title: Physical activity for men receiving androgen deprivation therapy for prostate cancer: benefits from a 16-week intervention Age- and gender-related test performance in community-dwelling elderly people: Six-Minute Walk Test, Berg Balance Scale, Timed Up & Go Test, and gait speeds. Effects of an oncologist’s recommendation to exercise on self-reported exercise behavior in newly diagnosed breast cancer survivors: a single-blind, randomized controlled trial A phase III clinical trial of exercise modalities on treatment side-effects in men receiving therapy for prostate cancer Intensive lifestyle changes may affect the progression of prostate cancer. A randomized, controlled trial of aerobic exercise for treatment‐related fatigue in men receiving radical external beam radiotherapy for localized prostate carcinoma Skeletal fractures negatively correlate with overall survival in men with prostate cancer. Resistance training and reduction of treatment side effects in prostate cancer patients. Exercise prevents fatigue and improves quality of life in prostate cancer patients undergoing radiotherapy. Reduced muscle strength and functional performance in men with prostate cancer undergoing androgen suppression: a comprehensive cross-sectional investigation Cross‐sectional and longitudinal comparisons of health‐related quality of life between patients with prostate carcinoma and matched controls Physical Function in Men With Prostate Cancer on Androgen Deprivation Therapy Exercise adherence in breast cancer survivors training for a dragon boat race competition: a preliminary investigation. Prospective study of fatigue in localized prostate cancer patients undergoing radiotherapy. Home-based physical activity intervention for breast cancer patients. Lifestyle and health-related quality of life of men with prostate cancer managed with active surveillance. Comparative Effects of Home- and Group-Based Exercise on Balance Confidence and Balance Ability in Older Adults: Cluster Randomized Trial Quality of life intervention for prostate cancer patients: design and baseline characteristics of the active for life after cancer trial. A prospective study of physical activity and incident and fatal prostate cancer. The effect of 6 months of androgen deprivation therapy on muscle and fat mass in older men with localized prostate cancer Sit-to-stand as home exercise for mobility-limited adults over 80 years of age--GrandStand System may keep you standing? Dog ownership, walking behavior, and maintained mobility in late life. Comparing eccentric resistance exercise in prostate cancer survivors on and off hormone therapy: a pilot study. A low-fat diet and/or strenuous exercise alters the IGF axis in vivo and reduces prostate tumor cell growth in vitro. Home exercise to improve strength and walking velocity after hip fracture: a randomized controlled trial. Clinical events in prostate cancer lifestyle trial: results from two years of follow-up. Prospective evaluation of the prevalence and severity of fatigue in patients with prostate cancer undergoing radical external beam radiotherapy and neoadjuvant hormone therapy. Randomized controlled trial of resistance or aerobic exercise in men receiving radiation therapy for prostate cancer.
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 AND PURPOSE The interpretation of patient scores on clinical tests of physical mobility is limited by a lack of data describing the range of performance among people without disabilities . The purpose of this study was to provide data for 4 common clinical tests in a sample of community-dwelling older adults . SUBJECTS Ninety-six community-dwelling elderly people ( 61 - 89 years of age ) with independent functioning performed 4 clinical tests . METHODS Data were collected on the  Six-Minute Walk Test ( 6MW ) , Berg Balance Scale ( BBS ) , and Timed Up & Go Test ( TUG ) and during comfortable- and fast-speed walking ( CGS and FGS ) . Intraclass correlation coefficients ( ICCs ) were used to determine the test-retest reliability for the 6MW , TUG , CGS , and FGS measurements . Data were analyzed by gender and age ( 60 - 69 , 70 - 79 , and 80 - 89 years ) cohorts , similar to previous studies . Means , st and ard deviations , and 95 % confidence intervals for each measurement were calculated for each cohort . RESULTS The 6MW , TUG , CGS , and FGS measurements showed high test-retest reliability ( ICC [2,1]=.95-.97 ) . Mean test scores showed a trend of age-related declines for the 6MW , BBS , TUG , CGS , and FGS for both male and female subjects . DISCUSSION AND CONCLUSION Preliminary descriptive data suggest that physical therapists should use age-related data when interpreting patient data obtained for the 6MW , BBS , TUG , CGS and FGS . Further data on these clinical tests with larger sample sizes are needed to serve as a reference for patient comparisons Background : Increased attention has focused on exercise as a quality of life intervention for breast cancer survivors