A randomized, controlled trial of aerobic exercise for treatment‐related fatigue in men receiving radical external beam radiotherapy for localized prostate carcinoma

Abstract

BACKGROUND. Advice to rest and take things easy if patients become fatigued during radiotherapy may be detrimental. Aerobic walking improves physical functioning and has been an intervention for chemotherapy-related fatigue. A prospective, randomized, controlled trial was performed to determine whether aerobic exercise would reduce the incidence of fatigue and prevent deterioration in physical functioning during radiotherapy for localized prostate carcinoma. METHODS. Sixty-six men were randomized before they received radical radiotherapy for localized prostate carcinoma, with 33 men randomized to an exercise group and 33 men randomized to a control group. Outcome measures were fatigue and distance walked in a modified shuttle test before and after radiotherapy. RESULTS. There were no significant between group differences noted with regard to fatigue scores at baseline (P ϭ 0.55) or after 4 weeks of radiotherapy (P ϭ 0.18). Men in the control group had significant increases in fatigue scores from baseline to the end of radiotherapy (P ϭ 0.013), with no significant increases observed in the exercise group (P ϭ 0.203). A nonsignificant reduction (2.4%) in shuttle test distance at the end of radiotherapy was observed in the control group; however, in the exercise group, there was a significant increase (13.2%) in distance walked (P ϭ 0.0003). CONCLUSIONS. Men who followed advice to rest and take things easy if they became fatigued demonstrated a slight deterioration in physical functioning and a significant increase in fatigue at the end of radiotherapy. Home-based, moderateintensity walking produced a significant improvement in physical functioning with no significant increase in fatigue. Improved physical functioning may be necessary to combat radiation fatigue. Cancer 2004;101:550-7.

Exercise therapy across the prostate cancer continuum

“…The men participating in the exercise intervention had significantly higher aerobic fitness (as measured by increased walking distance) than their nonexercising counterparts. 58 These results support that exercise has beneficial effects on muscle strength, aerobic fitness and QOL for patients with PC receiving ADT or radiation therapy as exercise may counter some of the morbid side effects of these treatments. Although the significance of symptom control and improved patient QOL as valuable clinical end points are undisputed, major unanswered questions in this field have yet to be determined.…”

Body Composition, Physical Fitness, Functional Performance, Quality of Life, and Fatigue Benefits of Exercise for Prostate Cancer Patients: A Systematic Review

“…Of the 12 eligible studies, three were categorized as being Level I 57-59 , five as level II 51,[60][61][62][63] and four as Level III-V 63,66 . Aerobic endurance was assessed using walking tests conducted on a treadmill or specific older adult 6 minute, 400 m and shuttle walking tests 51,57,59,[61][62][63][64][65][66] .…”

“…Aerobic endurance was assessed using walking tests conducted on a treadmill or specific older adult 6 minute, 400 m and shuttle walking tests 51,57,59,[61][62][63][64][65][66] . Functional performance was generally assessed with walking speed, STS and TUG tests 61,62,65,66 , all of which are commonly used with older adults to predict physical function and falls risk 67,68 .…”

“…Functional performance was generally assessed with walking speed, STS and TUG tests 61,62,65,66 , all of which are commonly used with older adults to predict physical function and falls risk 67,68 . Quality of life was generally assessed using cancer-specific questionnaires (FACT-P and QLQ-C30) 4 three studies recruited those on radiation therapy 51,59,62 (of which two of these studies also reported that 27.3% 51 and 61.2% 59 of the participants were currently using ADT) and two studies recruited those who were/had used a mixture of ADT and surgery 4,66 . Only in one study was it unclear what treatments were previously or currently employed by the participants 60 .…”

“…Roberts et al 47 also showed that while many physicians who responded to a survey do not disapprove of their cancer patients becoming more physically active, they rarely initiated such discussions. It would appear that the primary barriers influencing the lack of promotion of physical activity by cancer clinicians is their limited knowledge of the current literature on exercise for cancer patients and their relative inability to give specific exercise recommendations to patients or to refer their patients to qualified exercise physiologists 51 .…”