Exercise can prevent and even reverse adverse effects of androgen suppression treatment in men with prostate cancer

Abstract

Side effects accompanying androgen deprivation therapy (ADT), including sarcopenia, loss of bone mass and reduction in muscle strength, can compromise physical function, particularly in older patients. Exercise, specifically resistance training, may be an effective and cost-efficient strategy to limit or even reverse some of these adverse effects during and following therapy. In this review, we discuss common morphological and physiological ADT-related side effects or 'Androgen Deprivation and Sarcopenia-Related Disorders' and the existing clinical trials incorporating physical exercise in prostate cancer patients receiving active therapy. Further, training concepts and guidelines are provided for prescribing resistance exercise programs for this population.

Cardiovascular and metabolic complications during androgen deprivation: exercise as a potential countermeasure

“…50 It is also recommended that patients undertake aerobic exercise (for example, walking, cycling) programs with intensity, volume and frequency similar to those we have previously reported (50-90% maximal heart rate, 20-60 min of continuous or intermittent exercise and 3-5 times per week). 66 Specific recommendations for cancer patients including ADT-treated men can be found in Table 3.…”

“…49 Resistance exercise has considerable potential to counteract the catabolic side effects of ADT by promoting positive effects on the musculoskeletal system. 50 Further, the use of resistance exercise has been reported in the management and prevention of a range of chronic conditions including overweight and mild obesity, diabetes, hypertension and atherosclerotic coronary heart disease. [51][52][53][54][55] Preliminary work 50,56,57 supports the potential beneficial role of resistance exercise in patients diagnosed with prostate cancer undertaking ADT, with improvements in muscle strength, functional performance and psychological outcomes (for example, improvements in quality of life), without compromising androgen suppression and treatment intent.…”

“…50 Men on ADT should initiate a program of resistance training incorporating 7-10 exercises, To convert plasma glucose from mg per 100 ml to mmol l…”

“…[5][6][7][8] Further details on exercise training variables, practical examples of structured resistance programs based on previous studies with ADT-treated men, 56,58 as well as availability of resources (for example, free weights, elastic bands, gravitational weight force machines) have been published elsewhere. 50 Pictorial examples of resistance exercises tailored to cancer patients are available on request by The Cancer Council of Western Australia -http://www.cancerwa.asn.au/. Undertaking resistance exercise in small groups will facilitate adherence and compliance, and also reduce the financial cost to the patient, and this can be suggested to patients.…”

20 years—A retrospective of prostate cancer and prostatic diseases

“…Indeed, multiple studies in PCAN have explored and reviewed exercise to reduce side effects of hormonal therapy showing that exercise can prevent and reverse many of the adverse effects of hormonal therapy [5] while still preserving sexual function [6]. Yet other studies published in PCAN have explored the role of pomegranates for prostate cancer finding initially that treatment appeared to slow the rate of PSA rise in men with recurrent prostate cancer with no dose-effect [7].…”