Exercise Training Improves Quality of Life for PCa Patients

Supervised exercise programs incorporating resistance training can improve the quality of life of men with prostate cancer (PCa).

Investigators led by Riccardo Valdagni, MD, PhD, and Lara Bellardita, PsyD, PhD, of the Fondazione IRCSS Istituto Nazionale dei Tumori in Milan, Italy, conducted a systematic review of randomized controlled trials (RCTs) testing lifestyle interventions, such as diet or exercise, for PCa patients. They identified 17 RCTs published 2003 to 2015 involving 1989 patients (aged 65 to 74) from 7 countries. Quality of life was the main end point and was assessed by various tools, such as the generic Short Form 36 Health Survey (SF-36) and the disease-specific Functional Assessment of Cancer Therapy-Prostate scale (FACT-P).

Due to study heterogeneity, meta-analyses could not be performed. Eight studies involved patients undergoing androgen deprivation therapy (ADT)—for whom exercise is recommended to reduce adverse effects—3 radiation therapy, and 1 each active surveillance, radical prostatectomy, and radiation plus ADT. The remaining studies included different active treatments. Control groups received standard care or active monitoring.

The quality of the evidence was strongest for exercise interventions, which lasted 4 weeks up to 8 years and were supervised by exercise physiologists, specialists, or kinesiotherapists, according to results published in Oncology Hematology. The findings on dietary or combined interventions were less robust, although cutting calories potentially reduces body mass index and thereby improves quality of life.

In most studies on physical activity, resistance exercises, such as weightlifting for 6 months, significantly improved patients’ quality of life, along with mood, fatigue, physical functioning, and sexual functioning. A 2009 study by Roanne Segal, MD, FRCPC, et al, for example, found that resistance training provided lasting benefits compared with aerobics involving walking, jogging, or cycling (J Clin Oncol 2009 Jan 20;27(3):344-51). In addition, a 2007 study by Uma Monga, MD, et al. found that an 8-week cardiovascular exercise program for patients with localized PCa treated with radiation improved cardiovascular fitness, flexibility, muscle strength, fatigue, and quality of life (Arch Phys Med Rehabil. 2007 Nov;88(11):1416-22). 

“…[E]xercises where the body’s musculature has to work against some type of resistance should be particularly proposed for PCa patients,” according to Dr  Valdagni, Dr Bellardita, and colleagues. “Resistance training based on improving muscles strengths was also shown to have positive effects on mood and physical functioning of healthy older men.”

Patient motivation is a key aspect for the success of any program, the investigators noted. They encouraged additional research, especially quality studies on age-based exercise programs.