Effects of aerobic exercise training in anemic cancer patients receiving darbepoetin alfa: a randomized controlled trial. Physical activity for men receiving androgen deprivation therapy for prostate cancer: benefits from a 16-week intervention A lifestyle intervention among elderly men on active surveillance for non-aggressive prostate cancer: a randomised feasibility study with whole-grain rye and exercise Benefits of partnered strength training for prostate cancer survivors and spouses: results from a randomized controlled trial of the Exercising Together project A randomized, controlled trial of aerobic exercise for treatment‐related fatigue in men receiving radical external beam radiotherapy for localized prostate carcinoma Lifestyle Intervention in Men with Advanced Prostate Cancer Receiving Androgen Suppression Therapy: A Feasibility Study Physical exercise for functional capacity, blood immune function, fatigue, and quality of life in high-risk prostate cancer patients during radiotherapy: a prospective, randomized clinical study. Effects of nonlinear aerobic training on erectile dysfunction and cardiovascular function following radical prostatectomy for clinically localized prostate cancer. Effect of a 2-year home-based endurance training intervention on physiological function and PSA doubling time in prostate cancer patients Effects of a lifestyle intervention on endothelial function in men on long-term androgen deprivation therapy for prostate cancer Effects of resistance training frequency on physical functioning and quality of life in prostate cancer survivors: a pilot randomized controlled trial Exercise prevents fatigue and improves quality of life in prostate cancer patients undergoing radiotherapy. Football training improves lean body mass in men with prostate cancer undergoing androgen deprivation therapy. Physical Activity and Survival After Prostate Cancer. A Walking Intervention Among Men With Prostate Cancer: A Pilot Study Resistance exercise in men receiving androgen deprivation therapy for prostate cancer. Age and androgen-deprivation therapy on exercise outcomes in men with prostate cancer The Effect on Bone Outcomes of Home-based Exercise Intervention for Prostate Cancer Survivors Receiving Androgen Deprivation Therapy: A Pilot Randomized Controlled Trial Randomized controlled trial of the effects of aerobic exercise on physical functioning and quality of life in lymphoma patients. Skeletal response to resistance and impact training in prostate cancer survivors. Effects of strength training on body composition, physical functioning, and quality of life in prostate cancer patients during androgen deprivation therapy A randomized trial of aerobic versus resistance exercise in prostate cancer survivors. Novel physical activity interventions for older patients with prostate cancer on hormone therapy: A pilot randomized study. A Clinician Referral and 12-Week Exercise Training Program for Men With Prostate Cancer: Outcomes to 12 Months of the ENGAGE Cluster Randomized Controlled Trial. Updated systematic review of exercise studies in breast cancer survivors: attention to the principles of exercise training Randomized controlled trial of resistance or aerobic exercise in men receiving radiation therapy for prostate cancer. Lifestyle changes for improving disease-specific quality of life in sedentary men on long-term androgen-deprivation therapy for advanced prostate cancer: a randomised controlled trial. Associations of Postdiagnosis Physical Activity and Change from Prediagnosis Physical Activity with Quality of Life in Prostate Cancer Survivors
BACKGROUND Anemia in patients with solid tumors is a common problem that is associated with impaired exercise capacity , increased fatigue , and lower quality of life ( QoL ) . Erythropoiesis-stimulating agents ( ESAs ) have been shown to improve these outcomes ; however , it is unknown if additional benefits can be achieved with aerobic exercise training . METHODS We conducted a single-center , prospect i ve , r and omized , controlled trial in 55 mild-to-moderately anemic patients with solid tumors . Patients were r and omized to either darbepoetin alfa alone ( DAL , n = 29 ) or darbepoetin alfa plus aerobic exercise training ( DEX ; n = 26 ) . The DEX group performed aerobic exercise training three times per week at 60%-100 % of baseline exercise capacity for 12 weeks . The primary endpoint was QoL assessed by the Functional Assessment of Cancer Therapy-Anemia scale . Secondary endpoints were fatigue , cardiorespiratory fitness ( VO(2peak ) ) , hemoglobin ( Hb ) response , and darbepoetin alfa dosing . RESULTS Intention-to-treat analyses indicated significant improvements in QoL and fatigue in both groups over time but there were no between-group differences . The DEX group had a significantly greater VO(2peak ) than the DAL group ( mean group difference , + 3.0 ml/kg per minute ; 95 % confidence interval , 1.2 - 4.7 ; p = .001 ) and there were borderline significant differences in favor of the DEX group for Hb response and darbepoetin alfa dosing . CONCLUSIONS Aerobic exercise training did not improve QoL or fatigue beyond the established benefits of DAL but it did result in favorable improvements in exercise capacity and a more rapid Hb response with lower dosing requirements . Our results may be useful to clinicians despite the more recent restrictions on the indications for ESAs Goals of workProstate cancer patients receiving and rogen deprivation therapy ( ADT )  are vulnerable to a number of potentially debilitating side effects , which can significantly impact quality of life . The role of alternate therapies , such as physical activity ( PA ) , in attenuating these side effects is largely understudied for such a large population . Thus , the purpose of this study was to investigate the effects of PA intervention for men receiving ADT on PA behavior , quality of life , and fitness measures . Patients and methods One hundred participants were r and omized into an intervention ( n = 53 ) or a wait-list control group ( n = 47 ) , with 11 dropping out of the intervention group and 23 dropping out of the wait-list control group prior to post-testing . The intervention consisted of both an individually tailored home-based aerobic and light resistant training program and weekly group sessions .  