during and after adjuvant therapy . Purpose : Our objective was to examine the effects of an oncologist ’s recommendation to exercise on self-reported exercise behavior in newly diagnosed breast cancer survivors attending their first adjuvant therapy consultation . Methods : Using a single-blind , 3-armed , r and omized controlled trial , 450 breast cancer survivors were r and omly assigned to receive an oncologist exercise recommendation only , an oncologist exercise recommendation plus referral to an exercise specialist , or usual care . The primary outcome was self-reported total exercise ( in metabolic equivalent [ MET ] hours per week ) at 5 weeks postconsultation . Results : The follow-up assessment rate was 73 % ( 329 of 450 ) . Intention-to-treat analysis based on participants with follow-up data indicated a significant difference in total exercise in favor of the recommendation -only group over the usual care group ( mean difference , 3.4 MET hr per week ; 95 % confidence interval [ CI ] , 0.7–6.1 MET hr per week ; p = .011 ) . There was no significant difference between the recommendation -plus-referral group and the usual care group ( mean difference , 1.5 MET hr per week ; 95 % CI , −1.0 to 4.0 MET hr per week ; p = .244 ) . Ancillary on-treatment analyses showed that participants who recalled an exercise recommendation reported significantly more total exercise than participants who did not recall an exercise recommendation ( mean difference , 4.1 MET hr per week ; 95 % CI , 1.9–6.4 MET hr per week ; p < .001 ) . Conclusions : Our findings suggest that an oncologist recommendation may increase exercise behavior in newly diagnosed breast cancer survivors , particularly if it is recalled 1 week after the recommendation Background And rogen deprivation therapy ( ADT ) is accompanied by a number of adverse side effects including reduced bone mass and increased risk for fracture , reduced lean mass and muscle strength , mood disturbance and increased fat mass compromising physical functioning , independence , and quality of life . The purpose of this investigation is to examine the effects of long term exercise on reversing musculoskeletal-related side effects , and cardiovascular and diabetes risk factors in men receiving and rogen deprivation for their prostate cancer . Specifically , we aim to investigate the effects of a 12-month exercise program design ed to load the musculoskeletal system and reduce cardiovascular and diabetes disease progression on the following primary endpoints : 1 ) bone mineral density ; 2 ) cardiorespiratory function and maximal oxygen capacity ; 3 ) body composition ( lean mass and fat mass ) ; 4 ) blood pressure and cardiovascular function ; 5 ) lipids and glycemic control ; and 6 ) quality of life and psychological distress . Methods / Design Multi-site r and omized controlled trial of 195 men ( 65 subjects per arm ) undergoing treatment for prostate cancer involving ADT in the cities of Perth and Brisbane in Australia . Participants will be r and omized to ( 1 ) resistance/impact loading exercise , ( 2 ) resistance/cardiovascular exercise groups and ( 3 ) usual care/delayed exercise . Participants will then undergo progressive training for 12 months . Measurements for primary and secondary endpoints will take place at baseline , 6 and 12 months ( end of the intervention ) . Discussion The principal outcome of this project will be the determination of the strength of effect of exercise on the well established musculoskeletal , cardiovascular and insulin metabolism side effects of and rogen deprivation in prostate cancer patients . As this project is much longer term than previous investigations in the area of exercise and cancer , we will gain knowledge as to the continuing effects of exercise in this patient population specifically targeting bone density , cardiovascular function , lean and fat mass , physical function and falls risk as primary study endpoints . In terms of advancement of prostate cancer care , we expect dissemination of the knowledge gained from this project to reduce fracture risk , improve physical and functional ability , quality of life and ultimately survival rate in this population . Clinical Trial RegistryA Phase III clinical trial of exercise modalities on treatment side-effects in men receiving therapy for prostate cancer ; PURPOSE Men with prostate cancer are often advised to make changes in diet and lifestyle , although the impact of these changes has not been well documented . Therefore , we evaluated the effects of comprehensive lifestyle changes on prostate specific antigen ( PSA ) , treatment trends and serum stimulated LNCaP cell growth in men with early , biopsy proven prostate cancer after 1 year . MATERIAL S AND METHODS Patient recruitment was limited to men who had chosen not to undergo any conventional treatment , which provided an unusual opportunity to have a nonintervention r and omized control group to avoid the confounding effects of interventions such as