title: Physical activity for men receiving androgen deprivation therapy for prostate cancer: benefits from a 16-week intervention Randomized Controlled Trial of a Behavior Change Intervention to Increase Physical Activity and Quality of Life in Prostate Cancer Survivors Feasibility and Preliminary Efficacy of an Online Intervention to Increase Physical Activity in Nova Scotian Cancer Survivors: A Randomized Controlled Trial Examining Participant Engagement in an Information Technology-Based Physical Activity and Nutrition Intervention for Men: The Manup Randomized Controlled Trial Reach out to enhance wellness home-based diet-exercise intervention promotes reproducible and sustainable long-term improvements in health behaviors, body weight, and physical functioning in older, overweight/obese cancer survivors. Benefits of partnered strength training for prostate cancer survivors and spouses: results from a randomized controlled trial of the Exercising Together project Impact of a nutrition and physical activity intervention (ENRICH: Exercise and Nutrition Routine Improving Cancer Health) on health behaviors of cancer survivors and carers: a pragmatic randomized controlled trial Efficacy of a referral and physical activity program for survivors of prostate cancer [ENGAGE]: Rationale and design for a cluster randomised controlled trial Resistance training and reduction of treatment side effects in prostate cancer patients. Long-term physical activity outcomes of home-based lifestyle interventions among breast and prostate cancer survivors Testing for baseline differences in randomized controlled trials: an unhealthy research behavior that is hard to eradicate Exercise and nutrition routine improving cancer health (ENRICH): The protocol for a randomized efficacy trial of a nutrition and physical activity program for adult cancer survivors and carers Main outcomes of the FRESH START trial: a sequentially tailored, diet and exercise mailed print intervention among breast and prostate cancer survivors. Social cognitive theory mediators of physical activity in a lifestyle program for cancer survivors and carers: findings from the ENRICH randomized controlled trial Sex-differences in reasons for non-participation at recruitment: Geelong Osteoporosis Study The ‘Healthy Dads, Healthy Kids’ randomized controlled trial: efficacy of a healthy lifestyle program for overweight fathers and their children The Exercising Together project: design and recruitment for a randomized, controlled trial to determine the benefits of partnered strength training for couples coping with prostate cancer. Design of FRESH START: a randomized trial of exercise and diet among cancer survivors. Active for Life After Cancer: a randomized trial examining a lifestyle physical activity program for prostate cancer patients. No change in health behavior, BMI or self-rated health after a psychosocial cancer rehabilitation: Results of a randomized trial A comparison of physical activity correlates across breast, prostate and colorectal cancer survivors in Nova Scotia, Canada Prospective study of fatigue in localized prostate cancer patients undergoing radiotherapy. Leading the Way in Exercise and Diet (Project LEAD): intervening to improve function among older breast and prostate cancer survivors. Long-term outcomes of the FRESH START trial: exploring the role of self-efficacy in cancer survivors' maintenance of dietary practices and physical activity. Lifestyle intervention development study to improve physical function in older adults with cancer: outcomes from Project LEAD. Quality of life impact of treatments for localized prostate cancer: cohort study with a 5 year follow-up. Quality of life intervention for prostate cancer patients: design and baseline characteristics of the active for life after cancer trial. Reach out to ENhancE Wellness in Older Cancer Survivors (RENEW): design, methods and recruitment challenges of a home-based exercise and diet intervention to improve physical function among long-term survivors of breast, prostate, and colorectal cancer. A prospective study of physical activity and incident and fatal prostate cancer. Effects of home-based diet and exercise on functional outcomes among older, overweight long-term cancer survivors: RENEW: a randomized controlled trial. Novel physical activity interventions for older patients with prostate cancer on hormone therapy: A pilot randomized study.
abstract: 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 Physical activity improves health in prostate cancer survivors ; however , participation rates are low . Purpose This study aims to determine the effects of an implementation intention intervention on physical activity and quality of life in prostate cancer survivors . Methods Prostate cancer survivors ( N = 423 ) were r and omly assigned to a st and ard physical activity recommendation , a self-administered implementation intention , or a telephone-assisted implementation intention .  Physical activity and quality of life were assessed at baseline , 1 , and 3 months . Results Analyses of covariance using multiple imputation showed that physical activity at 1 month increased by 86 min/week in the st and ard physical activity recommendation group compared with 168 min/week in the self-administered implementation intention group ( P = 0.023 ) and 105 min/week in the telephone-assisted implementation intention group ( P = 0.35 ) . Conclusions A self-administered implementation intention intervention result ed in a meaningful short-term increase in physical activity . Supplementation with additional intervention strategies and more frequent intervention may improve longer-term exercise . ( Clinical Trials.gov number NCT01410656 ) Background Physical activity ( PA ) behavior change interventions among cancer survivors have used face-to-face , telephone , email , and print-based methods . However , computer-tailored , Internet-delivered programs may be a more viable option to achieve PA behavior change . Objective The objective of this study is to test the feasibility and preliminary efficacy of a Web-based PA behavior change program among cancer survivors . Methods Nova Scotian cancer survivors ( N=415 ) who previously expressed interest in a research study were approached . Interested participants were asked to complete an online assessment of PA and quality of life ( QOL ) before being r and omized to either a theory-based PA behavior change program using the PA tracking website UWALK ( UCAN ; n=48 ) or usual care ( UC ; n=47 ) . After the intervention ( 9 weeks ) , participants completed another  online assessment of PA and QOL  as well as measures to evaluate the program and website .  