PA , quality of life , fitness , and physiological outcomes were assessed pre and post the 16-week intervention . Results Significant increases in PA , supported by changes in girth measures and blood pressure , support the beneficial impact of the intervention . Positive trends were also evident for depression and fatigue . However , due to the high dropout rate , these results must be interpreted with caution . Conclusions PA effectively attenuates many of the side effects of ADT and should be recommended to prostate survivors as an alternate therapy . Determining the maintenance of this behavior change will be important for underst and ing how the long-term benefits of increased activity levels may alleviate the late effects of ADT Background The prognosis for men with non-aggressive prostate cancer is good , and several studies have investigated the impact of lifestyle changes including physical activity and diet on the prognosis . Despite positive results in animal studies and a few human interventions with whole-grain rye on markers of prostate cancer progression , the feasibility of trials investigating such dietary changes in combination with physical activity remains largely unstudied . The primary aim was to investigate the feasibility of an intervention with high whole-grain rye intake and vigorous physical activity for 6 months in men diagnosed with prostate cancer . Methods In total , 26 men ( 53–72 years ) recently diagnosed with non-aggressive prostate cancer and on active surveillance , were enrolled in 2011–2012 and r and omly assigned to an intervention or a control group . The intervention included 170 g/day of whole-grain rye and 3 × 45 minutes/week of vigorous physical activity . The duration of the intervention was 6 months and end of follow-up 12 months after baseline . Clinic visits were scheduled at baseline and 3 , 6 and 12 months after baseline . Compliance with the intervention was evaluated by diaries , food frequency question naires , biomarkers , and heart rate monitor data . The effect of the intervention was evaluated by linear multiple regression analysis . Results In the intervention group , the mean daily intake of whole-grain rye measured from diaries was 146 g ( SD : 19 ) for the first 3 months and 125 g ( SD : 40 ) for the last 3 months of the intervention . The median level ( 5th and 95th percentiles ) of vigorous physical activity was 91 ( 17 , 193 ) min/week for the first 3 months and 66 ( 13 , 259 ) min/week for the last 3 months . No recordings of physical activity were done for the control group . Aerobic fitness ( VO2 peak ) increased in the intervention group compared to the control group after the intervention . No effects were found on other cardio-metabolic outcomes or prostate cancer progression . Conclusions The lifestyle intervention appeared feasible for 6 months among Danish men and the results are encouraging for conducting full-scale studies , where the impact of whole-grain rye and vigorous physical activity on prostate cancer progression and metabolic parameters can be evaluated . Trial registration Clinical Trials.gov , NCT01300104 . Registered on 18 February 2011 Background Prostate cancer can negatively impact quality of life of the patient and his spouse caregiver , but interventions rarely target the health of both partners simultaneously . We tested the feasibility and preliminary efficacy of a partnered strength training program on the physical and mental health of prostate cancer survivors ( PCS ) and spouse caregivers . Methods Sixty-four couples were r and omly assigned to 6 months of partnered strength training ( Exercising Together , N = 32 ) or usual care ( UC , N = 32 ) . Objective measures included body composition ( lean , fat and trunk fat mass ( kg ) , and % body fat ) by DXA , upper and lower body muscle strength by 1-repetition maximum , and physical function by the physical performance battery ( PPB ) . Self-reported measures included the physical and mental health summary scales and physical function and fatigue subscales of the SF-36 and physical activity with the CHAMPS question naire . Results Couple retention rates were 100 % for Exercising Together and 84 % for UC . Median attendance of couples to Exercising Together sessions was 75 % . Men in Exercising Together became stronger in the upper body ( p < 0.01 ) and more physically active ( p < 0.01 ) than UC . Women in Exercising Together increased muscle mass ( p = 0.05 ) and improved upper ( p < 0.01 ) and lower body ( p < 0.01 ) strength and PPB scores ( p = 0.01 ) more than UC . Conclusions Exercising Together is a novel couples-based approach to exercise that was feasible and improved several health outcomes for both PCS and their spouses . Implication s for cancer survivorsA couples-based approach should be considered in cancer survivorship programs so that outcomes can mutually benefit both partners . Trial registration Clinical Trials.gov Advice to rest and take things easy if patients become fatigued during radiotherapy may be detrimental . Aerobic walking improves physical functioning and has been an intervention for chemotherapy‐related fatigue . A prospect i ve , r and omized , controlled trial was performed to determine whether aerobic exercise would reduce the incidence of fatigue and prevent deterioration in physical functioning during radiotherapy for localized prostate carcinoma Background : Healthy lifestyle behaviors could have a role in ameliorating some of the adverse effects of and rogen 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 r and omized to a 12-week lifestyle program comprising aerobic and resistance exercise , plus dietary advice ( n = 25 ) , or st and ard care ( n = 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 = 0.001 ) , total energy intake ( P = 0.005 ) , fatigue ( P = 0.002 ) , aerobic exercise tolerance ( P < 0.001 ) , and muscle strength ( P = 0.033 ) compared with st and ard 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 . © 2011 AACR BACKGROUND During radiotherapy ( RT ) , prostate cancer ( PCa ) patients may report cancer related fatigue ( CRF ) , which impairs functional capacity , psychological status , and quality of life ( QoL ) . RT can induce cytokine responses that could play a role in mediating radiation toxicity by increasing inflammation . While it is known that physical exercise plays an important anti-inflammatory role in healthy adults , its specific anti-inflammatory effects in PCa patients with CRF have not yet been determined . AIM Previous studies have shown that physical exercise in cancer patients undergoing RT improves cardiac fitness , muscle strength , and QoL , however it is still unknown how physical exercise affects inflammation and its specific consequences in PCa patients . Therefore , the purpose of this trial was to examine the effect of supervised physical exercise on inflammatory blood markers , as well as the relationship of these parameters with functional capacity , fatigue , and QoL in high-risk PCa patients undergoing RT .  