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ADT and Exercise

Erik Wibowo, Richard J Wassersug, John W Robinson, Andrew Matthew, Deborah McLeod, Lauren M Walker
BACKGROUND: Androgen deprivation therapy (ADT) for prostate cancer has numerous side effects. Clinical guidelines for side effect management exist; however, these are not always integrated into routine practice. What remains undocumented and therefore the objective of this study, is to describe patients' willingness to employ established strategies. PATIENTS AND METHODS: Study participants were 91 men who had attended an educational program (ie, attend a class plus read a book), designed to prepare patients for managing ADT side effects...
December 20, 2018: Clinical Genitourinary Cancer
Stephen J Freedland, Lauren Howard, Jenifer Allen, Jordan Smith, Jennifer Stout, William Aronson, Brant A Inman, Andrew J Armstrong, Daniel George, Eric Westman, Pao-Hwa Lin
PURPOSE: The objective of this study was to test a low-carbohydrate diet (LCD) plus walking to reduce androgen deprivation therapy (ADT)-induced metabolic disturbances. MATERIALS AND METHODS: This randomized multi-center trial of prostate cancer (PCa) patients initiating ADT was designed to compare an LCD (≤20g carbohydrate/day) plus walking (≥30 min for ≥5 days/week) intervention vs. control advised to maintain usual diet and exercise patterns. Primary outcome was change in insulin resistance by homeostatic model assessment at 6 months...
January 21, 2019: Prostate Cancer and Prostatic Diseases
Agnieszka Lemanska, Karen Poole, Jonathan J Aning, Bruce A Griffin, Ralph Manders, John M Saxton, Joe Wainwright, Sara Faithfull
Background: Assessing fitness and promoting regular physical activity can improve health outcomes and early recovery in prostate cancer. This is however, underutilised in clinical practice. The cardiopulmonary exercise test (CPET) is increasingly being used pre-treatment to measure aerobic capacity and peak oxygen consumption (VO2 peak - a gold standard in cardiopulmonary fitness assessment). However, CPET requires expensive equipment and may not always be appropriate. The Siconolfi step test (SST) is simpler and cheaper, and could provide an alternative...
2019: European Review of Aging and Physical Activity
Shabbir M H Alibhai, Daniel Santa Mina, Paul Ritvo, George Tomlinson, Catherine Sabiston, Murray Krahn, Sara Durbano, Andrew Matthew, Padraig Warde, Meagan O'Neill, Narhari Timilshina, Roanne Segal, Nicole Culos-Reed
BACKGROUND: Existing evidence demonstrates that 1:1 personal training (PT) improves many adverse effects of androgen deprivation therapy (ADT). Whether less resource-intensive exercise delivery models are as effective remains to be established. We determined the feasibility of conducting a multi-center non-inferiority randomized controlled trial comparing PT with supervised group (GROUP) and home-based (HOME) exercise programs, and obtained preliminary efficacy estimates for GROUP and HOME compared to PT on quality of life (QOL) and physical fitness...
January 3, 2019: BMC Cancer
Prue Cormie, Eva M Zopf
Androgen deprivation therapy (ADT) is associated with considerable adverse side effects which compromise the health and wellbeing of many men with prostate cancer. Exercise has been identified as a therapy to help manage ADT-related treatment toxicities. This paper systematically reviews the scientific literature investigating the impact of exercise on men receiving ADT and discusses strategies to effectively implement exercise in clinical practice. The findings of this review demonstrate that exercise has therapeutic benefit for the management of ADT-related side effects...
November 13, 2018: Urologic Oncology
Hisashi Matsushima
Androgen deprivation therapy(ADT)is a standard systemic therapy for prostate cancer. ADT induces bone loss(ADTIBL)and muscle loss(sarcopenia)leading to falls and farctures. There are 2 aims in bone management of prostate cancer:one is to prevent fragility fractures in patients without bone metastasis and the other is to prevent symptomatic skeletal events(SSE)which are pathologic fractures, spinal compression, radiation to bones and surgery to bones. Bone fractures and SSE are both correlated with worse overall survival(OS)...
2018: Clinical Calcium
Margaret Roller, Aimie Kachingwe, Janna Beling, Dawn-Marie Ickes, Allyson Cabot, Gabrielle Shrier
OBJECTIVE: To investigate the effects of Pilates exercises using a Reformer on measures of fall risk, balance and mobility, self-efficacy, and active range of motion in adults age 65 and over at risk for falls compared to a control group. DESIGN: Randomized Controlled Trial. METHODS: Fifty-five subjects (27 Pilates intervention, 28 control; 38 females, 17 males; mean age 77.6 years, range 65-95) were randomly assigned to either a Pilates Reformer intervention group or a control group (no intervention)...
