Lifestyle Intervention in Men with Advanced Prostate Cancer Receiving Androgen Suppression Therapy: A Feasibility Study

Abstract

Background: Healthy lifestyle behaviors could have a role in ameliorating some of the adverse effects of androgen suppression therapy (AST) in men with prostate cancer. The primary aim of this study was to assess the feasibility of a tapered supervised exercise program in combination with dietary advice in men with advanced prostate cancer receiving AST.Methods: Advanced prostate cancer patients receiving AST for a minimum of 6 months were randomized to a 12-week lifestyle program comprising aerobic and resistance exercise, plus dietary advice (n ¼ 25), or standard care (n ¼ 25). Exercise behavior, dietary macronutrient intake, quality of life, fatigue, functional fitness, and biomarkers associated with disease progression were assessed at baseline, after the intervention, and at 6 months.Results: The lifestyle group showed improvements in exercise behavior (P < 0.001), dietary fat intake (P ¼ 0.001), total energy intake (P ¼ 0.005), fatigue (P ¼ 0.002), aerobic exercise tolerance (P < 0.001), and muscle strength (P ¼ 0.033) compared with standard care controls. Although a high rate of attrition (44%) was observed at 6 months, the improvements in key health outcomes were sustained. No effects on clinical prostate cancer disease markers were observed.Conclusions: This preliminary evidence suggests that pragmatic lifestyle interventions have potential to evoke improvements in exercise and dietary behavior, in addition to other important health outcomes in men with advanced prostate cancer receiving AST.Impact: This study shows for the first time that pragmatic lifestyle interventions are feasible and could have a positive impact on health behaviors and other key outcomes in men with advanced prostate cancer receiving AST. Cancer Epidemiol Biomarkers Prev; 20(4); 647-57. Ó2011 AACR.

Exercise effects on adipokines and the IGF axis in men with prostate cancer treated with androgen deprivation: A randomized study

“…18 To our knowledge, no studies have assessed the extent to which leptin and adiponectin can be modified with exercise programs for prostate cancer patients receiving ADT who are vulnerable to deleterious changes to body composition that may negatively influence these biomarkers. There is biological plausibility that altering IGFs and adipokines with healthy lifestyle changes may contribute to improved cancer control and survival rate in prostate cancer.…”

“…[34][35][36][37] Beneficial changes in IGF-axis proteins have been observed in vivo with a low-fat diet; routine exercise in older men at risk for prostate cancer has been shown to reduce cancer cell growth in vitro. 30,38,39 To assess whether men undergoing ADT for prostate cancer would experience similar changes in the IGF-axis proteins, Bourke and colleagues 18 randomized 50 patients to 3 months of mixed-modality exercise and dietary advice or usual care. At the end of the intervention, they found no difference between intervention participants and controls in any of the biomarkers.…”

A systematic review and metaethnography to identify how effective, cost-effective, accessible and acceptable self-management support interventions are for men with long-term conditions (SELF-MAN)

“…The majority of the studies were conducted in the USA (n = 23), with the remainder conducted in the UK (n = 6), [71][72][73][74][75][76][77][78] Canada (n = 5), [79][80][81][82][83] Spain (n = 3), [84][85][86][87][88] Sweden (n = 1), 89 Poland (n = 1) 90 and Greece (n = 1). 91 Males with prostate cancer were the most frequently studied male-only population (n = 15) included in this review.…”

Physical Activity and Cancer

“…Despite the potential advantages of supervising cancer survivors during physical activity, supervised programmes are resource-intensive, and therefore are not feasible for delivery in the long-term. Furthermore, Irwin (2008) suggests that home-based interventions which encourage individuals to find ways to fit physical activity into their daily routine may lead to more effective long-term maintenance, and this was supported by Bourke et al (2011) who noted the importance of equipping survivors with the skills and confidence to maintain positive health behaviours independently. Some interventions have involved participants being supervised at the beginning of the programme before leaving them to continue with a physical activity programme individually; alternatively, some interventions have involved both supervised and self-directed approaches with some supervised and some individual sessions each week (e.g.…”