Improving sexual health in men with prostate cancer through exercise and psychosexual therapies

INTERVENTION: EXERCISE INTERVENTION The physical exercise intervention program will include 6 months of resistance (i.e. lifting weights) and aerobic exercise (e.g. walking, jogging, cycling) undertaken 3 times per week in an exercise clinic. Exercise sessions will take approximately 60 minutes and will be conducted in small groups under the supervision of an accredited exercise physiologist. EXERCISE + PSYCHOSEXUAL INTERVENTION This intervention program will involve the same exercise intervention as described above as well as a brief psychosexual self‐management intervention that addresses psychological and sexual well‐being. Participants will attend a single, 60 minute, one‐on‐one psycho‐educational session with their exercise physiologist and receive a self‐management kit. Specifically, the education session addresses: stress management; problem solving coping for treatment challenges; and goal setting for sexual rehabilitation. This session will occur during the week prior to initiating the exercise program. The self‐management kit includes: a published self‐help book for men with prostate cancer and their partners; study specific tip sheets about treatments for erectile dysfunction and goal setting for sexual rehabilitation; a progress journal‐diary; and audio resources for stress management. CONDITION: Prostate Cancer Sexual Dysfunction PRIMARY OUTCOME: Sexual health as determined by European Organisation for Research and Treatment of Cancer prostate cancer specific questionnaire. Sexual health as determined by the Expanded Prostate Cancer Index Composite questionnaire. Sexual Health as determined by the International Index of Erectile Functioning questionnaire. SECONDARY OUTCOME: Body image as determined by the Body Image Scale. Fatigue as determined by the Functional Assessment of Chronic Illness Therapy‐Fatigue questionnaire. Masculine self‐esteem as determined by the Masculine Self‐Esteem Scale. Physical activity levels as determined by an accelerometer activity monitor worn for 7 days. Physical function as determined by 400‐m walk (aerobic capacity), one repetition maximum in the leg press and chest press (muscular strength), repeated chair rise (muscular power), usual and fast pace 6‐m walk (ambulation), and backwards tandem 6‐m walk (balance). Psychological distress as determined by the Brief Symptom Inventory‐18. Quality of life as determined by the Medical Outcomes Short Form 36. Relationship satisfaction as determined by the Dyadic Adjustment Scale. Sexual self‐confidence as determined by the Short Form Psychological and Interpersonal Relationship Scale Sexual supportive care needs as determined by the Supportive Care Needs Survey. Testosterone, C‐reactive protein and Prostate Specific Antigen as determined by a blood sample. Utilisation of sexual aids as determined by a scale assessing whether participants have sought medical assistance for sexual dysfunction. All treatments will be documented and the impact of these treatments rated. Whole body and regional fat and lean mass as determined by Dual Energy X‐Ray Absorptiometry. INCLUSION CRITERIA: 1. Prior and/or current treatment for prostate cancer including prostatectomy, radiotherapy or androgen deprivation therapy 2. Being concerned about sexual health (as assessed by International Index of Erectile Functioning overall satisfaction score and/or Expanded Prostate Cancer Index Composite sexual bother score)