DESIGN This was a prospect i ve , two-arm r and omized controlled clinical trial . SETTING The study was performed in our out patients center . POPULATION Fifty-four high-risk PCa men were r and omly allocated to two groups prior to undergoing RT . METHODS Twenty-seven patients performed supervised , moderate-intensity physical exercise ( exercise group ; EG )  and the other 27 formed a control group that carried out normal daily physical activity ( usual group ; UG ) . The following parameters were assessed before and after RT : functional capacity , changes in blood count variables and production of pro-inflammatory cytokines ( interleukin [IL]-1β , IL-6 , tumor necrosis factor [TNF]-α ) , fatigue , and QoL ( using FACT-F score and EORTC question naires ) . RESULTS No significant differences existed between the study groups at baseline assessment . After RT , there was a significant improvement in functional capacity ( P<0.05 ) and a decrease in pro-inflammatory cytokine levels ( P>0.05 ) and fatigue ( P<0.05 ) in the EG compared to the UG . Fatigue level was significantly higher in the UG ( F[2.126 ] ; P<0.05 ) after RT than before . Physical exercise had no effect on the correlation between inflammatory blood markers and functional capacity and fatigue scores provided by study participants . CONCLUSIONS Regular , moderate-intensity physical exercise improves functional capacity , decreases the production of inflammatory markers and fatigue , and has a positive influence on QoL in high-risk PCa patients during RT . CLINICAL REHABILITATION IMPACT This is one of the first studies to examine the effects of supervised exercise training on pro-inflammatory cytokine levels during RT in PCa patients by measuring functional capacity , fatigue , and UNLABELLED Erectile dysfunction ( ED ) is a major adverse effect of radical prostatectomy ( RP ) . We conducted a r and omized controlled trial to examine the efficacy of aerobic training ( AT ) compared with usual care ( UC ) on ED prevalence in 50 men ( n=25 per group ) after RP . AT consisted of five walking sessions per week at 55 - 100 % of peak oxygen uptake ( VO2peak ) for 30 - 60 min per session following a nonlinear prescription . The primary outcome was change in the prevalence of ED , as measured by the International Index of Erectile Function ( IIEF ) , from baseline to 6 mo . Secondary outcomes were brachial artery flow-mediated dilation ( FMD ) , VO2peak , cardiovascular ( CV ) risk profile ( eg , lipid profile , body composition ) , and patient-reported outcomes ( PROs ) . The prevalence of ED ( IIEF score ≤ 21 ) decreased by 20 % in the AT group and by 24 % in the UC group ( difference : p=0.406 ) . There were no significant between-group differences in any erectile function subscale ( p>0.05 ) . Significant between-group differences were observed for changes in FMD and VO2peak , favoring AT . There were no group differences in other markers of CV risk profile or PROs . In summary , nonlinear AT does not improve ED in men with localized prostate cancer in the acute period following RP . TRIAL REGISTRATION Clinical trials.gov identifier NCT00620932 Aim Physical activity after prostate cancer diagnosis has been shown to reduce the risk of disease progression . Here , we aim ed to evaluate the effect of a 2-year home-based endurance training intervention on body composition , biomarkers levels , and prostate-specific antigen ( PSA ) doubling time as a surrogate end-point for progressing disease . Methods Out-clinic patients with either biochemical recurrence following radical prostatectomy or patients managed on active surveillance were r and omized to either 24 months ( 3 times/week ) of home-based endurance training or usual care .  Aerobic fitness , body composition , insulin sensitivity , and biomarkers were measured at 0 , 6 , and 24 months of intervention . PSA doubling time ( PSADT ) was calculated based on monthly PSA measurements . Results Twenty-five patients were enrolled , and 19 patients completed the study .  PSADT increased in the training group from 28 to 76 months ( p < 0.05 ) during the first 6 months and was correlated with changes in VO2max ( p < 0.01 , r2 = 0.41 ) . The training group lost 3.6 ± 1.0 kg ( p < 0.05 ) exclusively as fat mass , yet the changes in body composition were not associated with the increased PSADT . The training group showed significant improvements in plasma triglycerides , adiponectin , IGF-1 , IGFBP-1 , and fasting glucose levels , but no changes in insulin sensitivity ( measured as Matsuda index ) , testosterone , cholesterols , fasting insulin , plasma TNF-alpha , IL-6 , or leptin levels . The control group showed no changes in any of the evaluated parameters across the 2-year intervention . Conclusion In this small r and omized controlled trial , we found that improvements in fitness levels correlated with increasing PSADT , suggesting a link between training and disease progression Background : Treatment of prostate cancer with and rogen deprivation therapy ( ADT ) is associated with metabolic changes that have been linked to an increase in cardiovascular risk . Methods : This r and omised controlled trial investigated the effects of a 12-week lifestyle intervention that included supervised exercise training and dietary advice on markers of cardiovascular risk in 50 men on long-term ADT recruited to an on-going study investigating the effects of such a lifestyle intervention on quality of life . Participants were r and omly allocated to receive the intervention or usual care . Cardiovascular outcomes included endothelial function ( flow-mediated dilatation ( FMD ) of the brachial artery ) , blood pressure , body composition and serum lipids . Additional outcomes included treadmill walk time and exercise and dietary behaviours . Outcomes were assessed before r and omisation ( baseline ) , and 6 , 12 and 24 weeks after r and omisation . Results : At 12 weeks , the difference in mean relative FMD was 2.2 % ( 95 % confidence interval ( CI ) 0.1–4.3 , P=0.04 ) with an effect size of 0.60 ( 95 % CI < 0.01–1.18 ) favouring the intervention group . Improvements in skeletal muscle mass , treadmill walk time and exercise behaviour also occurred in the intervention group over that duration ( P<0.05 ) . At 24 weeks , only the difference in treadmill walk time was maintained . Conclusions : This study demonstrates that lifestyle changes can improve endothelial function in men on long-term ADT for prostate cancer . The implication s for cardiovascular health need further investigation in larger studies over longer duration Background : Resistance training ( RT ) improves muscular strength , physical