THE PHYSIOLOGICAL AND PSYCHOSOCIAL EFFECTS OF A 16-WEEK COMBINED AEROBIC AND RESISTANCE EXERCISE PROGRAM IN MEN RECEIVING ANDROGEN DEPRIVATION THERAPY FOR PROSTATE CANCER

Abstract

Objectives: Men who receive androgen deprivation therapy (ADT) for prostate cancer (PCa) are at risk of several adverse effects that can be detrimental to both their physical and mental health. Common adverse effects include weight gain, muscle wasting, cardiovascular morbidity, fatigue and impaired quality of life (QOL). This study tested whether a combined aerobic and resistance exercise program can alleviate some of these symptoms in men receiving ADT. Design: Men with PCa, aged 50-80 years, receiving ADT were recruited to participate in this prospective randomized controlled trial. Subjects were assigned to a usual care group (UCG) or an exercise intervention group (EIG). The EIG completed a 16 week combined aerobic and resistance exercise program. Outcomes measures were assessed at baseline, 16 weeks, and 24 weeks and included: cardio-respiratory fitness; muscle strength and endurance; body composition; and reports of QOL, fatigue, mood, partner relations, and exercise behaviour. Results: Fifteen men were recruited to this study, but two participants in the EIG did not finish the study leaving the EIG with an n = 6 and the UCG with an n = 7. The exercise program did not lead to changes in weight, BMI or body fat. There was a small, close to significant, increase in muscle mass in the EIG over the intervention period (p = 0.052). This is encouraging as it demonstrates that exercise can counteract the catabolic effects of ADT. Interestingly, cardio-respiratory fitness improved over the course of the study for both groups. Muscular fitness, however, improved only for the EIG. There was a significant difference in chest press strength (p = 0.041) and leg press strength was bordering significance (p = 0.058). Unexpectedly, QOL declined for both groups during the intervention (p = 0.029). Participants in both groups also reported increased levels of fatigue from baseline to 24 weeks, although these changes were not significant (p = 0.586). Mood worsened over the study period for both groups from baseline to 16 weeks, but this increase in anxiety and depression was reduced at the follow-up period. These changes, too, were not significant (p = 0.364). Reports of partner relationships trended towards lower scores from baseline to 16 weeks. The men’s report in both groups and the women’s report in the EIG improved at the 24 week mark, but women in the UCG experienced further decline. Surprisingly, participants in both groups reported increases in exercise behaviour from baseline to 24 weeks. This could account for the lack of difference found in many of the measures. The power of this study was 0.22. Conclusion: Although this was a small study, it showed that a combined aerobic and resistance exercise program can have some positive benefits for men with PCa who are receiving ADT. Larger trials are needed to further examine the role of exercise in ameliorating the side effects of ADT, particularly in the areas of mood and partner relationships.