Most prostate cancer is found early, when men are likely to get intense treatment. Researchers who thought it makes sense to offer men and their families more help dealing with side effects studied this issue and reported their findings in the journal Cancer (Vol. 94, No. 6:1854-1866).

Merle H. Mishel, PhD, RN, at the University of North Carolina in Chapel Hill, and colleagues said treatment side effects can cause men (and their families) distress, and can affect their quality of life. Not knowing how to cope only makes matters worse.

Mishel said men receiving treatment for early stage prostate cancer often have serious problems after surgery or radiation therapy. They may have trouble controlling urine (incontinence) and difficulty with bowel movements. In addition, they may have fatigue, and they may not be able to have sex.

In the study, 327 white and African-American men who had recently undergone treatment were given two types of care. Either they had “normal” care (visits with the doctors and answers to their questions) or special care.

In the special care group, trained nurses contacted these men every week for eight weeks to discuss any troubles the men were having. Then the nurses offered advice on what to expect and how to deal with the problems.

By teaching the men, and in some cases another member of their family as well, the researchers hoped to improve the symptoms and decrease the problems men have following prostate cancer treatment.

One of the interesting aspects of the study was the match of nurse to patient or spouse by both race and sex. The idea was to make each man or woman comfortable with the nurse.

Mishel said, “Matching by ethnicity was intended to address the lingering suspicions of African Americans about research participation based on (other) trials that resulted in mistrust of the health care establishment.”

The nurses even taught men how to ask their doctors questions. To promote the men’s sense of “self-advocacy," the nurses gave them assertiveness training as well.

Four months into the study, the men who received the special contact were better problem solvers than those who just relied on their doctors for help. But, by seven months, the treatment group became less able to solve problems, while the group that relied just on the usual doctor visits for help improved.

All groups had improvement in their symptoms. One of the most important differences was urine control, a problem that can lead to all sorts of other difficulties.

The nurses taught exercises to the men. This helped them learn how to control their urine flow. As a result, their control was much better than the group that only saw the doctor.

In the nurse treatment group, sexual function was improved for the African-American men.

This study showed that working with men and their families is an important means of improving their ability to cope with a serious disease, its treatment, and the sometimes serious side effects of treatment. It gave them help when they needed it.

“Men who received the intervention commented that one of its most meaningful aspects was that it provided a means for patients to get questions answered about treatment side effects and information about how to manage those side effects,” Mishel said.

Unexpected events also became more manageable as a result of the nurses’ efforts. Providing information about community and other resources (such as the Internet), and teaching the men how to use them, helped the men to improve their problem solving skills, Mishel said.

Spouses, working with the nurses, also played an important role in helping the men to solve their problems.

But, most important to the men was the information they received, and knowing that someone cared. “They did not feel alone,” concluded Mishel.