Descriptive analyses from surveys and Web analytic software were used to assess feasibility and mean change scores were used to test efficacy . Results Of all contacted survivors , 95 ( 22.3 % , 95/415 ) completed baseline measures and were r and omized with 84 ( 88 % , 84/95 ) completing the 9-week assessment . The behavior change program and website were rated highly on the satisfaction items . Average logins were 10.3 ( 1.1 per week ) and 26.0 % ( 111/432 ) of the weekly modules were completed . Most participants ( 71 % , 29/41 ) indicated they were more aware of their daily PA levels and 68 % ( 28/41 ) found the site easily navigable . Adjusted group differences in total exercise minutes favored the UCAN group by an increase of 42 minutes ( 95 % CI -65 to 150 ; P=.44 , d=0.17 ) . Results were more pronounced , though still nonsignificant , among those not meeting guidelines at baseline where UCAN increased PA by 52 minutes compared to a decrease of 15 minutes in UC ( adjusted between group difference=75 , 95 % CI -95 to 244 ; P=.38 , d=0.27 ) . Conclusions We found that Internet-delivery may be a feasible alternative to more costly methods to promote PA among Nova Scotian cancer survivors . Moreover , there was a trend toward increased PA among those in the UCAN group , especially among those who were not meeting PA guidelines at baseline . Future research should focus on recruiting inactive cancer survivors and engaging them in the website to determine the optimal potential of Web-based interventions for promoting PA in cancer survivors Background Males experience a shorter life expectancy and higher rates of chronic diseases compared to their female counterparts . To improve health outcomes among males , interventions specifically developed for males that target their health behaviors are needed . Information technology (IT)-based interventions may be a promising intervention approach in this population group , however , little is known about how to maximize engagement and retention in Web-based programs . Objective The current study sought to explore attributes hypothesized to influence user engagement among a sub sample of participants from the ManUp study , a r and omized controlled trial testing the efficacy of an interactive Web-based intervention for promoting physical activity and nutrition among middle-aged males . Methods Semistructured interviews were conducted and audiotaped with 20 of the ManUp participants . Interview questions were based on a conceptual model of engagement and centered on why participants took part in the study , what they liked and did not like about the intervention they received , and how they think the intervention could be improved . Interview recordings were transcribed and coded into themes . Results There were five themes that were identified in the study . These themes were : ( 1 ) users ’ motives , ( 2 ) users ’ desired outcomes , ( 3 ) users ’ positive experiences , ( 4 ) users ’ negative emotions , and ( 5 ) attributes desired by user . Conclusions There is little research in the field that has explored user experiences in human-computer interactions and how such experiences may relate to engagement , especially among males . Although not conclusive , the current study provides some insight into what personal attributes of middle-aged males ( such as their key motives and goals for participating ) and attributes of the intervention material s ( such as usability , control , and interactivity ) may impact on user engagement in this group . These findings will be helpful for informing the design and implementation of future health behavior interventions for males . Trial Registration Australian New Zeal and Clinical Trials Registry : ACTRN12611000081910 ; https://www.anzctr.org.au/Trial/ Registration /Trial Review .aspx?ACTRN=12611000081910 ( Archived by WebCite at http://www.webcitation.org/6M4lBlvCA ) PURPOSE Diet and exercise interventions have been tested in cancer survivors as a means to reduce late effects and comorbidity , but few have assessed adherence and health outcomes long term . METHODS Between July 2005 and May 2007 , the Reach Out to Enhance Wellness ( RENEW ) trial accrued 641 locoregionally staged , long-term ( ≥ 5 years from diagnosis ) colorectal , breast , and prostate cancer survivors in the United States ( 21 states ) , Canada , and the United Kingdom . All participants were sedentary ( < 150 minutes of physical activity [ PA ] a week ) , overweight or obese ( body mass index , 25 to 40 kg/m(2 ) ) , and over age 65 years . The trial tested a diet-exercise intervention delivered via mailed print material s and telephone counseling . RENEW used a wait-list control , cross-over design ( ie , participants received the year-long intervention immediately or after a 1-year delay ) , which allowed the opportunity to assess program efficacy ( previously reported primary outcome ) , durability , and reproducibility ( reported herein ) . Measures included diet quality ( DQ ) , PA , BMI , and physical function ( PF ) . RESULTS No significant relapse was observed in the immediate-intervention arm for DQ , PA , and BMI ; however , rates of functional decline increased when the intervention ceased . From year 1 to year 2 , significant improvements were observed in the delayed-intervention arm ; mean change scores in behaviors and BMI and PF slopes were as follows : DQ score , 5.2 ( 95 % CI , 3.4 to 7.0 ) ; PA , 45.8 min/wk ( 95 % CI , 26.9 to 64.6 min/wk ) ; BMI , -0.56 ( 95 % CI , -0.75 to -0.36 ) ; and Short Form-36 PF , -1.02 versus -5.52 ( P < .001 for all measures ) . Overall , both arms experienced significant improvements in DQ , PA , and BMI from baseline to 2-year follow-up ( P < .001 ) . CONCLUSION Older cancer survivors respond favorably to lifestyle interventions and make durable changes in DQ and PA that contribute to sustained weight loss . These changes positively reorient functional decline trajectories during intervention delivery 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 Background Physical activity and consuming a healthy diet have clear benefits to the physical and psychosocial health of cancer survivors , with guidelines recognising the importance of these behaviors for cancer survivors . Interventions to promote physical activity and improve dietary behaviors among cancer survivors and carers are needed . The aim of this study was to determine the effects of a group-based , face-to-face multiple health behavior change intervention on behavioral outcomes among cancer survivors of mixed diagnoses and carers . Methods The Exercise and Nutrition Routine Improving Cancer Health ( ENRICH ) intervention was evaluated using a two-group pragmatic r and omized controlled trial . Cancer survivors and carers ( n = 174 ) were r and omly allocated to the face-to-face , group-based intervention ( six , theory-based two-hour sessions delivered over 8 weeks targeting healthy eating and physical activity [ PA ] ) or wait-list control ( after completion of 20-week data collection ) . Assessment of the primary outcome ( pedometer-assessed mean daily step counts ) and secondary outcomes ( diet and alcohol intake [ Food Frequency Question naire ] , self-reported PA , weight , body mass index , and waist circumference ) were assessed at baseline , 8- and 20-weeks . Results There was a significant difference between the change over time in the intervention group and the control group . At 20 weeks , the intervention group had increased by 478 steps , and the control group had decreased by 1282 steps ; this represented an adjusted mean difference of 1761 steps ( 184 to 3337 ; P = 0.0028 ) . Significant intervention effects for secondary outcomes , included a half serving increase in vegetable intake ( difference 39 g/day ; 95 % CI : 12 to 67 ; P = 0.02 ) , weight loss ( kg ) ( difference -1.5 kg ; 95 % CI , -2.6 to -0.3 ; P = 0.014 ) and change in body mass index ( kg/m2 ) ( difference -0.55 kg/m2 ; 95 % CI , -0.97 to -0.13 ; P = 0.012 ) . No significant intervention effects were found for self-reported PA , total sitting time , waist circumference , fruit , energy , fibre , alcohol , meat , or fat consumption . Conclusions The ENRICH intervention was effective for improving PA , weight , body mass index , and vegetable consumption even with the inclusion of multiple cancer types and carers . As an example of successful research translation , the Cancer Council NSW has subsequently adopted ENRICH as a state-wide program . Trial registration Australian New Zeal and Clinical Trials