Exercise program benefits men treated with androgen deprivation therapy

New South Wales, Australia-Men with prostate cancer treated with androgen deprivation therapy (ADT) had significant improvement in strength and exercise capacity following a 10-week program of physical activity, education, and support, according to a study reported at the AUA annual meeting in San Diego.

Assessments before and after the program showed significant improvement in 16 of 18 outcomes. Weight and heart rate were the only measures that did not change during the exercise program.

Developed to offset the adverse metabolic effects of ADT, the program appeared to accomplish the goal, said Lawrence Kim, MD, urology registrar at Port Macquarie Base Hospital, New South Wales, Australia.

“The Lupron Man Plan program appears to improve the measured exercise outcomes,” Dr. Kim said during the discussion at his poster session. “The outcome does not appear to be affected by the duration of Lupron administration and the area of residence (metropolitan vs. regional). Long-term follow-up is required to assess the clinical significance.”

ADT can increase a prostate cancer patient’s risk of cardiovascular, musculoskeletal, and metabolic complications. Studies have shown that exercise can ameliorate these adverse effects, but no formal community-based activity programs have been developed for patients with advanced prostate cancer treated with ADT.

Exercise, education, and support

The Man Plan, supported by Abbott, combines resistance-based exercise, education, and support. Patients attend an introductory session, followed by supervised group training sessions twice weekly for 8 weeks and ending with an individual assessment visit.

Dr. Kim and A/Prof Prem Rashid, PhD, consultant urologist at the Urology Center in Port Macquarie, presented results from a study to determine whether the exercise program affects clinical parameters that can be adversely affected by ADT, whether duration of ADT affects outcomes, and whether results differ between men living in metropolitan or regional areas.

Prospectively collected data included demographics, duration of ADT, naivety to ADT (<3 months of treatment before starting the exercise program), body composition, cardiovascular parameters, and activity and strength outcomes.

Data analysis comprised 379 patients. Paired t-test analysis of change in parameters/outcomes before and after the program showed that mean weight and heart rate did not change significantly. All other measures of interest improved during the exercise program:

· body composition: waist (p<.0001) and hip circumference (p=.0155)

· cardiovascular: systolic (p=.0044) and diastolic blood pressure (p<.0001) and 400-meter walk (p<.0001)

· activities: amount of exercise per day per week (p=.0008), chair repetitions (p<.0001), chest press (p<.0001), leg press (p<.0001), rowing (p<.0001), sit and reach (p<.0001), push-up/toes (p<.0001), and push-up/knees (p<.0001)

· strength: abdominal (p<.0001), plank hold (p<.0001), and balance (p<.0001).

Analysis of other objectives showed that duration of ADT (naïve vs. experienced) did not affect the outcomes, nor did residence in regional versus metropolitan areas.UT

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