PALS

Prostate active living support

Prostate Cancer is the most commonly diagnosed cancer, with 129 men being diagnosed every day and around 400,000 men living with and after prostate cancer intervention in the UK currently. (Source, Prostate Cancer UK). Yet there is still very little specific provision to develop condition management strategies and support the long-term outcomes both physically and psychologically for these survivors. 

Prostate, as with all cancers, is unique in its diagnosis, treatment and outcomes for every individual. Every diagnosis brings a mix of emotions including shock, perhaps anger, worry, a fear for the future, a sense of failure. These feelings may change as treatment progresses for example anxiety, a sense of not being in control, concerns regarding the impact on family and friends and loneliness, plus – why me? 

Treatments vary, as do their outcomes and their impact on the individual, again both physically and psychologically. These may include weight gain, impact on existing or progression of other co-morbidities such as heart disease, diabetes, osteoporosis, sarcopenia, fatigue, bowel problems, urinary problems, erectile dysfunction, hot flushes, pain, anxiety and depression. The impact of just one or two, or perhaps all of possible effects can leave individuals simply at a loss or questioning ‘what can I do?’

Due to the current COVID-19 circumstances this has delayed our pilot programmes and subsequent launch of our new PALS – Prostate Active Living Support programme which was scheduled for the autumn of 2020. We are now hoping to complete our pilots by spring 2021, with the programme being available from June 2021.

Delivered in a community setting, PALS provides a steppingstone opportunity for survivors to engage with purposeful physical activity that supports long term condition management and mental wellbeing. It also provides the means to share experiences, concerns and knowledge with others who are travelling similar journeys creating a greater support network within a localised area.

The programmes aim: to educate, motivate and inspire participants to feel empowered, enabled to be in control of they own condition management, fitness and wellbeing moving forwards. 

In turn, building on their confidence, self-esteem and a sense of worth within the wider community. 

Participants take part in an 8-week intervention, for 2 hours per session in small groups of 10. They can self-refer directly to us or via their Health Care Professional (HCP). Every individual can access our services whether their cancer is localised, locally advanced, if medical intervention has taken place or they are on Active Surveillance. For advanced prostate cancer survivors, it is recommended, as with any physical activity intervention, that they seek medical advice before commencing. 

All participants are seen on an individual basis prior to attendance where our teachers gain an understanding of the participants specific needs and goals as well as conducting our ‘MOT’ fitness assessment to ascertain baseline outcomes relating to both Health Related and Skills Related components. Participants also complete the following questionnaires adding to our programme baseline indictors. These include: 

•  A Standard Participant Activity Readiness Questionnaire (PARQ)
•  A Practical Preparation Form specific to cancer history/side effects of  treatments specific to them/behavioural changes/psychosocial issues
• Postural Observation and Recording 
• The Cancer and Physical Activity Standard Evaluation Framework (CaPASEF) / EQ-5D-3L in association with MacMillan Cancer Support. Recommended Measurement Tools for the Assessment of Quality of Life, Physical Activity and Fatigue (January 2013)
• FACIT Fatigue Scale (Version 4)
• Physical Activity Questionnaire measuring tool for current general activity undertaken for one week 
• In-house Confidence and Self Esteem Questionnaire 

During this one to one meeting participants will be encouraged to share wider concerns which will then create the facilitation of the ‘Care ‘n’ Share’ time discussion. This will vary from group to group and will be ‘needs’ driven. 

The focus of the programme is functional fitness as well as fun. To develop an understanding of the underlining purpose of an holistic approach to physical activity, it uses and purpose and enables us to achieve ADL, Active Daily Living, 
markers along with the positive outcomes in terms of postural stability, falls prevention, condition management and disease suppression. Sessions target: 

• Cardiovascular/Aerobic capacity 
• Muscular strength and endurance 
• Flexibility
• Body Composition
• Skill-Related: power, speed, agility, coordination, balance and reaction time 

 This is complimented with specific condition support for Effective Pelvic Floor Ignition, Bone Health and Weight Management. All the sessions will deliver the benefits and specific correlation needs pertaining to condition management – the how’s and why’s.

There will be an opportunity for a carer, partner or buddy to join them in some specific sessions and these individuals will complete a Physical Activity Readiness 

Questionnaire (PAR Q) prior to participation. This intervention is to assess the participants understanding of the programmes content as we progress, to encourage 
self and the inclusion of others in the sustainability of physical activity through motivation, and to openly share the fun of our programme experience.

Over the 8 weeks, participants will begin to feel the benefits of regular physical activity participation and their adherence will be monitored at 1 month and 6 months post programme. At this time, we will revisit some of the questionnaires and assessments to encourage continuous learning and progression. This information enables the charity to seek further funding in support of providing our programmes free of charge.

You may be a Prostate Cancer survivor who would like to participate or a HCP who has patients that you feel may benefit from PALS. If this is the case, please get in touch with us via our contact page to talk to us further about PALS.