Register identifier : ANZCTRN1260901086257 Abstract Background Despite evidence that physical activity improves the health and well-being of prostate cancer survivors , many men do not engage in sufficient levels of activity . The primary aim of this study ( ENGAGE ) is to determine the efficacy of a referral and physical activity program among survivors of prostate cancer , in terms of increasing participation in physical activity . Secondary aims are to determine the effects of the physical activity program on psychological well-being , quality of life and objective physical functioning . The influence of individual and environmental mediators on participation in physical activity will also be determined . Methods / Design This study is a cluster r and omised controlled trial . Clinicians of prostate cancer survivors will be r and omised into either the intervention or control condition . Clinicians in the intervention condition will refer eligible patients ( n = 110 ) to participate in an exercise program , comprising 12 weeks of supervised exercise sessions and unsupervised physical activity . Clinicians allocated to the control condition will provide usual care to eligible patients ( n = 110 ) , which does not involve the recommendation of the physical activity program . Participants will be assessed at baseline , 12 weeks , 6 months , and 12 months on physical activity , quality of life , anxiety , depression , self-efficacy , outcome expectations , goals , and socio-structural factors . Discussion The findings of this study have implication s for clinicians and patients with different cancer types or other chronic health conditions . It will contribute to our underst and ing on the potential impact of clinicians promoting physical activity to patients and the long term health benefits of participating in physical activity programs . Trial registration Australia and New Zeal and Clinical Trials Register ( ANZCTR ) : ACTRN12610000609055 Deakin University Human Research Ethics Approval 2011 - PURPOSE To examine the effect of progressive resistance training on muscle function , functional performance , balance , body composition , and muscle thickness in men receiving and rogen deprivation for prostate cancer . METHODS Ten men aged 59 - 82 yr on and rogen deprivation for localized prostate cancer undertook progressive resistance training for 20 wk at 6- to 12-repetition maximum ( RM ) for 12 upper- and lower-body exercises in a university exercise rehabilitation clinic . Outcome measures included muscle strength and muscle endurance for the upper and lower body , functional performance ( repeated chair rise , usual and fast 6-m walk , 6-m backwards walk , stair climb , and 400-m walk time ) , and balance by sensory organization test . Body composition was measured by dual-energy x-ray absorptiometry and muscle thickness at four anatomical sites by B-mode ultrasound . Blood sample s were assessed for prostate specific antigen ( PSA ) , testosterone , growth hormone ( GH ) , cortisol , and hemoglobin . RESULTS Muscle strength ( chest press , 40.5 % ; seated row , 41.9 % ; leg press , 96.3 % ; P < 0.001 ) and muscle endurance ( chest press , 114.9 % ; leg press , 167.1 % ; P < 0.001 ) increased significantly after training . Significant improvement ( P < 0.05 ) occurred in the 6-m usual walk ( 14.1 % ) , 6-m backwards walk ( 22.3 % ) , chair rise ( 26.8 % ) , stair climbing ( 10.4 % ) , 400-m walk ( 7.4 % ) , and balance ( 7.8 % ) . Muscle thickness increased ( P < 0.05 ) by 15.7 % at the quadriceps site . Whole-body lean mass was preserved with no change in fat mass . There were no significant changes in PSA , testosterone , GH , cortisol , or hemoglobin . CONCLUSIONS Progressive resistance exercise has beneficial effects on muscle strength , functional performance and balance in older men receiving and rogen deprivation for prostate cancer and should be considered to preserve body composition and reduce treatment side effects Purpose Few studies have investigated long-term effects of physical activity ( PA ) interventions . The goal of this study was to evaluate whether or not increased levels of moderate to vigorous physical activity ( MVPA ) were maintained by cancer survivors 1 year after receipt of two home-based interventions . Methods The FRESH START trial r and omized 543 breast and prostate cancer survivors to 1-of-2 mailed print diet and exercise interventions : sequentially-tailored vs. st and ardized ( attention control ) . Each arm received eight mailings over a 1-year period , with follow-up at 1 and 2 years . This analysis focuses solely on the 400 participants who had suboptimal levels of MVPA at baseline ( measured by the 7-Day Physical Activity Recall ) and who completed the 2-year study . Results Median minutes of MVPA at baseline , 1-year and 2-year follow-up in the tailored intervention arm were as follows : 0 , 90 , and 60 min/week , respectively . The corresponding values in the attention control group were 0 , 30 , and 30 min/week . Significant improvements in MVPA from baseline to 2-year follow-up were observed in both study arms ( p < 0.01 ) . While significant between-arm differences were observed at 1-year follow-up ( p < 0.01 ) , there was only the suggestion of a trend ( p = 0.08 ) at 2-year follow-up . Conclusions This study provides evidence that mailed-print exercise interventions result in significant and sustainable improvements in MVPA among newly diagnosed cancer survivors that are observed well after the intervention is complete . While tailored interventions , as compared to st and ardized material s , appear to produce superior improvements in MVPA initially , these differences diminish over time Background According to the CONSORT statement , significance testing of baseline differences in r and omized controlled trials should not be performed . In fact , this practice has been discouraged by numerous authors throughout the last forty years . During that time span , reporting of baseline differences has substantially decreased in the leading general medical journals . Our own experience in the field of nutrition behavior research however , is that co- authors , review ers and even editors are still very persistent in their dem and for these tests . The aim of this paper is therefore to negate this dem and by providing clear evidence as to why testing for baseline differences between intervention groups statistically is superfluous and why such results should not be published . Discussion Testing for baseline differences is often propagated because of the belief that it shows whether r and omization was successful and it identifies real or important differences between treatment arms that should be accounted for in the statistical analyses . Especially the latter argument is flawed , because it ignores the fact that the prognostic strength of a variable is also important when the interest is in adjustment for confounding . In addition , including prognostic variables as covariates can increase the precision of the effect estimate . This means that choosing covariates based on significance tests for baseline differences might lead to omissions of important covariates and , less importantly , to inclusion of irrelevant covariates in the analysis . We used data from four supermarket trials on the effects of pricing strategies on fruit and vegetables purchases , to show that results from fully adjusted analyses sometimes do appreciably differ from results from analyses adjusted for significant baseline differences only . We propose to adjust for known or anticipated important prognostic