondary analysis evaluates PC-PEP's impact on relationship satisfaction, quality of life, and support group attendance among partnered participants. Methods: In a crossover randomized clinical trial ClinicalTrials.gov identifier: NCT03660085) of 128 men aged 50-82 scheduled for curative prostate cancer surgery or radiotherapy, 119 participants in relationships were included. Of these, 59 received the 6-month PC-PEP intervention, while 60 were randomized to a waitlist-control arm, receiving standard care for 6 months before starting PC-PEP. The intervention included daily emails with video instructions on mental and physical health, diet, social support, fitness, stress reduction, and intimacy. Outcomes were assessed using the Dyadic Adjustment Scale (DAS) and the Functional Assessment of Cancer Therapy-Prostate (FACT-P). Results: While relationship satisfaction remained stable, a significant improvement in emotional well-being was observed at 12 months in participants undergoing radiation therapy (p = 0.045). The PC-PEP intervention also led to significantly higher support group attendance at both 6 months (p = 0.001) and 12 months (p = 0.003), emphasizing its role in fostering social support and community engagement. Conclusions: The PC-PEP program effectively maintains relationship satisfaction and enhances emotional well-being, particularly in patients with fewer physical side effects. Its design promotes comprehensive care by integrating physical, psychological, and social support, making it a valuable resource for improving the quality of life in prostate cancer patients and potentially applicable to other cancer types.

Keywords: curative treatment; emotional well-being; functional well-being; prostate cancer; radiation therapy; radical prostatectomy; relationship satisfaction; social well-being; spiritual well-being; support group attendance.

Figure 1

Observed means for (A) self-reported distress factors between the control and PC-PEP groups at baseline, 6 months, and 12 months and stratified representations by treatment; (B) radical prostatectomy, (C) radiation therapy among 119 curative prostate cancer patients treated in Nova Scotia, Canada.

Figure 2

Observed means for (A) Dyadic Adjustment Scale (DAS) sum, (B) Consensus, (C) Affection, (D) satisfaction, and (E) Cohesion subscales between the control and PC-PEP groups at baseline, 6 months, and 12 months, with stratified representations by treatment among 119 curative prostate cancer patients treated in Nova Scotia, Canada.

Figure 2

Observed means for (A) Dyadic Adjustment Scale (DAS) sum, (B) Consensus, (C) Affection, (D) satisfaction, and (E) Cohesion subscales between the control and PC-PEP groups at baseline, 6 months, and 12 months, with stratified representations by treatment among 119 curative prostate cancer patients treated in Nova Scotia, Canada.

Figure 2

Observed means for (A) Dyadic Adjustment Scale (DAS) sum, (B) Consensus, (C) Affection, (D) satisfaction, and (E) Cohesion subscales between the control and PC-PEP groups at baseline, 6 months, and 12 months, with stratified representations by treatment among 119 curative prostate cancer patients treated in Nova Scotia, Canada.

Figure 3

Observed means for (A) Functional Assessment of Cancer Therapy–Prostate (FACT-P) Sum and Social Well-being, Emotional Well-being, and Functional Well-being Subscales and Functional Assessment of Chronic Illness Therapy–Spiritual Well-being (FACIT-Sp-12) Sum and Meaning, Peace, and Faith Subscales between the waitlist control and PC-PEP groups at baseline, 6 months, and 12 months and stratified representations by treatment (B) radical prostatectomy vs. (C) radiation among 119 curative prostate cancer patients treated in Nova Scotia, Canada.

Figure 3

Observed means for (A) Functional Assessment of Cancer Therapy–Prostate (FACT-P) Sum and Social Well-being, Emotional Well-being, and Functional Well-being Subscales and Functional Assessment of Chronic Illness Therapy–Spiritual Well-being (FACIT-Sp-12) Sum and Meaning, Peace, and Faith Subscales between the waitlist control and PC-PEP groups at baseline, 6 months, and 12 months and stratified representations by treatment (B) radical prostatectomy vs. (C) radiation among 119 curative prostate cancer patients treated in Nova Scotia, Canada.

Figure 3

Observed means for (A) Functional Assessment of Cancer Therapy–Prostate (FACT-P) Sum and Social Well-being, Emotional Well-being, and Functional Well-being Subscales and Functional Assessment of Chronic Illness Therapy–Spiritual Well-being (FACIT-Sp-12) Sum and Meaning, Peace, and Faith Subscales between the waitlist control and PC-PEP groups at baseline, 6 months, and 12 months and stratified representations by treatment (B) radical prostatectomy vs. (C) radiation among 119 curative prostate cancer patients treated in Nova Scotia, Canada.

Figure 4

The observed means for adherence to the intimacy and connection components of the PC-PEP program were recorded for both the intervention group (who began the intervention early) and the waitlist control group (who started the intervention 6 months after the trial began) over a 26-week period. These observations included the total number of times per day in each week patients spent engaging in the various forms of intimacy prescribed by the program. These data were collected from 128 prostate cancer patients undergoing curative treatment in Nova Scotia, Canada, who participated in the PC-PEP Trial. Note: PC-PEP = Prostate Cancer–Patient Empowerment Program.