radiation , surgery or and rogen deprivation therapy . A total of 93 volunteers with serum PSA 4 to 10 ng/ml and cancer Gleason scores less than 7 were r and omly assigned to an experimental group that was asked to make comprehensive lifestyle changes or to a usual care control group . RESULTS None of the experimental group patients but 6 control patients underwent conventional treatment due to an increase in PSA and /or progression of disease on magnetic resonance imaging . PSA decreased 4 % in the experimental group but increased 6 % in the control group ( p = 0.016 ) . The growth of LNCaP prostate cancer cells ( American Type Culture Collection , Manassas , Virginia ) was inhibited almost 8 times more by serum from the experimental than from the control group ( 70 % vs 9 % , p < 0.001 ) . Changes in serum PSA and also in LNCaP cell growth were significantly associated with the degree of change in diet and lifestyle . CONCLUSIONS Intensive lifestyle changes may affect the progression of early , low grade prostate cancer in men . Further studies and longer term followup are warranted Advice to rest and take things easy if patients become fatigued during radiotherapy may be detrimental . Aerobic walking improves physical functioning and has been an intervention for chemotherapy‐related fatigue . A prospect i ve , r and omized , controlled trial was performed to determine whether aerobic exercise would reduce the incidence of fatigue and prevent deterioration in physical functioning during radiotherapy for localized prostate carcinoma PURPOSE We assessed the correlation of skeletal fracture with survival in men with prostate cancer on chronic and rogen suppressive therapy .  MATERIAL S AND METHODS A total of 195 consecutive patients on chronic and rogen suppression for prostate cancer were evaluated for the history and type of skeletal fracture . Correlation with overall survival was performed via multivariate analysis . RESULTS Of these 195 men 24 reported skeletal fracture since the diagnosis of prostate cancer . Median overall survival was 121 and 160 months in men without and with a history of skeletal fracture since the diagnosis of prostate cancer , respectively ( p = 0.04 ) . A history of skeletal fracture was retained as a negative predictor of survival on forward stepwise regression analysis ( RR = 7.4 , p = 0.007 ) . CONCLUSIONS Our results suggest that skeletal fracture in patients with prostate cancer is an independent and adverse predictor of survival . Consideration for screening men at greatest risk via bone mineral density measurements and initiating empirical skeletal therapies ( bisphosphonates , estrogens and so forth ) may be warranted . This recommendation awaits validation through prospect i ve r and omized trials 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 OBJECTIVE To show fatigue prevention and quality of life ( QOL ) improvement from cardiovascular exercise during  radiotherapy .  DESIGN Prospect i ve enrollment ( n=21 ) , r and omized to exercise ( n=11 ) and control groups ( n=10 ) , with pre- and post-radiotherapy between- and within-group comparisons . SETTING Academic medical center . PARTICIPANTS Localized prostate cancer patients undergoing radiotherapy . INTERVENTIONS The interventional group received radiotherapy plus aerobic exercise 3 times a week for 8 weeks whereas the control group received radiotherapy without exercise . MAIN OUTCOME MEASURES Pre- and post-radiotherapy differences in cardiac fitness , fatigue , depression , functional status , physical , social , and functional well-being , leg strength , and flexibility were examined within and between 2 groups . RESULTS No significant differences existed between 2 groups at pre-radiotherapy assessment . At post-radiotherapy assessment , the exercise group showed significant within group improvements in : cardiac fitness ( P<.001 ) , fatigue ( P=.02 ) , Functional Assessment of Cancer Therapy-Prostate ( FACT-P ) ( P=.04 ) , physical well-being ( P=.002 ) , social well-being ( P=.02 ) , flexibility ( P=.006 ) , and leg strength ( P=.000 ) . Within the control group , there was a significant increase in fatigue score ( P=.004 ) and a decline in social well-being ( P<.05 ) at post-radiotherapy assessment . Between-group differences at post-radiotherapy assessment were significant in cardiac fitness ( P=.006 ) , strength ( P=.000 ) , flexibility ( P<.01 ) , fatigue ( P<.001 ) , FACT-P ( P=.006 ) , physical well-being ( P<.001 ) , social well-being ( P=.002 ) , and functional well-being ( P=.04 ) . CONCLUSIONS An 8-week cardiovascular exercise program in patients with localized prostate cancer undergoing radiotherapy improved cardiovascular fitness , flexibility , muscle strength , and overall QOL and prevented fatigue This study examined the effects of and rogen suppression therapy ( AST ) on upper and lower body muscle strength and a range of direct measures of physical performance using a cross-sectional design with 118 men ( 48 men