variables . These could or should be pre-specified in trial protocol s. Subsequently , authors should report results from the fully adjusted as well as crude analyses , especially for dichotomous and time to event data . Summary Based on our arguments , which were illustrated by our findings , we propose that journals in and outside the field of nutrition behavior actively adopt the CONSORT 2010 statement on this topic by not publishing significance tests for baseline differences anymore Background The Exercise and Nutrition Routine Improving Cancer Health ( ENRICH ) study is investigating a novel lifestyle intervention aim ed at improving the health behaviors of adult cancer survivors and their carers . The main purpose of the study is to determine the efficacy of lifestyle education and skill development delivered via group-based sessions on the physical activity and dietary behaviors of participants . This article describes the intervention development , study design , and participant recruitment . Methods / Design ENRICH is a r and omized controlled trial , conducted in Australia , with two arms : an intervention group participating in six , two-hour face-to-face sessions held over eight weeks , and a wait-list control group . Intervention sessions are co-facilitated by an exercise physiologist and dietician . Content includes healthy eating education , and a home-based walking ( utilizing a pedometer ) and resistance training program ( utilizing elastic tubing resistance devices ) . The program was developed with reference to social cognitive theory and chronic disease self-management models . The study population consists of cancer survivors ( post active-treatment ) and their carers recruited through community-based advertising and referral from health professionals . The primary outcome is seven-days of sealed pedometry . Secondary outcomes include : self-reported physical activity levels , dietary intake , sedentary behavior , waist circumference , body mass index , quality of life , and perceived social support . The outcomes will be measured at baseline ( one week prior to attending the program ) , eight-weeks ( at completion of intervention sessions ) , and 20-weeks . The intervention group will also be invited to complete 12-month follow-up data collection . Process evaluation data will be obtained from participants by question naire and attendance records . Discussion No trials are yet available that have evaluated the efficacy of group-based lifestyle education and skill development amongst mixed groups of cancer survivors and their carers . The results will have implication s for the planning and provision of health and support services during the cancer survivorship phase . Clinical Trials Registration Australian New Zeal and Clinical Trials Register identifier : ANZCTRN12609001086257 PURPOSE Cancer survivors are at increased risk for cardiovascular disease , diabetes , osteoporosis , and second primary tumors . Healthful lifestyle practice s may improve the health and well-being of survivors . The FRESH START trial tested the efficacy of sequentially tailored versus st and ardized mailed material s on improving cancer survivors ' diet and exercise behaviors . METHODS Five hundred forty-three individuals with newly diagnosed locoregional breast or prostate cancer were recruited from 39 states and two provinces within North America . Participants were r and omly assigned either to a 10-month program of tailored mailed print material s promoting fruit and vegetable ( F&V ) consumption , reducing total/saturated fat intake , and /or increasing exercise or to a 10-month program of nontailored mailed material s on diet and exercise available in the public domain . Telephone surveys conducted at baseline and 1 year assessed body mass index ( BMI ) , dietary consumption , physical activity , and other psychosocial/behavioral indices . Clinical assessment s were conducted on a 23 % sub sample ; information was used to vali date self-reports . RESULTS Five hundred nineteen participants completed the 1-year follow-up ( 4.4 % attrition ; sample characteristics : 57 + /- 10.8 years old , 83 % white , 56 % female , 64 % overweight/obese , and 0 % underweight ) . Although both arms significantly improved their lifestyle behaviors ( P < .05 ) , significantly greater gains occurred in the FRESH START intervention versus the control arm ( practice of two or more goal behaviors : + 34 % v + 18 % , P < .0001 ; exercise minutes per week : + 59.3 v + 39.2 minutes , P = .02 ; F&V per day : + 1.1 v + 0.6 servings , P = .01 ; total fat : -4.4 % v -2.1 % , P < .0001 ; saturated fat : -1.3 % v -0.3 % , P < .0001 ; and BMI : -0.3 v + 0.1 kg/m2 , respectively , P = .004 ) . CONCLUSION Mailed material interventions , especially those that are tailored , are effective in promoting healthful lifestyle changes among cancer survivors . Further study is needed to determine sustainability , cost to benefit , and generalizability to other cancer population Background Despite increasing numbers of cancer survivors and evidence that diet and physical activity improves the health of cancer survivors , most do not meet guidelines . Some social cognitive theory (SCT)-based interventions have increased physical activity behavior , however few have used objective physical activity measures . The Exercise and Nutrition Routine Improving Cancer Health ( ENRICH ) r and omized controlled trial reported a significant intervention effect for the primary outcome of pedometer-assessed step counts at post-test ( 8-weeks ) and follow-up ( 20-weeks ) . The aim of this study was to test whether the SCT constructs operationalized in the ENRICH intervention were mediators of physical activity behavior change . Methods R and omized controlled trial with 174 cancer survivors and carers assessed at baseline , post-test ( 8-weeks ) , and follow-up ( 20-weeks ) . Participants were r and omized to the ENRICH six session face-to-face healthy lifestyle program , or to a wait-list control . Hypothesized SCT mediators of physical activity behavior change ( self-efficacy , behavioral goal , outcome expectations , impediments , and social expectations ) were assessed using valid and reliable scales . Mediation was assessed using the Preacher and Hayes SPSS INDIRECT macro . Results At eight weeks , there was a significant intervention effect on behavioral goal ( A = 9.12 , p = 0.031 ) and outcome expectations ( A = 0.25 , p = 0.042 ) . At 20 weeks , the intervention had a significant effect on self-efficacy ( A = 0.31 , p = 0.049 ) and behavioral goal ( A = 13.15 , p = 0.011 ) . Only changes in social support were significantly associated with changes in step counts at eight weeks ( B = 633.81 , p = 0.023 ) . Behavioral goal was the only SCT construct that had a significant mediating effect on step counts , and explained 22 % of the intervention effect at 20 weeks ( AB = 397.9 , 95 % CI 81.5–1025.5 ) . Conclusions SCT constructs had limited impact on objective ly-assessed step counts in a multiple health behavior change intervention for cancer survivors and their carers . Behavioral goal measured post-intervention was a significant mediator of pedometer-assessed step counts at 3-months after intervention completion , and explained 22 % of the intervention effect . Future research should examine the separate impact of goals and planning , as well as examining mediators of behavior maintenance in physical activity interventions targeting cancer survivors . Trial registration Australian and New Zeal and Clinical Trials registry ANZCTRN1260901086257 Background Underst and ing reasons