THE "NEW" PROSTATE CANCER INFOLINK

It has long been understood that taking regular exercise can be helpful in management of risk for fatigue among men being treated with androgen deprivation therapy (ADT) for prostate cancer — whatever the stage of prostate cancer that the patient is being treated for.

What we have not known is whether particular types of exercise may be more beneficial that others in mitigating fatigue among such patients, but a newly reported set of data from a group of Australian researchers has given us some additional insight into that question.

Taaffe et al. have just reported results from a randomized clinical trial in which patients being treated with ADT were randomized to one of three different categories of exercise regimen. Patients were enrolled into this trial between 2009 and 2012, and the three different type of exer ise prescribed were the following:

• Supervised exercises targeted primarily to the musculoskeletal system (i.e., impact loading and resistance training or ILRT; n = 58 patients) for a period of 12 months
• Supervised exercises targeted to the cardiovascular and muscular systems (i.e., aerobic and resistance training or ART; n = 54 patients) for an initial period of 6 months followed by a recommendedhome-based program for an additional 6 months
• Usual care  with delayed exercise (DEL; n = 51 patients), in which the patients received a printed booklet containing exercise information followed by a 6-month-long stationary cycling regimen

Thus, all patients were asked to participate in a prescribed exercise program for a period of 12 months, and standard questionnaires were used to assess patient quality of life and vitality along the way. All exercise programs were overseen by university-affiliated exercise clinics in Australia.

Here are the core study findings:

• Participating patients range in age from 43 to 90 years.
• A limitation of the study was that most of the participants were relatively healthy “well-funtioning” individuals.
• Fatigue was significantly reduced (by ~ 5 points) in all three groups of patients compared to baseline levels
  • At 6 months and at 12 months in the ILRT group  (p = 0.005)
  • At 12 months in the ART group (p = 0.005)
  • At 12 months in the DEL group (p = 0.022)
• Vitality was significantly increased (by ~ 4 points) in all three groups (p ≤ 0.001) at 12 months compared to baseline levels.
• Patients with the highest levels of fatigue and lowest levels of vitality at baseline were the ones who benefited the most from the exercise regimens.

It appears (from this study at least) that the type of exercise undertaken by men on ADT may be less important to their levels of fatigue and vitality than simply the taking of exercise on a regular basis … and perhaps we shouldn’t be surprised by this (but it is nice to have the confirmation).

And of course if exercise is good for men with prostate cancer who are on ADT, then why wouldn’t it also be good for men who aren’t (so long as they don’t overdo it too soon after treatment)?

Filed under: Living with Prostate Cancer, Management | Tagged: ADT, androgen, deprivation, exercise |