Cormie, P., Galvao, D.A., Spry, N., Joseph, D., Chee, R., Taaffe, D.R., . . . Newton, R.U. (2015). Can supervised exercise prevent treatment toxicity in patients with prostate cancer initiating androgen-deprivation therapy: A randomised controlled trial. BJU International, 115, 256–266. 

To determine if supervised exercise minimizes toxicity in patients receiving androgen deprivation therapy (ADT)

Patients were randomly assigned to usual care or a three-month exercise program. The program included aerobic and resistance exercise sessions two times per week in various exercise clinics. Sessions were conducted in groups and supervised by exercise physiologists. Sessions were 60 minutes in length involving moderate- to high-intensity aerobics. Study measures were obtained at baseline and after three months.

• N = 63
• MEAN AGE = 68.4 years
• MALES: 100%         
• KEY DISEASE CHARACTERISTICS: Prostate cancer receiving ADT

• SITE:  Multi-site
• SETTING TYPE:  Outpatient  
• LOCATION:  Australia

Randomized controlled trial

• Body composition measures
• 400 m walk test
• Static balance test
• Activities Specific Balance Confidence scale for falls self efficacy
• SF-36
• EORTC-QLQ-PR25
• FACIT Fatigue scale
• Brief Symptom Inventory (BSI) for anxiety and depression

Exercise participants attendance at sessions ranged from 14-24 sessions out of a possible 24 sessions. There was a non-significant trend for those in the exercise group to have less loss of lean body mass. Fatigue scores (SF-36) remained stable in the exercise group, whereas fatigue increased in the control group (p = 0.045). Depression remained stable in the exercise group and increased in the control group (p = 0.054). There was no difference between groups in anxiety.

Participation in a group-based, supervised, moderate- to high-intensity exercise program was associated with lower fatigue and improvement in some functional domains after three months when compared to usual care. No significant impact was noted on anxiety or depression.

• Small sample (less than 100)
• Risk of bias (no blinding)
• Measurement validity/reliability questionable
• Subject withdrawals 10% or greater
• Other limitations/explanation:  More patients in usual care withdrew and there is no clear ITT analysis. BSI measures were only for anxiety and depression.

The findings add to the body of evidence that exercise is beneficial for patients with cancer to reduce fatigue associated with cancer and cancer treatment.