functioning and quality of life in prostate cancer survivors , but the optimal frequency of RT is unknown . We conducted a pilot r and omized controlled trial to compare the effects of 3 versus 2 days per week of RT in prostate cancer survivors diagnosed within the past 2 years . Methods : Prostate cancer survivors ( N=30 ) were r and omized to 12 weeks of supervised RT  performed either 3 days per week ( n=16 ) or 2 days per week ( n=14 ) . The primary outcome was muscular strength assessed by a multiple repetition maximum test at baseline and postintervention . Secondary outcomes were objective physical functioning , quality of life and psychosocial functioning . Results : A trend ( P<0.10 ) and /or potentially meaningful effects ( st and ardized effect size d⩾0.20 ) were found favoring 3 days per week over 2 days per week for the primary outcome of lower body strength ( mean difference=27.8 kg ; 95 % confidence interval=−0.9 to 56.5 ; P=0.057 ; d=0.72 ) and for the secondary outcomes of 30-s chair st and ( d=0.29 ; P=0.31 ) , sit and reach ( d=0.24 ; P=0.33 ) , 6 -min walk ( d=0.21 ; P=0.42 ) and the physical component summary ( d=0.21 ; P=0.41 ) . Conversely , a trend and /or potentially meaningful effects were found favoring 2 days per week over 3 days per week for the mental component summary ( d=−0.38 ; P=0.10 ) , mental health ( d=−0.44 ; P=0.11 ) , vitality ( d=−0.31 ; P=0.28 ) , role-emotional ( d=−0.23 ; P=0.43 ) , anxiety ( d=0.32 ; P=0.29 ) , happiness ( d=−0.31 ; P=0.36 ) and perceived stress ( d=0.23 ; P=0.39 ) . Conclusions : This pilot r and omized dose – comparison trial provides preliminary data to suggest that RT 3 days per week compared with 2 days per week may improve the strength and physical functioning in prostate cancer survivors , but may also blunt improvements in psychosocial functioning . Larger and more targeted phase II and III trials are needed to confirm the potentially complex effects of RT frequency in prostate cancer survivors OBJECTIVE To show fatigue prevention and quality of life ( QOL ) improvement from cardiovascular exercise during  radiotherapy .  DESIGN Prospect i ve enrollment ( n=21 ) , r and omized to exercise ( n=11 ) and control groups ( n=10 ) , with pre- and post-radiotherapy between- and within-group comparisons . SETTING Academic medical center . PARTICIPANTS Localized prostate cancer patients undergoing radiotherapy . INTERVENTIONS The interventional group received radiotherapy plus aerobic exercise 3 times a week for 8 weeks whereas the control group received radiotherapy without exercise . MAIN OUTCOME MEASURES Pre- and post-radiotherapy differences in cardiac fitness , fatigue , depression , functional status , physical , social , and functional well-being , leg strength , and flexibility were examined within and between 2 groups . RESULTS No significant differences existed between 2 groups at pre-radiotherapy assessment . At post-radiotherapy assessment , the exercise group showed significant within group improvements in : cardiac fitness ( P<.001 ) , fatigue ( P=.02 ) , Functional Assessment of Cancer Therapy-Prostate ( FACT-P ) ( P=.04 ) , physical well-being ( P=.002 ) , social well-being ( P=.02 ) , flexibility ( P=.006 ) , and leg strength ( P=.000 ) . Within the control group , there was a significant increase in fatigue score ( P=.004 ) and a decline in social well-being ( P<.05 ) at post-radiotherapy assessment . Between-group differences at post-radiotherapy assessment were significant in cardiac fitness ( P=.006 ) , strength ( P=.000 ) , flexibility ( P<.01 ) , fatigue ( P<.001 ) , FACT-P ( P=.006 ) , physical well-being ( P<.001 ) , social well-being ( P=.002 ) , and functional well-being ( P=.04 ) . CONCLUSIONS An 8-week cardiovascular exercise program in patients with localized prostate cancer undergoing radiotherapy improved cardiovascular fitness , flexibility , muscle strength , and overall QOL and prevented fatigue And rogen deprivation therapy ( ADT ) remains a cornerstone in the management of patients with prostate cancer ( PCa ) despite adverse effects on body composition and functional parameters . We compared the effects of football training with st and ard care in PCa patients managed with ADT ( > 6 months ) . Fifty-seven men aged 67 ( range : 43 - 74 ) were r and omly assigned to a football group ( FG , n = 29 ) or a usual care control group ( CON , n = 28 ) . The primary outcome was change in lean body mass ( LBM ) assessed by dual-energy X-ray absorptiometry scanning . Secondary outcomes included changes in knee-extensor muscle strength ( one repetition maximum ) , fat percentage , and maximal oxygen uptake ( VO2max ) . Mean heart rate during training was 137.7 ( st and ard deviation 13.7 ) bpm or 84.6 (3.9)% HRmax . In FG , LBM increased by 0.5 kg [ 95 % confidence interval ( CI ) 0.1 - 0.9 ; P = 0.02 ] with no change in CON ( mean group difference 0.7 kg ; 95 % CI 0.1 - 1.2 ; P = 0.02 ) . Also , muscle strength increased in FG ( 8.9 kg ; 95 % CI 6.0 - 11.8 ; P < 0.001 ) with no change in CON ( mean group difference 6.7 kg ; 95 % CI 2.8 - 10.7 ; P < 0.001 ) . In FG , VO2max increased ( 1.0 mL/kg/min ; 95 % CI 0.2 - 1.9 ; P = 0.02 ) and fat percentage tended to decrease ( 0.7 % ; 95%CI 1.3 - 0.0 ; P = 0.06 ) , but these changes were not significantly different from CON . In conclusion , football training over 12 weeks improved LBM and muscle strength compared with usual care in men with prostate cancer receiving ADT BACKGROUND Despite the high global prevalence of prostate cancer ( PCa ) , few epidemiologic studies have assessed physical activity in relation to PCa survival . OBJECTIVE To evaluate different types , intensities , and timing of physical activity relative to PCa survival . DESIGN , SETTING , AND PARTICIPANTS A prospect i ve study was conducted in Alberta , Canada , in a cohort of 830 stage II-IV incident PCa cases diagnosed between 1997 and 2000 with follow-up to 2014 ( up to 17 yr ) . Prediagnosis lifetime activity was self-reported at diagnosis . Postdiagnosis activity was self-reported up to three times during follow-up . OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Cox proportional hazards models related  physical activity to all-cause and PCa-specific deaths and to first recurrence/progression of PCa . RESULTS AND LIMITATIONS A total of 458 deaths , 170 PCa-specific deaths , and , after first follow-up , 239 first recurrences/progressions occurred . Postdiagnosis  total  activity ( > 119 vs ≤42 metabolic equivalent [MET]-hours/week per year ) was associated with a significantly lower all-cause mortality risk ( hazard ratio [ HR ] : 0.58 ; 95 % confidence interval [ CI ] , 0.42 - 0.79 ; p value for trend < 0.01 ) . Postdiagnosis recreational activity ( > 26 vs ≤4 MET-hours/week per year ) was associated with a significantly lower PCa-specific mortality risk ( HR : 0.56 ; 95 % CI , 0.35 - 0.90 ; p value for trend = 0.01 ) .  