Evaluating the role of wearable technology and patient-reported outcomes to monitor physical function decline in prostate cancer survivors
Abstract
Scientific Objective and Rationale: Physical function decline is a significant problem among older men diagnosed with advanced prostate cancer. While common treatment with androgen deprivation therapy can improve overall survival, it is associated with increased toxicity burden that can result in diminished quality of life. The majority of prostate cancer diagnoses occur in men 65 years or older, who often present with chronic comorbid conditions at time of diagnosis, further adding to the risk for physical function decline. There are currently no validated methods to systematically evaluate and monitor decline in physical function, which often occurs within the first 3 months of treatment. Routine monitoring of patient-reported outcomes is known to improve quality of life and survival among cancer survivors. However, it does not capture the performance-based component of physical function, which requires objective activity assessment. Recent advances in wearable technology present a fresh opportunity to address this need. Wearable activity monitors allow real-time monitoring of daily activity, including step counts, sleep, or heart rate. To date, their role as tools to predict functional outcomes in cancer survivors is relatively unexplored. Based on our previous work, which suggested correlations between objectively assessed step counts, patient-reported outcomes, and physician-assessed performance status, we hypothesize that decline in daily activity, such as step counts, as measured with wearable activity monitors can predict physical function decline. To test this hypothesis, we will measure daily activity with a Fitbit activity monitor in prostate cancer survivors undergoing androgen therapy and determine whether reduction in daily activity, such as step counts, predicts physical function decline at 3 months from treatment initiation. We will develop a model that includes wearable activity monitor outcomes, patient-reported symptoms, and individual characteristics to identify risk factors for physical function decline (Aim 1). We will supplement our analyses with qualitative data from focus groups and in-depth interviews to explore the barriers and facilitators to physical activity in this vulnerable group of men (Aim 2). Applicability of the Research: Our research has direct clinical implications and can be applied to any man diagnosed with advanced prostate cancer who may be at elevated risk for physical function decline. Physical function is integral to achieving and maintaining functional independence in prostate cancer survivors. As physical function decline is potentially preventable, any downstream effects on quality of life may also be prevented. Thus, by identifying prostate cancer survivors at higher risk for physical function decline early in their treatment experience, we can develop strategies and intervene in a timely and appropriate manner. Findings from the second, qualitative research aim will further improve our understanding of the specific needs of prostate cancer survivors and their relationships with their treatment symptoms and physical health. For instance, our findings will inform the development of individualized interventions tailored to Veterans living with prostate cancer, who may present with different risk factors for physical function decline and benefit from other preventive strategies. Our research may also inform the role of wearable technology to monitor physical function in hard-to-reach populations such as those unable to travel to clinic visits, lacking health insurance, or of lower socioeconomic status. As the prostate cancer survivor population continues to grow and the burden of cancer care increases, this will be important as survivors will have the opportunity to self-monitor and engage in their own health care and management. If our research indicates that there is no added value of wearable technology in the assessment of physical function decline, we
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Mar 10, 2021
- Source ID
- W81XWH2010411
Entities
People
- Gillian Gresham
Organizations
- Cedars-Sinai Medical Center
- United States Army