undertaking AST for prostate cancer and 70 healthy aged-matched controls ) from a single tertiary center . Primary end points included muscle strength for the upper- and lower-body ; functional performance — repeated chair rise , usual and fast 6-m walk , 6-m backwards walk and 400-m walk time ; and dual-energy X-ray absorptiometry assessment —whole body , regional soft tissue composition and bone mineral density ( BMD ) . Men on AST  had significantly reduced muscle strength for the upper- and lower-body and impaired functional performance compared to controls ( P<0.05 ) . As expected , AST patients had significantly lower whole-body and hip BMD and higher percent of body fat than controls ( P<0.05 ) , and tended to have lower whole-body lean mass ( −2.3 kg , P=0.077 ) . Appendicular skeletal muscle was positively associated with upper-body ( r=0.400–0.606 , P<0.001 ) and lower-body ( r=0.549–0.588 , P<0.001 ) muscle strength , and strength was related to functional performance . Men undertaking  AST were consistently impaired across a broad range of physical and functional musculoskeletal performance assessment s compared with their age-matched normal controls . These findings are relevant for those patients considering AST for sub clinical disease management , but whose physical reserve is marginal . Strategies to counter these adverse effects of AST need to be initiated so that independent living and quality of life can be maintained Prostate carcinoma and treatments affect health‐related quality of life ( HRQOL ) . The authors prospect ively compared prostate and general HRQOL between prostate carcinoma cases and an age‐matched and ethnicity‐matched control group Background and Purpose : And rogen deprivation therapy ( ADT ) has become an increasingly st and ard intervention for both early and advanced stages of prostate cancer ; however , decreased physical function and hypogonadism have been reported in men receiving ADT . The objectives of this study were : ( 1 ) to determine whether ADT ( and hypogonadism ) result ed in decreased strength and mobility and ( 2 ) to examine the effect of ADT on an associated test of cognitive and motor function by assessing visuomotor performance . Subjects and Methods : Physical function , walking speed , visuomotor performance , gonadal status , body composition , and Comorbidity Disease Index ( CMDI ) scores were assessed in a cohort of 100 participants that included : ( 1 ) men with prostate cancer who were not on ADT , ( 2 ) men with prostate cancer who were on short-term ADT ( < 6 months ) , ( 3 ) men with prostate cancer who were on long-term ADT ( ≥6 months ) , and ( 4 ) control subjects who did not have prostate cancer . Results : Walking speed varied significantly across the 4 groups , even after adjusting for age , CMDI , and percentage of body fat . Age and CMDI were significantly associated with measurements of physical performance . Adjusted for covariates , men on long-term ADT  walked 0.18 m/s slower than the control subjects . Physical function also varied significantly across the 4 groups . And rogen deprivation therapy did not have a significant effect on visuomotor performance . Discussion and Conclusion : The results suggest that ADT has a significant effect on walking speed and physical performance in men with prostate cancer Recent research has applied the theory of planned behavior ( TPB ) to underst and ing exercise after a cancer diagnosis , but studies are few and have been limited by retrospective design s , self-report measures of exercise and varied results . In the present study , we extended this research by using a prospect i ve design and an objective measure of exercise adherence . Participants were a convenience sample of 24 breast cancer survivors attending a twice weekly , 12-week training program in preparation for a dragon boat race competition . Participants completed a baseline question naire that assessed demographic and medical variables  , past exercise , and the TPB ( i.e. beliefs , subjective norm , attitude , perceived behavioral control and intention ) . Program attendance was monitored over a 12-week period by the class instructor . Overall , participants attended 66 % of the training sessions . Multiple regression analyses indicated that : ( a ) intention was the sole determinant of program attendance and explained 35 % of the variance ; ( b ) the TPB constructs explained 49 % of the variance in intention with subjective norm being the most important determinant ; and ( c ) the key underlying beliefs were support from physician , spouse , and friends , and confidence in being able to attend the training class when having limited time , no one to exercise with , fatigue , and other health problems . Based on this preliminary study , it was concluded that the TPB may provide a good framework on which to base interventions design ed to promote exercise in breast 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 PURPOSE The efficacy of a home-based