October 2018: Journal of Bodywork and Movement Therapies
Shabbir M H Alibhai, Paul Ritvo, Daniel Santa Mina, Catherine Sabiston, Murray Krahn, George Tomlinson, Andrew Matthew, Himu Lukka, Padraig Warde, Sara Durbano, Meagan O'Neill, S Nicole Culos-Reed
BACKGROUND: Androgen deprivation therapy (ADT) is commonly used to treat prostate cancer. However, side effects of ADT often lead to reduced quality of life and physical function. Existing evidence demonstrates that exercise can ameliorate multiple treatment-related side effects for men on ADT, yet adherence rates are often low. The method of exercise delivery (e.g., supervised group in-centre vs. individual home-based) may be important from clinical and economic perspectives; however, few studies have compared different delivery models...
October 23, 2018: BMC Cancer
Dennis R Taaffe, Daniel A Galvão, Nigel Spry, David Joseph, Suzanne K Chambers, Robert A Gardiner, Dickon Hayne, Prue Cormie, David H K Shum, Robert U Newton
OBJECTIVES: To examine whether it is more efficacious to commence exercise medicine in men with prostate cancer at the onset of androgen-deprivation therapy (ADT) rather than later on during treatment to preserve bone and soft-tissue composition, as ADT results in adverse effects including: reduced bone mineral density (BMD), loss of muscle mass, and increased fat mass (FM). PATIENTS AND METHODS: In all, 104 patients with prostate cancer, aged 48-84 years initiating ADT, were randomised to immediate exercise (IMEX, n = 54) or delayed exercise (DEL, n = 50) conditions...
September 21, 2018: BJU International
Synne-Kristin Hoffart Bøhn, Sophie Dorothea Fosså, Torbjørn Wisløff, Lene Thorsen
PURPOSE: The present study aimed to determine the level of physical activity (PA) among prostate cancer (PCa) patients across treatment modalities and explore the association between PA and treatment-induced adverse effects (AEs). METHODS: The present study was based on a cross-sectional postal survey among members of the Norwegian Prostate Cancer Association. Patients were eligible for the present study if they had either (1) completed radical prostatectomy, (2) completed radiotherapy and (neo)-adjuvant androgen deprivation therapy (ADT), or (3) were undergoing lifelong ADT...
August 9, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Miaofa Ying, Rui Zhao, Deqi Jiang, Shenglong Gu, Mingxing Li
Background: Prostate cancer (PCa) patients receiving androgen deprivation therapy (ADT) are prone to suffer a series of potential side effects, including metabolic change, declining physical strength and worsening fatigue. Recent studies found that the change of lifestyle interventions can help to alleviate some adverse reactions, but the results were controversial. Therefore, the aim of this review was to comprehensively evaluate the effects of these lifestyle interventions on the side effects on PCa patients who received ADT...
September 1, 2018: Japanese Journal of Clinical Oncology
Liam Bourke, Rebecca Turner, Rosa Greasley, Eileen Sutton, Liz Steed, Dianna Smith, Janet Brown, Ben Kelly, Claire Hulme, Diana Greenfield, Raj Persad, Amanda Farrin, Jenny Hewison, Derek J Rosario
BACKGROUND: National guidelines (NICE-CG175) recommended 12 weeks of supervised exercise training for men treated with androgen deprivation therapy (ADT) for prostate cancer to counter debilitating adverse effects of castration. As with other chronic conditions where exercise is indicated, it is uncertain if these services are being delivered in the health services. The aim of this multi-centre investigation was to examine what exercise referral is currently available for men on ADT as provided by the NHS and if a supervised, individually-tailored exercise training package (as per the national NICE guidelines CG175) is embedded within prostate cancer care...
2018: PloS One
Rosa U Greasley, Rebecca Turner, Karen Collins, Janet Brown, Liam Bourke, Derek J Rosario
BACKGROUND: This study aimed to explore the opinions of healthcare professionals regarding the management of men with advanced prostate cancer with particular emphasis on treatment timing and sequencing; treatment adverse-effects and exercise a supportive therapy. METHODS: Semi-structured interviews with a purposively selected group of healthcare professionals involved in prostate cancer care within the NHS, conducted over the phone or face to face. A total of 37 healthcare professionals participated in the interviews including urologists, clinical oncologists, medical oncologists, clinical nurse specialists, general practitioners, physiotherapists, exercise specialists, service managers, clinical commissioners and primary care physicians...
June 19, 2018: BMC Cancer
Robert U Newton, Emily Jeffery, Daniel A Galvão, Carolyn J Peddle-McIntyre, Nigel Spry, David Joseph, James W Denham, Dennis R Taaffe
OBJECTIVES: To investigate the association between lean mass (LM) and fat mass (FM) with fatigue and vitality before and after exercise in patients with prostate cancer already undergoing androgen-deprivation therapy (ADT). SUBJECTS AND METHODS: Cross-sectional associations between LM and FM with fatigue and/or vitality measures were examined in 229 patients (aged 43-90 years). Prospective analysis was undertaken in 129 patients who underwent a supervised 3-6 months exercise programme (predominantly resistance + aerobic)...