Sustained recreational activity before and after diagnosis ( > 18 - 20 vs < 7 - 8 MET-hours/week per year ) was associated with a lower risk of all-cause mortality ( HR : 0.66 ; 95 % CI , 0.49 - 0.88 ) . Limitations included generalisability to healthier cases and an observational study design . CONCLUSIONS These findings support emerging recommendations to increase physical activity after the diagnosis of PCa and would inform a future exercise intervention trial examining PCa outcomes . PATIENT SUMMARY In a 17-yr prostate cancer ( PCa ) survival study , men who survived at least 2 yr who were more physically active postdiagnosis or  performed more recreational physical activity  before and after diagnosis survived longer . Recreational physical activity  after diagnosis was associated with a lower risk of PCa death Micro‐ Abstract Men diagnosed with prostate cancer have increased risk of disease progression , cardiovascular events , and quality of life impairments . Men with a recent diagnosis r and omly assigned to a walking group intervention maintained 10,000 steps per day and experienced improvement in cardiovascular biomarkers compared with usual care . A larger walking group intervention is needed to investigate its potential for improvement in long‐term outcomes . Background : Men diagnosed with prostate cancer have increased risk for disease progression , cardiovascular events , and impairments in quality of life . This pilot study evaluated the feasibility of a r and omized walking group intervention to improve quality of life , circulating biomarkers , and morbidity among men with newly diagnosed prostate cancer . Methods : Men were recruited at Örebro University Hospital , Sweden , and r and omized to an 11‐week walking group intervention ( n = 21 ) or usual care ( n = 20 ) . The intervention included weekly 1‐hour walking group sessions and maintenance of 10,000 steps/day . Outcomes were changes in body composition , clinical factors , biomarkers of cardiovascular health , and quality of life between baseline and end of study . Analysis of covariance was used to compare outcomes in each group adjusted for baseline values . Results : All 41 men r and omized completed the 11‐week trial . Men assigned to the intervention walked on average 10,644 steps/day , and 92 % reported missing 2 or fewer sessions . Both groups experienced similar weight loss at 11 weeks . Men in the intervention had a significant adjusted mean change in high‐density lipoprotein of 0.14 mmol/L ( 95 % confidence interval [ CI ] , 0.01‐0.27 ; P = .04 ) , and suggestive adjusted mean changes in low‐density lipoprotein of −0.22 mmol/L ( 95 % CI , −0.47 to 0.03 ; P = .08 ) and in systolic blood pressure of −8.5 mm Hg ( 95 % CI , −21.2 to 4.2 ; P = .18 ) , compared with the usual care group . Conclusions : A walking group intervention among men with recent diagnosis of prostate cancer is feasible and potentially effective in improving cardiovascular health . A larger r and omized trial of longer duration is required to eluci date its potential for improvement in longer term outcomes PURPOSE And rogen deprivation therapy is a common treatment in men with prostate cancer that may cause fatigue , functional decline , increased body fatness , and loss of lean body tissue . These physical changes can negatively affect health-related quality of life .  Resistance exercise may help to counter some of these side effects by reducing fatigue , elevating mood , building muscle mass , and reducing body fat . METHODS In a two-site study , 155 men with prostate cancer who were scheduled to receive and rogen deprivation therapy for at least 3 months after recruitment were r and omly assigned to an intervention group that participated in a resistance exercise program three times per week for 12 weeks ( 82 men ) or to a waiting list control group ( 73 men ) . The primary outcomes were fatigue and disease-specific quality of life as assessed by self-reported question naires after 12 weeks . Secondary outcomes were muscular fitness and body composition . RESULTS Men assigned to resistance exercise had less interference from fatigue on activities of daily living ( P = .002 ) and higher quality of life ( P = .001 ) than men in the control group . Men in the intervention group demonstrated higher levels of upper body ( P = .009 ) and lower body ( P < .001 ) muscular fitness than men in the control group . The 12-week resistance exercise intervention did not improve body composition as measured by changes in body weight , body mass index , waist circumference , or subcutaneous skinfolds . CONCLUSION Resistance exercise reduces fatigue and improves quality of life and muscular fitness in men with prostate cancer receiving and rogen deprivation therapy .  This form of exercise can be an important component of supportive care for these patients Purpose The purpose of this study is to examine the effects of age ( ≤65 years or > 65 years ) and and rogen-deprivation therapy ( ADT , presence or absence ) as factors that may predict changes in body composition and fitness following a 24-week exercise program in prostate cancer patients . Methods One hundred twenty-one men were r and omly allocated to either : ( 1 ) aerobic exercise ( AE ) , ( 2 ) resistance exercise ( RE ) , or ( 3 ) usual care ( UC ) . Body composition was assessed by DXA . Aerobic fitness was assessed through a maximal treadmill test  . Muscular strength was assessed by leg extension and bench press using the eight-repetition maximum test . Responses were compared between younger ( ≤65 years ) and older ( > 65 years ) patients with or without ADT  . Results There did not appear to be an interaction between age and ADT on body composition or fitness , nor were there any significant changes in body composition for participants ≤65 years . In participants aged > 65 years , lean mass decreased in AE ( p = 0.013 ) and UC ( p = 0.006 ) , but was preserved in RE . In participants receiving ADT , there was a decrease in lean mass in AE ( p = 0.003 ) and UC ( p < 0.001 ) but not in RE . The non-ADT group did not show any changes in body composition but did show improvements in muscular fitness following resistance training ( p < 0.001 ) . Conclusion Changes in body composition and physical fitness following a 24-week exercise program in men with prostate cancer are not influenced by age and /or ADT . Resistance training appears to attenuate the age-related decrease