THE "NEW" PROSTATE CANCER INFOLINK

A small, but randomized Phase II clinical trial has shown benefits of structured yoga classes for men receiving radiation therapy for the treatment of prostate cancer. The results of this trial have recently been reported by Ben-Joseph et al. in the “Red Journal”.

The trial appears to have been very straightforward. Between October 2014 and January 2016, 68 eligible prostate cancer patients initially agreed to participate in the study. All of the patients had to be “yoga naive”. In other words, they had no prior experience of practicing yoga. They were then randomized to one of two groups:

• Patients in the yoga group were scheduled to receive twice-weekly yoga classes during the 6 to 9 weeks of their radiation therapy.
• Patients in the no-yoga group were not offered any form of supplementary care.

The study’s primary endpoint was any effect on fatigue. Secondary endpoints included effects on a variety of other known side effects of radiation therapy, including erectile dysfunction, urinary continence, and quality of life.

Here are the core findings of the study:

• Of the 68 patients who initially agreed to participate in the study
  • 18 withdrew early (primarily because of treatment schedule-related time constraints)
  • 28 were in the no-yoga group
  • 22 were in the yoga group (the control group)
• Over the full course of the study, the men in the yoga group
  • Reported less overall fatigue than the men in the non-yoga group
  • Demonstrated significant effects of the yoga on global fatigue, impact of fatigue, and severity of fatigue subscales
  • Displayed a significant impact on sexual health scores (based on the IIEF-5  survey data)
• While the men in the yoga group had improvements in the emotional, physical, and social scores for quality of life, there was no impact on their functional quality of life scores as compared to the men in the control group.

The authors conclude that, among prostate cancer patienst undergoing radiation therapy

A structured yoga intervention of twice-weekly classes during a course of radiotherapy was associated with a significant reduction in pre-existing and [radiotherapy]-related fatigue, urinary and sexual dysfunction.

Now this is obviously just a small, Phase II trial, but it continues to support the other recent studies that have shown benefits for prostate cancer patients associated with participation in structured, exercise-related programs as a component of the patients’ overall care for their prostate cancer.

One of the most interesting aspects of this study, however, is that clear impact could be observed on fatigue levels after as little as 6 to 9 weeks of doing (or not doing) yoga.

Your sitemaster is becoming increasingly convinced that building formal recommendations for exercise-related activities, and possibly the support of nutritional counseling, into guidelines for the management of prostate cancer is now a key element in the overall treatment of this disorder because it helps men with the psychological adjustment to their disease as well as demonstrating at least one aspect of how they can  still “live well” with their prostate cancer.  This is a topic that we will continue to explore over the next few months.

There is likely to be a need for larger randomized trials to be able to “prove” the impact of things like yoga and diet on fatigue levesl and quality of life after a diagnosis with prostate cancer, but the overall costs of running such trials (by comparison with the costs of conducting trials of new pharmaceutical agents) is probably relatively low.

Filed under: Living with Prostate Cancer, Management, Treatment | Tagged: exerice, radiation, structured, therapy, trial, yoga |