December 2018: BJU International
Brian C Focht, Alexander R Lucas, Elizabeth Grainger, Christina Simpson, Ciaran M Fairman, Jennifer M Thomas-Ahner, Jackie Buell, J Paul Monk, Amir Mortazavi, Steven K Clinton
Background: Although androgen-deprivation therapy (ADT) is the foundation of treatment for prostate cancer, the physiological impacts of ADT result in functional decline and enhanced risk of chronic disease and metabolic syndrome. Purpose: The Individualized Diet and Exercise Adherence Pilot Trial (IDEA-P) is a single-blind, randomized, pilot trial comparing the effects of a group-mediated, cognitive-behavioral (GMCB) exercise and dietary intervention (EX+D) with those of a standard-of-care (SC) control during the treatment of prostate cancer patients undergoing ADT...
April 19, 2018: Annals of Behavioral Medicine: a Publication of the Society of Behavioral Medicine
E D Hanson, S Sakkal, W S Evans, J A Violet, C L Battaglini, G K McConell, A Hayes
Exercise training reduces the side effects of cancer treatments; however, the stress hormone response to acute exercise during prostate cancer (PCa) treatment is unclear. The study purpose was to examine the effects of acute exercise on circulating cortisol, epinephrine (Epi), and norepinephrine (NE) concentrations during PCa treatment with and without androgen deprivation therapy (ADT). Men with PCa (n = 11), with PCa on ADT (n = 11), and with non-cancer controls (n = 8) had blood samples for stress hormones collected before and immediately (0 hour), 2 hours, and 24 hours after 45 minutes of intermittent cycling at 60% of peak wattage...
August 2018: Scandinavian Journal of Medicine & Science in Sports
Jacqueline K Dawson, Tanya B Dorff, E Todd Schroeder, Christianne J Lane, Mitchell E Gross, Christina M Dieli-Conwright
BACKGROUND: Prostate cancer patients on androgen deprivation therapy (ADT) experience adverse effects such as lean mass loss, known as sarcopenia, fat gain, and changes in cardiometabolic factors that increase risk of metabolic syndrome (MetS). Resistance training can increase lean mass, reduce body fat, and improve physical function and quality of life, but no exercise interventions in prostate cancer patients on ADT have concomitantly improved body composition and MetS. This pilot trial investigated 12 weeks of resistance training on body composition and MetS changes in prostate cancer patients on ADT...
April 3, 2018: BMC Cancer
K M Di Sebastiano, J H Pinthus, W C M Duivenvoorden, M Mourtzakis
BACKGROUND: Hyperinsulinemia, obesity and related metabolic diseases are associated with prostate cancer development. Prostate cancer patients undergoing androgen deprivation therapy (ADT) are at increased risk for metabolic syndrome, cardiovascular disease and diabetes, while pre-existing metabolic conditions may be exacerbated. PURPOSE: An integrative approach is used to describe the interactions between insulin, glucose metabolism, obesity and prostate cancer...
July 2018: Obesity Reviews: An Official Journal of the International Association for the Study of Obesity
Christian Campos, Paula Sotomayor, Daniel Jerez, Javier González, Camila B Schmidt, Katharina Schmidt, Winfried Banzer, Alejandro S Godoy
Prostate cancer (PCa) is a disease of increasing medical significance worldwide. In developed countries, PCa is the most common non-skin cancer in men, and one of the leading causes of cancer-related deaths. Exercise is one of the environmental factors that have been shown to influence cancer risk. Moreover, systemic reviews and meta-analysis have suggested that total physical activity is related to a decrease in the risk of developing PCa. In addition, epidemiological studies have shown that exercise, after diagnosis, has benefits regarding PCa development, and positive outcome in patients under treatment...
June 2018: Prostate
Derek S Tsang, Jennifer M Jones, Osai Samadi, Suhayb Shah, Nicholas Mitsakakis, Charles N Catton, William Jeon, Joshua To, Henriette Breunis, Shabbir M H Alibhai
PURPOSE: To evaluate the ability of a multimodal patient education initiative to improve adherence to healthy bone behaviors (HBBs) in men with prostate cancer receiving androgen deprivation therapy (ADT). METHODS: This was a pilot prospective, single-site, before-and-after clinical trial. The control arm (n = 51) received routine care. The intervention arm (n = 52) received multimodal HBB education which included a healthy bones prescription (BoneRx), focused face-to-face education with an oncology nurse or physician, and customized educational materials...
August 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
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