Exercise may delay biochemical progression of localized prostate cancer while improving cardiorespiratory fitness, according to the results of a small randomized clinical trial.
For the ERASE trial, investigators randomly assigned 52 men (mean age 63.4 years) on active surveillance for localized low- or intermediate-risk prostate cancer to a usual care group or a high-intensity interval training (HIIT) group. Each group had 26 patients.
Men in the HIIT group were asked to complete 12 weeks of thrice-weekly supervised aerobic sessions on a treadmill including eight 2-minute intervals at 85% to 95% peak oxygen consumption. The usual-care group maintained their usual exercise levels.
Compared with the usual-care group, the HIIT group experienced significantly improved peak oxygen consumption (the study’s primary outcome) — which rose by 0.9 mL/kg/min in the HIIT group and decreased by 0.5 mL/kg/min in the usual care group, a team led by Kerry S. Courneya, PhD, of the University of Alberta in Edmonton, Alberta, Canada, reported in JAMA Oncology.
From baseline to post-intervention, the mean PSA level declined from 6.1 ng/mL at baseline to 5.7 ng/mL following intervention in the HIIT group, whereas it increased from 8.3 to 8.6 ng/mL in the usual-care group, resulting in a significant adjusted between-group mean difference of –1.1 ng/mL favoring the HIIT group. The mean PSA velocity decreased from 1.1 to 0.1 ng/mL per year in the HIIT group and from 1.3 to 1.2 ng/mL per year in the usual-care group, resulting in a significant adjusted between-group mean difference of –1.3 ng/mL per year favoring the HIIT group. The investigators adjusted between-group differences for baseline values of the outcomes and resistance exercise behavior.
Dr Courneya’s team found no significant changes in PSA doubling time or testosterone level.
“The findings of this study indicate that exercise may be an effective intervention for improving cardiorespiratory fitness and suppressing the progression of prostate cancer for patients undergoing active surveillance,” the authors concluded.
Kang DW, Fairey AS, Boulé NG, et al. Effects of exercise on cardiorespiratory fitness and biochemical progression in men with localized prostate cancer under active surveillance. JAMA Oncol. Published online August 19, 2021. doi:10.1001/jamaoncol.2021.3067