in lean mass and increase in body fat in older patients with prostate cancer and those  receiving ADT Background : Cancer treatment – induced bone loss has important long-term effects in prostate cancer survivors ( PCSs ) receiving and  rogen deprivation therapy ( ADT ) , but little is known about preventive interventions . Objective : The aim of this study was to examine the feasibility and preliminary effectiveness of a 6-month home-based exercise intervention in PCSs . Methods : In this pilot , r and omized controlled trial , 51 men ( mean age , 70.8 years ) were r and omized to a 6-month home-based exercise intervention for preventing osteoporosis group ( n = 26 ) or an exercise placebo intervention of stretching exercise group ( n = 25 ) . Primary outcomes were bone mineral density and bone turnover markers . Secondary outcomes were physical performance ( level of physical activity , muscle strength , and balance ) and health-related quality of life . Results : The patient retention rate for 6 months was 80.4 % . The mean adherence rate was 84.7 % for weight-bearing exercise and 64.8 % for resistance exercise . No adverse events during the study period were reported . Although primary outcomes did not differ significantly between the 2 groups , the home-based exercise intervention for preventing osteoporosis group demonstrated significantly greater increased muscle strength than the stretching exercise group . Conclusions : A home-based exercise program is relatively feasible and safe and may improve muscle strength but not bone outcomes . Implication s for Practice : Given the importance of preventing cancer treatment – induced bone loss among PCSs receiving ADT , a home-based exercise intervention can be considered , but further trials with a larger sample are required to determine its effect for bone outcomes PURPOSE Lymphoma patients commonly experience declines in physical functioning and quality of life ( QoL )  that may be reversed with exercise training . PATIENTS AND METHODS We conducted a r and omized controlled trial in Edmonton , Alberta , Canada , between 2005 and 2008 that stratified 122 lymphoma patients by major disease type and current treatment status and r and omly assigned them to usual care ( UC ; n = 62 ) or 12 weeks of supervised aerobic exercise training ( AET ; n = 60 ) . Our primary end point was patient-rated physical functioning assessed by the Trial Outcome Index-Anemia . Secondary end points were overall QoL , psychosocial functioning , cardiovascular fitness , and body composition . RESULTS Follow-up assessment for our primary end point was 96 % ( 117 of 122 ) at postintervention and 90 % ( 110 of 122 ) at 6-month follow-up . Median adherence to the supervised exercise program was 92 % . At postintervention , AET was superior to UC for patient-rated physical functioning ( mean group difference , + 9.0 ; 95 % CI , 2.0 to 16.0 ; P = .012 ) , overall QoL ( P = .021 ) , fatigue ( P = .013 ) , happiness ( P = .004 ) , depression ( P = .005 ) , general health ( P < .001 ) , cardiovascular fitness ( P < .001 ) , and lean body mass ( P = .008 ) . Change in peak cardiovascular fitness mediated the change in patient-rated physical functioning . AET did not interfere with chemotherapy completion rate or treatment response . At 6-month follow-up , AET was still borderline or significantly superior to UC for overall QoL ( P = .054 ) , happiness ( P = .034 ) , and depression ( P = .009 ) without an increased risk of disease recurrence/progression . CONCLUSION AET significantly improved important patient-rated outcomes and objective physical functioning in lymphoma patients without interfering with medical treatments or response . Exercise training to improve cardiovascular fitness should be considered in the management of lymphoma patients INTRODUCTION And rogen deprivation therapy ( ADT ) is associated with significant bone loss and an increase in fracture risk among prostate cancer survivors ( PCS ) . We investigated whether impact + resistance training could stop ADT-related declines in bone mineral density ( BMD ) among PCS on ADT . METHODS We r and omized 51 PCS ( mean age , 70.2 yr ) currently prescribed ADT to participate in 1 yr of impact + resistance training ( Prevent Osteoporosis with Impact + Resistance ( POWIR ) )  or in an exercise placebo program of stretching exercise ( FLEX ) . Outcomes were proximal femur ( total hip , femoral neck , and greater trochanter ) and spine ( L1-L4 ) BMD ( g·cm ) and bone turnover markers ( serum osteocalcin ( ng·mL ) and urinary deoxypyrodinoline cross-links ( nmol·mmol Cr ) ) . RESULTS Retention in the 1-yr study was 84 % and median attendance to supervised classes was 84 % in POWIR and 74 % in FLEX . No study -related injuries were reported . There were no significant differences between groups for average L1-L4 BMD or for BMD at any hip site . When examining individual vertebrae , POWIR has a significant effect on preservation of BMD ( -0.4 % ) at the L4 vertebrae compared with losses ( -3.1 % ) in FLEX ( P = 0.03 ) . CONCLUSION Impact + resistance training was a safe and acceptable form of exercise for older PCS on ADT . Among our limited sample , POWIR did not appear to have a clinical ly meaningful effect on hip or spine BMD , but some evidence of skeletal adaptation to resistance + impact training in an and rogen-deprived state was apparent . Future studies need to be conducted on a larger sample of patients and should consider modifications to POWIR that could further enhance loading across the spine and at the hip to preserve BMD at these clinical ly relevant sites Background . And rogen deprivation therapy ( ADT ) increases survival rates in prostate cancer ( PCa ) patients with locally advanced disease , but is associated with side effects that may impair daily function . Strength training may counteract several side effects of ADT , such as changes in body composition and physical functioning , which in turn may affect health-related quality of life ( HRQOL ) . However , additional r and omised controlled trials are needed to exp and this knowledge . Material and methods . Fifty-eight PCa patients on ADT were r and omised to either 16 weeks of high-load strength training ( n = 28 ) or usual care ( n = 30 ) . The primary outcome was change in total lean body mass ( LBM ) assessed by dual x-ray absorptiometry ( DXA ) . Secondary outcomes were changes in regional LBM , fat mass , and areal bone mineral density ( aBMD ) measured by DXA ; physical functioning assessed by 1-repetition maximum ( 1RM ) tests , sit-to-st and test , stair climbing test and Shuttle walk test ; and HRQOL as measured by the European Organization for