for non-participation in health studies can help guide recruitment strategies and inform research ers about potential sources of bias in their study sample . Whilst there is a paucity of literature regarding this issue , it remains highly plausible that men and women may have varied reasons for declining an invitation to participate in research . We aim ed to investigate sex-differences in the reasons for non-participation at baseline of the Geelong Osteoporosis Study ( GOS ) . Methods The GOS , a prospect i ve cohort study , r and omly recruited men and women aged 20 years and over from a region in south-eastern Australia using Commonwealth electoral rolls ( 2001–06 and 1993–97 , respectively ) . Reasons for non-participation ( n=1,200 ) were documented during the two recruitment periods . We used the Pearson ’s chi squared test to explore differences in the reasons for non-participation between men and women . Results Non-participation in the male cohort was greater than in the female cohort ( 32.9 % vs. 22.9 % ; p<0.001 ) . Overall , there were sex-differences in the reasons provided for non-participation ( p<0.001 ) ; apparent differences related to time constraints ( men 26.3 % vs. women 10.4 % ) , frailty/inability to cope with or underst and the study ( men 18.7 % vs. women 30.6 % ) , and reluctance over medical testing ( men 1.1 % vs women 9.9 % ) . No sex-differences were observed for non-participation related to personal reason/disinterest , and language - or travel-related reasons . Conclusions Improving participation rates in epidemiological studies may require different recruitment strategies for men and women in order to address sex-specific concerns about participating in research Objective : To evaluate the feasibility and efficacy of the ‘ Healthy Dads , Healthy Kids ’ ( HDHK ) program , which was design ed to help overweight fathers lose weight and be a role model of positive health behaviors for their children . Design : R and omized controlled trial . Participants : A total of 53 overweight/obese men ( mean ( s.d . ) age=40.6 ( 7.1 ) years ; body mass index ( BMI ) = 33.2 ( 3.9 ) ) and their primary school-aged children ( n=71 , 54 % boys ; mean ( s.d . ) age=8.2 ( 2.0 ) years ) were r and omly assigned ( family unit ) to either ( i )  the HDHK program ( n=27 fathers , n=39 children ) or ( ii ) a wait-list control group ( n=26 fathers , n=32 children).Intervention : Fathers in the 3-month program attended eight face-to-face education sessions . Children attended three of these sessions . Outcomes : The primary outcome was fathers ’ weight .  Fathers and their children were assessed at baseline , and at 3- and 6-month follow-up , for weight , waist circumference , BMI , blood pressure , resting heart rate ( RHR ) , objective ly measured physical activity and self-reported dietary intake . Results : Intention-to-treat analysis revealed significant between-group differences at 6 months for weight loss ( P<0.001 ) , with HDHK fathers  losing more weight ( −7.6 kg ; 95 % confidence interval ( CI ) −9.2 , −6.0 ; d=0.54 ) than control group fathers ( 0.0 kg ; 95 % CI −1.4 , 1.6 ) . Significant treatment effects ( P<0.05 ) were also found for waist circumference ( d=0.62 ) , BMI ( d=0.53 ) , systolic blood pressure ( d=0.92 ) , RHR ( d=0.66 ) and physical activity ( d=0.91 ) , but not for dietary intake . In children , significant treatment effects ( P<0.05 ) were found for physical activity ( d=0.74 ) , RHR ( d=0.51 ) and dietary intake ( d=0.84 ) . Conclusion : The HDHK program result ed in significant weight loss and improved health-related outcomes in fathers and improved eating and physical activity among children . Targeting fathers is a novel and efficacious approach to improving health behavior in their children Prostate cancer can threaten quality of life for the patient and his spouse and the quality of his marital relationship . The purpose of our study is to evaluate the effects of " Exercising Together " - a partnered strength training program for married couples coping with prostate cancer - on the physical and emotional health of  prostate cancer survivors ( PCS ) and their spouses and on marital quality . We are conducting a 6-month r and omized controlled trial with two groups : 1 ) Exercising Together - a progressive , supervised strength training program and 2 ) a usual care control condition . The primary aims of this exploratory study are to : 1 ) Determine the effect of partnered strength training on physical and emotional health ( muscle strength , physical function , body composition and self-report physical and mental health ) in PCS , 2 ) Determine the effect of partnered strength training on physical and emotional health in spouses and 3 ) Explore the effect of partnered strength training on marital quality ( incongruence , communication , relationship quality , intimacy ) of the PCS and spouse . Target accrual has been met in this study with 64 couples enrolled and r and omized to exercise ( n=32 ) or usual care ( n=32 ) groups . This study is the first to examine the feasibility of this exercise format in both the chronically ill patient and spouse and explore benefits at the individual and couple level PURPOSE FRESH START is a r and omized controlled trial that will test whether a personally tailored , distance-medicine-based program will increase exercise and fruit and vegetable consumption , and decrease fat intake of individuals recently diagnosed with breast or prostate cancer . METHODS Early-stage breast and prostate cancer cases ( N= 530 ) will be identified within 9 months of diagnosis from hospital cancer registries and large oncologic practice s throughout the United States . These individuals will be sent a letter of invitation and screened for eligibility . After a baseline telephone interview , participants will be r and omized into one of two arms that receive material s aim ed at increasing exercise and fruit and vegetable intake , and decreasing dietary fat : 1 ) . an experimental arm that receives a workbook and a series of six 4-page newsletters delivered every 7 wk and personally tailored on type of cancer , cancer coping style , race , age , self-efficacy , stage of readiness , and barriers and /or progress toward goal behavior ( i.e. , > or= 30 min of exercise at least 5 d.wk , > or= 5 servings of vegetables and fruit per day , and < or= 30 % of calories from fat ) ; or 2 ) . a control arm that receives a series of nontailored health brochures . Follow-up interviews scheduled 1 and 2 yr postbaseline will determine short- and long-term efficacy and the effects of the interventions on other endpoints ( quality of life , perceived health , etc . ) . Factors , such as gender , race , and social support , also will be explored to determine potential interactions with program efficacy . CONCLUSION Given the growing number of cancer survivors , distance-medicine-based interventions addressing multiple behaviors and targeting this high-risk group have the potential to make a positive and broad public health impact BACKGROUND Active for Life After Cancer is a r and omized trial evaluating the efficacy of a 6-month group-based lifestyle physical activity program ( Lifestyle ) for prostate cancer patients to improve quality of life ( QOL ) including physical and emotional functioning compared to a group-based Educational Support Program and a St and ard Care Program ( no group ) . METHOD A total of 134 prostate cancer patients receiving continuous and rogen-ablation were r and omly assigned to one of the three study conditions . RESULTS Results indicated no significant improvements