Rehabilitation for Individuals with Genitourinary Cancers
Preliminary evidence suggesting need for cancer rehabilitation
in prostate, bladder, testicular and kidney cancers
Overview of the Research

Bladder cancer:

A systematic review published in 2018 found five RCTs and one non-randomized study looking at the impact of exercise and psychosocial interventions for patients with bladder cancer undergoing radical cystectomy. Exercise was found to have a positive impact on physical fitness, health-related quality of life, function (activities of daily living) and muscle strength. Psychosocial interventions had an impact on mental health, health-related quality of life (HRQOL) and fatigue.1

Kidney cancer:

In a large Surveillance, Epidemiology and End Results (SEER) sample, of approximately 19,000 patients, about 29 percent had at least one functional impairment and 16 percent had two or more. Two of the common impairments were fall-related injury and mobility-related use of an assistive device. Functional impairment was associated with increased risk of medical or geriatric events, and mortality. Authors suggest prehabilitation as a way to potentially improve care and decrease costs.2 Functional health is associated as a significant predictor in survival for adults with kidney cancer who undergo surgery.3 Kidney cancer can impact psychosocial and physical function if supportive care needs remain unmet.4

Prostate cancer:

Prevalence of falls, balance and walking problems are significantly higher in adults with prostate cancer than other cancers (other than lung) and compared to those without cancer.5 Although rehabilitation is highly recommended to treat balance impairment, falls are not asked about or documented in the medical chart, 6 Functional health is associated as a significant predictor in survival for adults with kidney cancer who undergo surgery. 3 Kidney cancer can impact psychosocial and physical function if supportive care needs remain unmet.7-9

Men with prostate cancer have lower employment rates, higher risk of early retirement, longer absences from work 10 and decreased ability to complete physical work-related tasks11 compared to men without a cancer diagnosis.12 In Germany, a study of cancer rehabilitation for men with prostate cancer immediately following radical prostatectomy demonstrated to return 87 percent of them back to work.13

Testicular cancer:

In small studies, preliminary data suggests adults treated with cisplatin-based chemotherapy demonstrate negative changes in cognitive function.14 In a larger study (72 individuals) cognition impairment was found in a majority (62.5 percent) in the sample suggesting the impact of treatment on cognition is higher than initially considered.15

Adults with extensive treatment for testicular cancer are at a higher risk of long-term work loss.16 Men with testicular cancer who are able to participate in high-intensity training (exercise) were able to improve quality of life and decrease fatigue.17

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  1. Rammant E, Decaestecker K, Bultijnck R, et al. A systematic review of exercise and psychosocial rehabilitation interventions to improve health-related outcomes in patients with bladder cancer undergoing radical cystectomy. Clin Rehabil. 2018;32(5):594-606.
  2. Tan HJ, Shirk JD, Chamie K, Litwin MS, Hu JC. Patient Function and the Value of Surgical Care for Kidney Cancer. J Urol. 2017;197(5):1200-1207.
  3. Tan HJ, Chamie K, Daskivich TJ, Litwin MS, Hu JC. Patient function, long-term survival, and use of surgery in patients with kidney cancer. Cancer. 2016;122(24):3776-3784.
  4. Jones J, Bhatt J, Avery J, et al. The kidney cancer research priority-setting partnership: Identifying the top 10 research priorities as defined by patients, caregivers, and expert clinicians. Can Urol Assoc J. 2017;11(12):379-387.
  5. Huang MH, Blackwood J, Godoshian M, Pfalzer L. Prevalence of self-reported falls, balance or walking problems in older cancer survivors from Surveillance, Epidemiology and End Results—Medicare Health Outcomes Survey. Journal of geriatric oncology. 2017;8(4):255-261.
  6. Guerard EJ, Deal AM, Williams GR, Jolly TA, Nyrop KA, Muss HB. Falls in older adults with cancer: Evaluation by oncology providers. Journal of oncology practice. 2015;11(6):470-474.
  7. Cheville A, Beck L, Petersen T, Marks R, Gamble G. The detection and treatment of cancer-related functional problems in an outpatient setting. Supportive Care in Cancer. 2009;17(1):61-67.
  8. Cheville AL, Kornblith AB, Basford JR. An Examination of the Causes for the Underutilization of Rehabilitation Services Among People with Advanced Cancer. American Journal of Physical Medicine & Rehabilitation. 2011;90(5):S27-S37.
  9. Pergolotti M, Deal AM, Lavery J, Reeve BB, Muss HB. The prevalence of potentially modifiable functional deficits and the subsequent use of occupational and physical therapy by older adults with cancer. J Geriatr Oncol. 2015;6(3):194-201.
  10. Bradley CJ, Oberst K, Schenk M. Absenteeism from work: the experience of employed breast and prostate cancer patients in the months following diagnosis. Psycho-Oncology. 2006;15(8):739-747.
  11. Oberst K, Bradley CJ, Gardiner JC, Schenk M, Given CW. Work task disability in employed breast and prostate cancer patients. J Cancer Surviv. 2010;4(4):322-330.
  12. Bradley CJ, Neumark D, Luo Z, Bednarek H, Schenk M. Employment Outcomes of Men Treated for Prostate Cancer. JNCI: Journal of the National Cancer Institute. 2005;97(13):958-965.
  13. Ullrich A, Rath HM, Otto U, et al. Return to work in prostate cancer survivors - findings from a prospective study on occupational reintegration following a cancer rehabilitation program. BMC Cancer. 2018;18(1):751.
  14. Amidi A, Hosseini SMH, Leemans A, et al. Changes in Brain Structural Networks and Cognitive Functions in Testicular Cancer Patients Receiving Cisplatin-Based Chemotherapy. JNCI: Journal of the National Cancer Institute. 2017;109(12):djx085-djx085.
  15. Amidi A, Wu LM, Pedersen AD, et al. Cognitive impairment in testicular cancer survivors 2 to 7 years after treatment. Supportive Care in Cancer. 2015;23(10):2973-2979.
  16. Nord C, Olofsson S-E, Glimelius I, et al. Sick leave and disability pension among Swedish testicular cancer survivors according to clinical stage and treatment. Acta Oncologica. 2015;54(10):1770-1780.
  17. Adams SC, DeLorey DS, Davenport MH, Fairey AS, North S, Courneya KS. Effects of high-intensity interval training on fatigue and quality of life in testicular cancer survivors. British Journal of Cancer. 2018;118(10):1313-1321.