A feasibility study of a home-based exercise intervention for prostate cancer patients on androgen deprivation therapy

Purpose: Androgen deprivation therapy (ADT) is an effective treatment for advanced-stage prostate cancer. Unfortunately, ADT has several adverse effects that significantly impair health-related quality of life (HRQOL). In patients receiving ADT, resistance training has been shown to improve important physical and psychosocial outcomes. However, little is known about the effects of aerobic exercise in this population. This feasibility study compares the effects of aerobic and resistance exercise interventions on a panel of psychological, physical fitness, and biological outcomes related to prostate cancer and ADT.

Methods: 66 men receiving ADT for prostate cancer were recruited for this prospective, randomized trial. Participants are assigned to either a resistance or aerobic, moderate-intensity exercise 3-5 times per week for 30-60 minutes/session. Participants were provided with equipment so that they could exercise at home. The primary outcomes were related to feasibility for future, large-scale trials. Secondary outcomes included: fatigue, HRQOL, physical fitness, adipokines, insulin-like growth factor axis proteins, and exercise adherence. Outcomes were assessed at baseline and at 3, 6, and 12 months.

Results: Preliminary findings are presented. 205 patients were approached for participation, 66 of which agreed to participate (n=34 in the resistance training group and 32 in the aerobic training group). Over the intervention period we experienced an attrition rate of 33%. There were no adverse events and biweekly booster sessions were poorly attended (n=27 aerobic training participants and n=22 resistance training participants did not attend any booster sessions). Intention-to-treat analyses showed that fatigue and HRQOL were not significantly different between groups; however, in a per-protocol analysis the resistance-training group demonstrated clinically significant improvements in HRQOL. Differential within-groups effects on physical fitness and biomarkers were also observed at various time-points. At all time-points, the aerobic training group engaged in significantly more physical activity than the resistance training group.

Conclusion: Our findings suggest that both resistance and aerobic training can have positive effects on body composition with differential effects on psychosocial and biological outcomes. It appears that the aerobic exercise intervention was more effective at producing long-term, clinically significant increases in physical activity volume than resistance training. Our study has set the framework to conduct future clinical trials investigating the effects of exercise in men treated for prostate cancer.