Exercise and radiotherapy: a controlled, randomized trial

It has long been known that external beam radiotherapy for treatment of prostate cancer may cause unfavorable changes in fatigue, quality of life (QOL), and physical fitness. This commentary discusses the results from the Prostate Cancer Radiotherapy and Exercise Versus Normal Treatment study, conducted in Canada.

Between 2003 and 2006, Segal et al. investigated the effects of resistance or aerobic training versus usual care on fatigue, QOL, physical fitness, body composition, and PSA, testosterone, hemoglobin, and lipid levels in men with prostate cancer who received radiotherapy.

This was a randomized, controlled trial, conducted in Ottawa, Canada, in which a total of 121 patients initiating radiotherapy with or without androgen deprivation therapy were randomly assigned to usual care (n = 41), resistance (n = 40), or aerobic exercise (n = 40) for 24 weeks. The primary end point was fatigue assessed by the Functional Assessment of Cancer Therapy-Fatigue scale.

The authors state the following results of the trial:

  • The follow-up assessment rate for our primary end point of fatigue was 92.6 percent.
  • Median adherence to the prescribed exercise regimen was 85.5 percent.
  • Both resistance training and aerobic exercise significantly mitigated fatigue over the short term.
  • Resistance exercise also produced longer-term improvements.
  • Compared with usual care, resistance training improved QOL, aerobic fitness, upper- and lower-body strength, and triglyceride levels, while preventing an increase in body fat.
  • Aerobic training also improved fitness.
  • One serious adverse event occurred in the group that performed aerobic exercise.

The authors conclude that, in the short term, both resistance and aerobic exercise mitigated fatigue in men with prostate cancer receiving radiotherapy. Resistance exercise generated longer-term improvements and additional benefits for QOL, strength, triglycerides, and body fat.

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