in QOL at 6 or 12 months . Both group-based programs were positively received and yielded good attendance and retention . Lifestyle participants demonstrated significant improvements in most theoretical mediators proposed by the Transtheoretical Model and Social Cognitive Theory to affect physical activity . Despite these improvements , no significant changes were found for most physical activity measures . CONCLUSIONS Results suggest a lifestyle program focusing on cognitive-behavioral skills training alone is insufficient for promoting routine physical activity in these patients Abstract Introduction . The aim of cancer rehabilitation is to enable patients to attain and maintain optimal physical , psychological and social functioning . We evaluated the effect on health behavior , BMI and self-rated health of a residential psychosocial rehabilitation course for cancer patients . Material and methods . Patients with a primary cancer of the breast , prostate , colon or rectum were r and omized to either a six-day multi-focus psychosocial residential rehabilitation intervention that included lectures , discussion s and peer group discussion s on issues related to treatment and life with cancer or to usual care . The end points were changes in smoking , alcohol consumption , physical activity , body mass index and self-rated health between baseline and follow-up after one and six months . The primary analyses included all participants who received their allocated condition . The two follow-up times were analyzed separately in general linear and logistic regression models for continuous and dichotomous outcomes , respectively . The analyses were adjusted for baseline outcome score , cancer site , time since diagnosis , age and education . Results . Of the 507 participants who were r and omly assigned , 452 were included in the analysis , of whom 404 completed the one month and 394 completed the six month assessment . The intervention group showed slightly more positive changes in health behavior , BMI and self-rated health than the usual care group , but the differences between the groups were small and not significant . Discussion . Participation in a six-day cancer rehabilitation course did not significantly influence health behavior , BMI or self-rated health among cancer patients Purpose The purpose of this study was to compare the medical , demographic and social cognitive correlates of physical activity ( PA ) in breast ( BCS ) , prostate ( PCS ) and colorectal ( CRCS ) cancer survivors . Methods A stratified r and om sample of 2062 BC , PC and CRC survivors diagnosed between 2003 and 2011 was identified by the Nova Scotia Cancer Registry ( NSCR ) and mailed a question naire assessing PA , social – cognitive constructs from the theory of planned behaviour ( TPB ) , and demographic and medical variables . Structural equation modelling was used to conduct path analyses of the TPB within each cancer survivor group and an invariance analysis was used to compare the TPB across groups . Results A total of 741 completed surveys were analysed . Overall , 42 % of cancer survivors were meeting PA guidelines with no differences among the cancer sites . Treatment-related variables were strong correlates of PA in PC survivors but not for BC or CRC . Body mass index was strongly associated with PA in BC survivors but not PC or CRC . Path analyses within each cancer survivor group showed that intention was significantly associated with PA for CRCS only ; planning was significantly associated with PA for BCS and PCS only ; and perceived behavioural control ( PBC ) was significantly associated with PA for PCS only . For intention , PBC and instrumental attitude ( IA ) were significant correlates in all three cancer survivor groups whereas affective attitude ( AA ) was significant for BCS and CRCS only ; and descriptive norm ( DN ) was significant for PCS and CRCS only . Invariance analyses revealed significantly stronger relationships for ( a ) intention to planning for BCS compared to PCS , ( b ) affective attitude to intention for CRCS compared to PCS , and ( c ) planning to PA for PCS compared to CRCS . Conclusions Although BC , PC , and CRC survivors have similar levels of PA , the correlates of their PA may differ . These findings may inform cancer site-specific interventions to promote PA in cancer survivors The objectives were to ( 1 ) prospect ively evaluate fatigue utilizing vali date d instruments in patients with localized prostate cancer , and ( 2 ) examine the relationships between fatigue , depression , quality of life , and sleep disturbance . The instruments used included : Piper Fatigue Scale , Beck Depression Inventory , Epworth Sleepiness Scale , and Functional Assessment of Cancer Therapy for Prostate Scale . Data on cancer stage , prostate specific antigen levels , hematocrit , patient 's body weight and radiation dosage were recorded . Patients were evaluated preradiotherapy , middle of radiotherapy , completion of radiotherapy , and at 4 - 5 weeks follow-up . Thirty-six veterans with localized prostate cancer were studied . Mean age was 66.9 years ( range 55 - 79 ) . Duration of treatment was 7 - 8 weeks . Univariate procedure and Wilcoxon Signed Rank-test were used to examine changes in pretreatment scores for each of the three subsequent study periods . To adjust for multiple comparisons Bonferroni test was used . Spearman Correlations were calculated among parameters . No significant changes were noted in mean scores of hematocrit and body weight during the study period . On the Piper Fatigue Scale , adjusted for multiple comparisons , the median scores were significantly higher at completion of radiotherapy as compared with preradiotherapy values . Three patients ( 8 % ) were experienced fatigue according to Piper Fatigue Scale before treatment as compared to nine patients ( 25 % ) at completion of radiotherapy . On Prostate Cancer Specific and Physical Well Being subscales of the Functional Assessment for Prostate Cancer Therapy , the scores were significantly lower at middle and completion of radiotherapy than at pretreatment . At preradiotherapy , middle of radiotherapy , completion of radiotherapy and follow-up evaluation , patients scoring higher on the Piper Fatigue Scale were more likely to report a poorer quality of Physical Well Being on Functional Assessment of Cancer Therapy for Prostates . No significant changes were noted in the Beck Depression Inventory and Epworth Sleepiness Scale scores during treatment . Eight patients scored 10 or more on the Beck Depression Inventory before starting radiotherapy , suggesting depressive symptomatology . Of these , only seven patients scored 10 or more at completion of treatment . The incidence of fatigue is lower in our study than in previously published data . A relationship exists between fatigue scores and physical well being subscale scores . Higher scores on the Piper Fatigue Scale at the completion of radiotherapy , as well as no changes on depression and sleepiness scales , suggest that fatigue may not be the result of depression or sleep disturbance . Based upon our previous work , we propose that the physical expression of fatigue may be secondary to a decline in neuromuscular efficiency and enhanced muscle fatigue The U.S. population is aging , bringing with it an increased prevalence of chronic disease and concomitant declines in physical function . The risk of developing cancer increases significantly with age , and functional decline is much more likely once a cancer diagnosis is rendered . Thus , functional status in later life is a key concern , one