Abstract

Background
Androgen deprivation therapy (ADT) used to treat advanced stages of prostate cancer, is often associated with a negative physical and psychological impact. Very few studies have investigated lifestyle interventions designed to ameliorate these side effects.

Aim
This study investigated the feasibility of a 12 week lifestyle intervention in prostate cancer patients receiving ADT.

Method
Following ethics approval, 49 ADT patients were randomised either to supervised exercise & diet advice for 12 weeks or to standard treatment only. Active intervention consisted of 45 minutes of moderate aerobic and resistance exercise, 3 times per week, for the duration of the intervention. Aerobic exercise tolerance was measured using the Bruce treadmill protocol. Functional capacity (30 s chair sit to stand test), self reported fatigue (FACT-F questionnaire) and neuromuscular efficiency (skeletal muscle electromyography during an isometric fatigue test) were also assessed. Post intervention focus groups were also conducted and included exploration of the impact of the intervention on quality of life (QoL).

Results
The lifestyle intervention elicited significant improvements in exercise tolerance (130 s vs. 5 s, P<0.001), functional capacity (+ 5 vs. + 1 repetition, P<0.001), fatigue score (+4.4 vs -1.8, P=0.007) and neuromuscular efficiency (+51% vs. -1%, P=0.037). Focus group responses indicated that patients enjoyed the intervention and found it improved QoL. Patients also indicated that this was the only form of support available to them in between 3-monthly hospital visits, and preferred exercise classes to conventional support groups.

Conclusion
The significant improvement on physical and psychological variables resulting from 12 weeks of exercise and diet advice suggests that lifestyle interventions could be beneficial for improving QoL in patients undergoing long term ADT.