the Research and Treatment of Cancer Quality of Life Question naire Core 30 . Results and Conclusion . No statistically significant effect of high-load strength training was demonstrated on total LBM ( p = 0.16 ) , but significant effects were found on LBM in the lower and upper extremities ( 0.49 kg , p < 0.01 and 0.15 kg , p < 0.05 , respectively ) . Compared to usual care , high-load strength training showed no effect on fat mass , aBMD or HRQOL , but beneficial effects were observed in all 1RM tests , sit-to-st and test and stair climbing tests . Adherence to the training program was 88 % for lower body exercises and 84 % for upper body exercises . In summary , high-load strength training improved LBM in extremities and physical functioning , but had no effect on fat mass , aBMD , or HRQOL in PCa patients on ADT And rogen-deprivation therapy ( ADT ) for prostate cancer ( PCa ) has side effects that significantly impair health-related quality of life ( HRQOL ) . Exercise ameliorates many side effects of ADT , but different modalities , particularly in the home-based setting , have not been well studied . In this study the authors r and omly assigned 66 PCa survivors receiving ADT to 6 mo of home-based aerobic or resistance training .  Psychosocial well-being and physical fitness were measured at baseline , 3 and 6 mo , and then 6 mo postintervention . Intention-to-treat analyses showed that fatigue and HRQOL were not significantly different between groups ; however , in a per- protocol analysis the resistance-exercise training group demonstrated clinical ly significant improvements in HRQOL . Differential within-group effects on physical fitness were also observed at various time points . At all time points , the aerobic-training group engaged in significantly more physical activity than the resistance-training group , a finding that should be further examined given evidence -based guidelines for activity volume in cancer survivors BACKGROUND And rogen deprivation therapy ( ADT ) can decrease the physical performance ( PP ) of older men with prostate cancer ( PC ) . METHODS We conducted a three-arm r and omized pilot study ( n=19 ) comparing a home-based walking and resistance intervention ( EXCAP ) and a technology-mediated walking and resistance intervention using Wii-Fit to a usual-care arm  in men ≥70 years with PC receiving ADT . The intervention lasted for 6 weeks , with follow-up at 12 weeks . The primary pre-specified outcome was change in Short Physical Performance Battery ( SPPB ) score . Mixed effects regression models were used to assess change in outcomes over time . RESULTS Mean participant age was 70 years ( range : 67 - 93 ) . Eight patients were r and omized to the Wii-Fit arm , 6 to the EXCAP arm , and 5 to the usual-care arm . SPPB scores remained nearly constant in the usual-care arm ( β=-0.12 ; p=0.79 ) , while individuals in the EXCAP arm had on average a 1.2 point increase at each follow-up ( β=1.20 ; 95 % CI : 0.36 , 2.06 ) . The Wii-fit arm had a non-significant increase in SPPB score over time relative to usual-care ( β=0.32 ; 95 % CI -0.43 , 1.06 ; p=0.46 ) . Individuals in the EXCAP arm had an increase in steps per day over time compared to the usual-care arm ( p-value=0.006 ) ; the EXCAP arm had an increase of 2720 steps ( 95 % CI : 1313 , 4128 ) while the usual-care arm had an increase of 97 steps ( 95 % CI : -1140 , 1333 ) . Participants in the Wii-Fit arm had an increase of 1020 steps ( 95 % CI : -474 , 1238 , p=0.710 ) . Other outcomes ( i.e. , h and grip strength , lean muscle mass , and chest press repetitions ) were not statistically significant . CONCLUSIONS A home-based aerobic and resistance exercise program , EXCAP , shows promise for improving PP in older men with PC on ADT BACKGROUND The ENGAGE ( efficacy of a referral and physical activity program for survivors of prostate cancer ) study established that a clinician referral and 12-week exercise training program increased vigorous physical activity at 12 weeks among men with prostate cancer . Here , we report the 6- and 12-month outcomes . METHODS In this multicenter cluster r and omized controlled trial , we compared a clinician referral and exercise training program to usual care . Discounted gym membership was offered to men in the intervention condition on completion of the 12-week exercise program .  Self-reported physical activity at 6 and 12 months was the primary outcome . Quality of life , anxiety , and depressive symptoms were secondary outcomes . RESULTS A total of 147 men meeting eligibility criteria agreed to participate ( 54 intervention , 93 control ) . A positive interaction effect for vigorous physical activity was observed at 6 months , but not 12 months . No significant effects for the secondary outcomes were found . CONCLUSIONS A clinician referral and community-based supervised and unsupervised exercise training program , along with discounted gym membership , had a positive short-term effect on vigorous physical activity levels , but did not improve quality of life , in men with prostate cancer Objectives To up date our previous evaluation of the exercise interventions used in r and omised controlled trials of breast cancer survivors in relation to ( 1 ) the application of the principles of exercise training in the exercise prescription ; ( 2 ) the reporting of the components of the exercise prescription ; and ( 3 ) the reporting of adherence of participants to the prescribed interventions . Design Systematic review . Data sources The OVID Medline , Embase , CINAHL and SPORTD iscus electronic data bases were search ed from January 2010 to January 2017 . Eligibility criteria R and omised controlled trials of at least 4 weeks of aerobic and /or resistance exercise in women diagnosed with breast cancer , reporting on physical fitness or body composition outcomes .  