that is heightened among elders who have been diagnosed with cancer . To date , however , there have been few trials that have exclusively addressed issues related to cancer survivorship among older cancer patients , and to our knowledge , none has focused on preserving or enhancing physical functioning . This paper describes the study design and method ological considerations of a r and omized controlled trial to determine if a personally tailored workbook and telephone counseling program can positively affect physical activity and dietary behaviors and ultimately the physical functioning of up to 420 older men and women newly diagnosed with breast or prostate cancer . This trial is unique because the cancer diagnosis is used not only as a marker of risk for functional decline , but also as a " teachable moment " - an opportune time when elders may be more receptive to making beneficial lifestyle changes . Undoubtedly , as cure rates for cancer increase and intersect with ever-growing numbers of elderly , there will be numerous opportunities to provide and test interventions within this vulnerable population and to target functional status as a primary outcome . In reporting our methods , we hope to give others " a leg up , " so that they can hurdle with greater ease the barriers we experienced , and thus advance the field more rapidly BACKGROUND This study examined whether changes in self-efficacy explain the effects of a mailed print intervention on long-term dietary practice s of breast and prostate cancer survivors . The relationship between change in self-efficacy and  long-term physical activity ( PA )  also was examined . METHODS Breast and prostate cancer survivors ( N = 543 ) from 39 US states and two Canadian provinces participated in the FRESH START intervention trial . Participants were r and omly assigned to receive a 10-month program of mailed print material s on diet and PA available in the public domain or a 10-month program of tailored material s design ed to increase fruit and vegetable ( F&V ) intake , decrease fat intake , and /or increase PA .  Changes in self-efficacy for F&V intake and fat restriction were analyzed as potential mediators of the intervention 's effects on diet at 2-year follow-up . Because we previously found that change in self-efficacy for  PA  did not vary by group assignment , the relationship between change in self-efficacy and  PA  at 2-year follow-up was examined across study conditions . RESULTS Results suggest that change in self-efficacy for fat restriction partially explained the intervention 's effect on fat intake ( mean indirect effect = -0.28 ) , and change in self-efficacy for F&V consumption partially explained the intervention 's effect on daily F&V intake ( mean indirect effect = .11 ) . Change in self-efficacy for fat restriction partially accounted for the intervention 's impact on overall diet quality among men only ( mean indirect effect = 0.60 ) . Finally , change in self-efficacy for PA  predicted  PA  at 2-year follow-up . CONCLUSIONS Findings suggest that self-efficacy may influence long-term maintenance of healthy lifestyle practice s among cancer survivors PURPOSE Declines in physical functioning ( PF ) among elderly cancer patients threaten quality of life and the ability to maintain independence . Adherence to healthy lifestyle behaviors may prevent functional decline . PATIENTS AND METHODS Project Leading the Way in Exercise and Diet ( LEAD ) , an intervention development study of the Pepper Older Americans Independence Center , aim ed to determine whether breast and prostate cancer survivors ( age 65 + years ) assigned to a 6-month home-based diet and exercise intervention  experienced improvements in PF when compared with an attention control arm receiving general health information . An accrual target was set at 420 , and PF ( Short Form-36 subscale ) , physical activity ( Community Healthy Activities Models Program for Seniors ) , and diet quality ( index from 3-day recalls ) were assessed at baseline and at 6 and 12 months ( 6 months after intervention ) . RESULTS This developmental project did not achieve its accrual target ( N = 182 ) ; however , PF change scores were in the direction and of the magnitude projected . Baseline to 6-month change scores in the intervention versus the control arms were as follows : PF , + 3.1 v -0.5 ( P = .23 ) ; physical activity energy expenditure , + 111 kcal/wk v -400 kcal/wk ( P = .13 ) ; and diet quality index , + 2.2 v -2.9 ( P = .003 ) , respectively . Differences between arms diminished during the postintervention period . CONCLUSION These findings suggest that home-based diet and exercise interventions hold promise in improving lifestyle behaviors among older cancer survivors , changes that trend toward improved PF . Future studies should incorporate larger sample sizes and interventions that sustain long-term effects and also take into account secular trends ; these efforts will require adequate planning and re sources to overcome the numerous barriers to intervening in this difficult to reach yet vulnerable population PURPOSE To assess long-term quality of life ( QoL ) impact of treatments in localized prostate cancer patients treated with radical prostatectomy , external beam radiotherapy or brachytherapy .  MATERIAL AND METHODS Observational , prospect i ve cohort study with pre-treatment QoL evaluation and follow-up until five years after treatment . 704 patients with low or intermediate risk localized prostate cancer were consecutively recruited in 2003 - 2005 .  QoL was measured by the EPIC question naire , with urinary irritative-obstructive , incontinence , bowel , sexual , and hormonal scores ( ranging 0 - 100 ) . RESULTS Brachytherapy 's  QoL impact was restricted to the urinary domain , Generalized Estimating Equation models showed score changes at five years of -12.0 ( 95 % CI=-15.0 , -9.0 ) in incontinence and -5.3 ( 95 % CI=-7.5 , -3.1 ) in irritative-obstructive scales . Compared to brachytherapy , radical prostatectomy fared + 3.3 ( 95 % CI=+0.0 , + 6.5 ) points better in irritative-obstructive but -17.1 ( 95 % CI=-22.7 , -11.5 ) worse in incontinence . Sexual deterioration was observed in radical prostatectomy ( -19.1 ; 95 % CI=-25.1 , -13.1 ) and external radiotherapy groups ( -7.5 ; 95 % CI=-12.5 , -2.5 ) . CONCLUSIONS Brachytherapy is the treatment causing the least impact on QoL except for moderate urinary irritative-obstructive symptoms . Our study provides novel long-term valuable information for clinical decision making , supporting brachytherapy as a possible alternative to radical prostatectomy for patients seeking an attempted curative treatment , while limiting the risk for urinary incontinence and sexual impact on Prostate cancer patients receiving and rogen ablation therapy  experience significant physical and psychological sequelae associated with their disease and treatment . Because physical activity improves physical and psychological well-being , a lifestyle physical activity intervention may help slow or reverse the associated decline in quality of life ( QOL ) . No studies have evaluated an intervention to improve multiple QOL domains in patients receiving and rogen ablation therapy . Active for Life After Cancer is a three-group r and omized controlled trial design ed to evaluate the effectiveness of a lifestyle physical activity intervention ( Lifestyle Program ) in improving QOL . The Lifestyle Program , a 6-month behavioral skills training group , is compared to an Educational Support Program and St and ard Care . The purpose of this paper is to describe the design of the r and omized trial and present baseline data that will characterize the QOL of the sample . Challenges to recruitment for the trial also will be presented and discussed OBJECTIVE Cure rates for cancer are increasing , especially for breast , prostate , and colorectal cancer . Despite positive trends in survivorship , a cancer diagnosis can trigger accelerated functional decline that can threaten independence , reduce quality -of-life and increase healthcare costs , especially among the elderly who comprise the majority of survivors .  