Improving Physical and Mental Health in Patients with Prostate Cancer Undergoing Androgen Deprivation Therapy: Strategies to Promote and Improve Physical Activity Quality and Quantity

Abstract

Objective: Prostate cancer continues to be one of the highest incident cancers among men.Reducing serum testosterone with androgen deprivation therapy (ADT) is a common effective treatment. While well demonstrated for cancer suppression, there are numerous adverse effects caused by ADT that can contribute to short-and long-term prognosis. Increased levels of physical activity (PA) during treatment may reduce these side effects, however uptake of PA is low. The purpose of this review is to identify and evaluate current literature on strategies to promote and increase the levels of PA in patients with prostate cancer undergoing ADT.Data sources: Electronic databases including CINAHL, MEDLINE, PsychINFO, Scopus, and grey literature were searched using Google scholar up until April 2020. Conclusion:At present the most appropriate modes and dosages of PA for specific ADT toxicities is not known. It is established that some PA in the form of exercise, whether aerobic or resistance, is better than being sedentary for improvements in physical health, but beyond this prescription specifics have not been established. Further research is required to understand the impact of PA on the mental and physical health of prostate cancer men undergoing ADT. Implications for Nursing Practice:Being physically active and avoiding sedentary behaviour is important for men with prostate cancer undergoing ADT, especially the implementation of strength training. Physical activity in the form of exercise can assist in reducing the adverse physical side effects in the short-and long-term, with limited understanding of the effects on mental health.Physical activity improves mental health outcomes across populations, which may also translate to men with prostate cancer, although further research is required. An important strategy to improve PA within the prostate cancer population is to provide an early referral to an exercise professional such as an Accredited Exercise Physiologist/Clinical Exercise Physiologist or Physical Therapist/Physiotherapist and is supported by research as best practice for people affected by cancer undergoing active treatment.

Mental Health in Urologic Oncology

“…Health Psychology Research other studies notating the benefits that physical activity and avoiding sedentary behavior has on mental health: one study discussed the benefits of physical activity for PCa patients undergoing ADT and another study reported that lower levels of aerobic exercise was associated with reduced physical and mental health for PCa patients with bone metastases. 49,50 In conclusion, for PCa patients, we found a greater number of studies citing associations with mental health effects and incidence for MHI post-interventional treatment such as RP, RT, and ADT given QoL marker changes. However, one study noted on potential greater incidence for anxiety post AS.…”

Effect of Aerobic Exercise on Mental Health in Older Adults: A Meta-Analysis of Randomized Controlled Trials

“…First, the quality of the included literature needs to be analyzed in terms of reliability. All the included studies were RCTs with the highest experimental grade, and all the studies were conducted in strict accordance with the established process for randomized controlled trials ( 45 ), except for four experimental designs with unclear random assignment methods and blinding points ( 11 , 27 , 33 , 37 ). The included studies were reliable, with more than 70% to ensure a low risk of bias.…”