Exercise-induced attenuation of treatment side-effects in newly diagnosed prostate cancer patients beginning androgen deprivation therapy: a randomised controlled trial

Objectives: 1) To assess whether exercise training attenuates the adverse effects of treatment in newly diagnosed prostate cancer patients beginning androgen deprivation therapy (ADT), and 2) to examine whether exercise-induced improvements are sustained after the withdrawal of supervised exercise. Patients and methods: Fifty prostate cancer patients scheduled for ADT were randomised to an exercise group (n = 24) or a control group (n = 26). The exercise group completed 3-months of supervised aerobic and resistance exercise training (2x/week for 60 min), followed by 3-months of self-directed exercise. Outcomes were assessed at baseline, 3-months, and 6-months. The primary outcome was difference in fat mass at 3-months. Secondary outcomes included fat-free mass, cardiopulmonary exercise testing variables, QRISK2 score, anthropometry, blood-borne biomarkers, fatigue, and quality of life (QoL). Results: At 3-months, exercise training prevented adverse changes in peak oxygen uptake (1.9 ml.kg-1.min-1, p = 0.038), ventilatory threshold (1.7 ml.kg-1.min-1, p = 0.013), oxygen uptake efficiency slope (0.21, p = 0.005) and fatigue (4.5, p = 0.024) compared with controls. After the supervised exercise was withdrawn, the differences in cardiopulmonary fitness and fatigue were not sustained, but the exercise group showed significantly higher QoL (8.5, p = 0.034) and a reduced QRISK2 score (-2.9%, p = 0.041) compared to controls. Conclusion: A short-term programme of supervised exercise for prostate cancer patients beginning ADT results in sustained improvements in QoL and cardiovascular event risk profile.