Lifestyle interventions may hold promise in reorienting functional decline in older cancer survivors , but few studies have been conducted . METHODS We describe the design and methods of a r and omized controlled trial , RENEW ( Reach out to ENhancE Wellness ) , that tests whether a home-based multi-behavior intervention focused on exercise , and including a low saturated fat , plant-based diet , would improve physical functioning among 641 older , long-term ( > or=5 years post-diagnosis ) survivors of breast , prostate , or colorectal cancer . Challenges to recruitment are examined . RESULTS Twenty thous and and fifteen cases were approached , and screened using a two-step screening process to assure eligibility . This population of long-term , elderly cancer survivors had lower rates of response ( approximately 11 % ) and higher rates of in eligibility ( approximately 70 % ) than our previous intervention studies conducted on adults with newly diagnosed cancer . Significantly higher response rates were noted among survivors who were White , younger , and more proximal to diagnosis and breast cancer survivors ( p-values<0.001 ) . CONCLUSION Older cancer survivors represent a vulnerable population for whom lifestyle interventions may hold promise . RENEW may provide guidance in allocating limited re sources in order to maximize recruitment efforts aim ed at this needy , but hard-to-reach population BACKGROUND Whether physical activity has benefits against prostate cancer incidence or progression is unclear . Therefore , we assessed physical activity in relation to prostate cancer incidence , mortality , and Gleason histologic grade . METHODS We used data from the Health Professionals Follow-up Study , a prospect i ve cohort study , to determine the number of cases of incident , advanced ( seminal vesicle invasion , metastasis , or fatal ) , fatal , and high- grade prostate cancer in a cohort of 47,620 US male health professionals , followed up from February 1 , 1986 , to January 31 , 2000 . RESULTS During 14 years of follow-up , we documented 2892 new cases of prostate cancer , including 482 advanced cases ( 280 of which were fatal ) . For total prostate cancer , no association was observed for total , vigorous , and nonvigorous physical activity . In men 65 years or older , we observed a lower risk in the highest category of  vigorous activity  for advanced ( multivariable relative risk , 0.33 ; 95 % confidence interval , 0.17 - 0.62 , for more than 29 vs 0 metabolic equivalent hours ) and for fatal ( relative risk , 0.26 ; 95 % confidence interval , 0.11 - 0.66 ) prostate cancer . No associations were observed in younger men . Differential screening by  prostate-specific antigen  or a reduction in physical activity  due to undiagnosed prostate cancer did not appear to account for the results . Among cases , men with high levels of physical activity were less likely to be diagnosed with poorly differentiated cancers ( Gleason grade > or = 7 ) . CONCLUSION Although the mechanisms are not yet understood , these findings suggest that regular vigorous activity could slow the progression of prostate cancer and might be recommended to reduce mortality from prostate cancer , particularly given the many other documented benefits of exercise CONTEXT Five-year survival rates for early stage colorectal , breast , and prostate cancer currently exceed 90 % and are increasing . Cancer survivors are at greater risk for second malignancies , other comorbidities , and accelerated functional decline . Lifestyle interventions may provide benefit , but it is unknown whether long-term cancer survivors can modify their lifestyle behaviors sufficiently to improve functional status . OBJECTIVE To determine whether a telephone counseling and mailed print material -based diet and exercise intervention is effective in reorienting functional decline in older , overweight cancer survivors . DESIGN , SETTING , AND PARTICIPANTS R and omized controlled trial of 641 overweight ( body mass index > or = 25 and < 40 ) , long-term ( > or = 5 years ) survivors ( aged 65 - 91 years ) of colorectal , breast , and prostate cancer , who were r and omly assigned to an intervention group ( n = 319 ) or delayed intervention ( control ) group ( n = 322 ) in Canada , the United Kingdom , and 21 US states . Individuals were recruited for the Reach out to Enhance Wellness ( RENEW ) trial from July 1 , 2005 , through May 17 , 2007 . INTERVENTION A 12-month , home-based tailored program of telephone counseling and mailed material s promoting exercise , improved diet quality , and modest weight loss . The control group was wait-listed for 12 months . MAIN OUTCOME MEASURES Change in self-reported physical function on the Short-Form 36 physical function subscale ( score range , 0 - 100 ; a high score indicates better functioning ) from baseline to 12 months was the primary end point . Secondary outcomes included changes in function on the basic and advanced lower extremity function subscales of the Late Life Function and Disability Index ( score range , 0 - 100 ) , physical activity , body mass index , and overall health-related quality of life . RESULTS The mean baseline Short-Form 36 physical function score was 75.7 . At the 12-month follow-up , the mean function scores declined less rapidly in the intervention group ( -2.15 ; 95 % confidence interval [ CI ] , -0.36 to -3.93 ) compared with the control group ( -4.84 ; 95 % CI , -3.04 to -6.63 ) ( P = .03 ) . The mean baseline basic lower extremity function score was 78.2 . The mean changes in basic lower extremity function were 0.34 ( 95 % CI , -0.84 to 1.52 ) in the intervention group compared with -1.89 ( 95 % CI , -0.70 to -3.09 ) in the control group ( P = .005 ) . Physical activity , dietary behaviors , and overall quality of life increased significantly in the intervention group compared with the control group , and weight loss also was greater ( 2.06 kg [ 95 % CI , 1.69 to 2.43 kg ] vs 0.92 kg [ 95 % CI , 0.51 to 1.33 kg ] , respectively ; P < .001 ) . CONCLUSION Among older , long-term survivors of colorectal , breast , and prostate cancer , a diet and exercise intervention reduced the rate of self-reported functional decline compared with no intervention . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00303875 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
target: Conclusion There is preliminary evidence to suggest that a variety of physical activity behaviour change interventions targeting men with a history of prostate cancer can be efficacious , at least in the short term .
background: Purpose Men who are survivors of prostate cancer report a variety of psychological and physical factors contributing to a lower quality of life , and physical activity can assist to mitigate these issues .
  This review aims to provide a summary of physical activity behaviour change trials targeting prostate cancer survivors , assess the feasibility of these interventions and , if possible , identify intervention and study characteristics associated with significant intervention effects .