Results Specificity was appropriately applied by 84 % , progression by 29 % , overload by 38 % and initial values by 67 % of newly identified studies . Reversibility was reported by 3 % and diminishing returns by 22 % of newly identified studies . No studies reported all components of the exercise prescription in the methods , or adherence to the prescribed intervention in the results . Reporting of reversibility has increased from 2010 , but no other improvements in reporting were noted from the previous review . Summary / Conclusion No studies of exercise in women with breast cancer attended to all principles of exercise training , or reported all components of the exercise prescription  in the methods , or adherence to the prescription in the results . Full reporting of the exercise prescribed and completed is essential for study replication in research and translating research findings into the community , and should be prioritised in future trials PURPOSE Radiotherapy for prostate cancer ( PCa ) may cause unfavorable changes in fatigue , quality of life ( QOL ) , and physical fitness . We report results from the Prostate Cancer Radiotherapy and Exercise Versus Normal Treatment study examining the effects of 24 weeks of resistance or aerobic training versus usual care on fatigue , QOL , physical fitness , body composition , prostate-specific antigen , testosterone , hemoglobin , and lipid levels in men with PCa receiving radiotherapy . PATIENTS AND METHODS Between 2003 and 2006 , we conducted a r and omized controlled trial in Ottawa , Canada , where 121 PCa patients initiating radiotherapy with or without and rogen deprivation therapy  were r and omly assigned to usual care ( n = 41 ) , resistance ( n = 40 ) , or aerobic exercise ( n = 40 ) for 24 weeks . Our primary end point was fatigue assessed by the Functional Assessment of Cancer Therapy-Fatigue scale . RESULTS The follow-up assessment rate for our primary end point of fatigue was 92.6 % . Median adherence to prescribed exercise was 85.5 % . Mixed-model repeated measures analyses indicated both resistance ( P = .010 ) and aerobic exercise ( P = .004 ) mitigated fatigue over the short term . Resistance exercise also produced longer-term improvements ( P = .002 ) . Compared with usual care , resistance training improved QOL ( P = .015 ) , aerobic fitness ( P = .041 ) , upper- ( P < .001 ) and lower-body ( P < .001 ) strength , and triglycerides ( P = .036 ) , while preventing an increase in body fat ( P = .049 ) . Aerobic training also improved fitness ( P = .052 ) . One serious adverse event occurred in the group that performed aerobic exercise . CONCLUSION In the short term , both resistance and aerobic exercise mitigated  fatigue in men with PCa receiving radiotherapy  . Resistance exercise generated longer-term improvements and additional benefits for QOL , strength , triglycerides , and body fat BACKGROUND Prostate cancer is a key driver of cancer-related global disability-adjusted life-years . And rogen-deprivation therapy ( ADT ) for advanced disease is linked to fatigue , reduced physical function , and quality of life ( QoL ) . OBJECTIVE To evaluate the effect of a lifestyle intervention on disease-specific QoL , diastolic blood pressure , and cancer-related fatigue in sedentary men receiving long-term ADT for advanced prostate cancer . DESIGN , SETTING , AND PARTICIPANTS A total of 100 hundred sedentary men with locally advanced or metastatic prostate cancer on long-term ADT were r and omised to an intervention or usual care group . INTERVENTION A 12-wk lifestyle intervention consisting of aerobic and resistance exercise with parallel dietary advice . OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Disease-specific QoL was measured using the Functional Assessment of Cancer Therapy-Prostate ( FACT-P ) and Functional Assessment of Cancer Therapy-Fatigue ( FACT-F ) question naires at 12 wk postintervention and at 6 mo following withdrawal of support . Analysis of covariance and mixed regression were conducted . RESULTS AND LIMITATIONS Clinical ly relevant improvements in FACT-P were seen at 12 wk in the intervention group compared with controls ( mean difference : 8.9 points ; 95 % confidence interval [ CI ] , 3.7 - 14.2 ; adjusted p=0.001 ) . No difference was apparent at 6 mo ( mean difference : 3.3 points ; 95 % CI , -2.6 to 9.3 ; adjusted p=0.27 ) . No difference in diastolic blood pressure was seen at either follow-up ( all p > 0.05 ) . Clinical ly relevant improvements in FACT-F were seen at 12 wk ( mean difference : 5.3 points ; 95 % CI , 2.7 - 7.9 ; adjusted p<0.001 ) and maintained following withdrawal of supervision ( mean difference : 3.9 points ; 95 % CI , 1.1 - 6.8 ; adjusted p=0.007 ) . Improvements in exercise tolerance and behaviour were maintained at 6 mo ( adjusted p<0.001 and 0.038 ) . CONCLUSIONS A lifestyle intervention result ed in a clinical ly meaningful improvement in disease-specific QoL that was not maintained postintervention . No effect on blood pressure occurred . Durability of response was seen in fatigue and exercise behaviour . Further evaluation of support structures is essential . TRIAL REGISTRATION IS RCT N88605738 Background : This prospect i ve study examined the associations between postdiagnosis physical activity and change from prediagnosis physical activity with quality of life ( QoL ) in prostate cancer survivors . Methods : Prostate cancer survivors ( N = 830 ) who participated in a case – control study with invasive stage ≥II disease were followed up to 2007 to capture QoL outcomes . At baseline and three time points postdiagnosis ( 2000–2007 ) , interviews/ question naires were used to collect data on physical activity , general QoL measured by the SF-36 , and other treatment/lifestyle factors . Multivariable linear regression was used to test the relation between postdiagnosis physical activity and QoL as well as the change in physical activity over the diagnostic period and QoL. Results : Both total and recreational physical activities were positively associated with physical QoL. Furthermore , when comparing changes in physical activity levels from pre- to postdiagnosis , men who consistently met physical activity guidelines had significantly higher physical [ β = 6.01 ; 95 % confidence interval ( CI ) , 4.15–7.86 ] and mental ( β = 2.32 ; 95 % CI , 0.29–4.34 ) QoL scores compared with those who did not meet guidelines pre- or postdiagnosis . Furthermore , those who adopted and met guidelines had increased QoL , whereas those who relapsed experienced decreased QoL. Conclusions : Postdiagnosis recreational physical activity is associated with better physical QoL in prostate cancer survivors . Moreover , prostate cancer survivors who maintain or adopt physical activity after diagnosis report substantially higher QoL than men who never exercised or stopped exercising after diagnosis . Impact : Future intervention studies should focus on achieving and maintaining adherence to physical activity guidelines postdiagnosis in prostate cancer survivors . Cancer Epidemiol Biomarkers Prev ; 26(2 ) ; 179–87 . © 2016 AACR
Background The purpose of this review is to up date previously published review s on exercise programming in exercise trials in prostate cancer survivors .
We evaluated : 1 ) the application of the principles of exercise training in prescribed programs ; 2 ) the reporting of the components of the exercise prescription ; and 3 ) the reporting of adherence of participants to the prescribed programs .