title: Male coping through a long-term cancer trajectory. Secondary outcomes from a RTC examining the effect of a multidisciplinary rehabilitation program (RePCa) among radiated men with prostate cancer.
abstract: BACKGROUND
  The objective of this study was to examine if rehabilitation influenced self-reported male coping styles during and up to three years after treatment with radiotherapy for prostate cancer.
  
  
  METHODS
  In a single-center oncology unit in Odense, Denmark, 161 prostate cancer patients treated with radiotherapy and androgen deprivation therapy were included in a randomized controlled trial from 2010 to 2012. The trial examined the effect of a multidisciplinary rehabilitation program within six months of treatment consisting of two nursing counseling sessions and two instructive sessions with a physical therapist (n = 79), or standard care (n = 82). As secondary outcomes coping was measured before radiotherapy, one month after radiotherapy (baseline), six month post-intervention (assessment) and three years after radiotherapy (follow-up) by the Mini-mental adjustment to cancer scale (Mini-MAC). The male coping styles towards the illness are expressed in five mental adjustment styles: Fighting Spirit, Helplessness-Hopelessness, Anxious Preoccupation, Fatalism and Cognitive Avoidance. Descriptive analysis and multiple linear regression analysis adjusting for the longitudinal design were conducted.
  
  
  RESULTS
  Most coping styles remained stable during the patient trajectory but Anxious Preoccupation declined from before radiotherapy to follow-up in both intervention and control groups. After six months the intervention group retained Fighting Spirit significantly (p = 0.025) compared with controls, but after three years this difference evened out. After three years the intervention group had lower Cognitive Avoidance (p = 0.044) than the controls. Factors as educational level, and depression influenced the use of coping styles after three years.
  
  
  CONCLUSIONS
  Multidisciplinary rehabilitation in irradiated prostate cancer patients retained the adjustment style Fighting Spirit stable after six months of radiotherapy, and in the long term reduced Cognitive Avoidance. Thus, the rehabilitation program supported the patient's active coping style and played down the passive coping style.
authors.affiliation: a Department of Oncology , Odense University Hospital , Odense C , Denmark.
authors.forename: Karin B
authors.initials: KB
authors.lastname: Dieperink
authors.affiliation: b Survivorship , Danish Cancer Society Research Center , Copenhagen , Denmark.
authors.forename: Christoffer
authors.initials: C
authors.lastname: Johansen
authors.affiliation: a Department of Oncology , Odense University Hospital , Odense C , Denmark.
authors.forename: Steinbjørn
authors.initials: S
authors.lastname: Hansen
authors.affiliation: c Farvergården , Vejby , Denmark.
authors.forename: Lis
authors.initials: L
authors.lastname: Wagner
authors.affiliation: d Statistics, Bioinformatics and Registry , Danish Cancer Society Research Center , Copenhagen , Denmark.
authors.forename: Klaus
authors.initials: K
authors.lastname: K Andersen
authors.affiliation: e Department of Rehabilitation , Odense University Hospital, Odense C , Denmark.|f Health Sciences Research Centre, University College Lillebaelt , Denmark.
authors.forename: Lisbeth R
authors.initials: LR
authors.lastname: Minet
authors.affiliation: a Department of Oncology , Odense University Hospital , Odense C , Denmark.
authors.forename: Olfred
authors.initials: O
authors.lastname: Hansen
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D003071:Cognition; D003863:Depression / Q000523:psychology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000523:psychology* / Q000532:radiotherapy / Q000534:rehabilitation*