A recent scoping review of randomized clinical trials (RCTs) indicates that prehabilitation and rehabilitation programs, incorporating exercise, nutrition, and psychological support, can substantially improve the quality of life for bladder cancer patients and survivors. The analysis, encompassing data from January 2004 to March 2022, highlights the potential of these interventions to alleviate the sequelae of bladder cancer and its treatment.
The review, which systematically searched six databases, identified 24 unique RCTs involving 2471 participants with bladder cancer. The studies focused on outpatient (p)rehabilitative programs, assessing outcomes across eight clinically relevant categories. A significant 71% (17 of 24) of the interventions yielded statistically significant results for the outcome of interest.
Psychological and Physical Interventions
Notably, psychological support interventions showed considerable promise, with 8 out of 11 RCTs demonstrating statistically significant results. Similarly, exercise interventions also proved effective, with 9 out of 11 RCTs showing statistically significant improvements. Educational interventions, nutritional support, and pharmacologic medications also showed some efficacy, though to a lesser extent.
Multimodal and Personalized Approaches
The review suggests that the most promising interventions for multimodal, personalized (p)rehabilitation programs include exercise, stress management training, cognitive training, smoking and alcohol cessation counseling, immunonutrition, stoma education, and penile rehabilitation. These approaches address various aspects of patient well-being, potentially leading to more comprehensive and effective care.
The Need for Further Research
Despite the promising findings, the authors emphasize the need for further research, particularly regarding cost-effectiveness and the efficacy of interventions for caregivers. Only one RCT included a cost-effectiveness analysis, and only two characterized the efficacy of interventions for caregivers, highlighting a gap in the current evidence base.
According to the study authors, clinicians should consider implementing such interventions for those affected by bladder cancer. The evidence suggests that a holistic approach, combining physical and psychological support, can significantly enhance patient outcomes and improve overall quality of life.