physical activity ( PA ) intervention for early-stage breast cancer patients was evaluated in a r and omized controlled trial . PATIENTS AND METHODS Eighty-six sedentary women ( mean age , 53.14 years ; st and ard deviation , 9.70 years ) who had completed treatment for stage 0 to II breast cancer were r and omly assigned to a PA or contact control group . Participants in the PA group received 12 weeks of PA counseling ( based on the Transtheoretical Model ) delivered via telephone , as well as weekly exercise tip sheets . Assessment s were conducted at baseline , after treatment ( 12 weeks ) , and 6 and 9 month after baseline follow-ups . The post-treatment outcomes are reported here . RESULTS Analyses showed that , after treatment , the PA group reported significantly more total minutes of PA , more minutes of moderate-intensity PA , and higher energy expenditure per week than controls . The PA group also out-performed controls on a field test of fitness . Changes in PA were not reflected in objective activity monitoring . The PA group was more likely than controls to progress in motivational readiness for PA and to meet PA guidelines . No significant group differences were found in body mass index and percent body fat . Post-treatment group comparisons revealed significant improvements in vigor and a reduction in fatigue in the PA group . There was a positive trend in intervention effects on overall mood and body esteem . CONCLUSION The intervention successfully increased PA and improved fitness and specific aspects of psychological well-being among early-stage breast cancer patients . The success of a home-based PA intervention has important implication s for promoting recovery in this population OBJECTIVES To assess the impact of lifestyle on health-related quality of life ( HR-QOL ) , perceived stress , and self-reported sexual function in men with early-stage prostate cancer electing active surveillance . METHODS A total of 44 intervention and 49 usual-care control participants were enrolled in a r and omized clinical trial examining the effects of lifestyle changes on prostate cancer progression . The intervention consisted of a low-fat , vegan diet , exercise , and stress management . Participants completed the Medical Outcomes Study Short Form-36 Health Status Survey ( a measure of mental and physical HR-QOL ) , the Perceived Stress Scale , the Sexual Function subscale of the University of California , Los Angeles , Prostate Cancer Index , and  measures of lifestyle behaviors  ( to yield an overall lifestyle  index ) at baseline and 12 months . The data were analyzed using analysis of variance for repeated measures . The relationship between lifestyle and QOL was also analyzed using multiple linear regression analyses . RESULTS Intervention participants had significantly improved their lifestyle compared with controls at 12 months . The quality -of-life scores were high across groups and time points . However , a healthier lifestyle was related to better QOL at baseline . Participants in both groups who reported a healthier lifestyle also reported better mental and physical HR-QOL and sexual function . Furthermore , participants whose lifestyle improved over time showed enhanced physical HR-QOL and decreased perceived stress . CONCLUSIONS Men who choose active surveillance for early-stage prostate cancer are able to make comprehensive lifestyle changes . Although the average QOL was already high in this sample , individuals who improved their lifestyle enhanced their QOL further Background : Exercise can modify fall risk factors such as balance and mobility impairments . However , can exercise improve balance confidence ? In one strength-training study , research ers reported that a change in balance confidence was not uniformly associated with changes in objective measures of fall risk or physical performance . In fact , some participants ’ balance confidence decreased while their physical abilities increased and vice versa . Objective : The aim of this study was to compare changes in balance confidence and balance ability result ing from three exercise interventions ( home-based resistance and balance training ( RBT ) , group-based RBT and group-based walking ) , and the concomitant relationships between change in balance confidence and change in ability . It was hypothesized that participants in the group-based RBT program would improve their balance confidence and performance more than those in the home-based or walking programs . Methods : In a cluster-r and omized design , nine retirement villages were assigned to one of the three exercise groups . One hundred and sixty-seven independent-living residents ( aged 65–96 years ) participated . Each group exercised twice weekly for 20 weeks . Objective balance ability was measured using timed t and em and one-leg st and s ( static balance ) , and the 8-foot ( 2.5 m ) up- and -go test ( dynamic balance/agility ) . Balance confidence was assessed using the self-report Activities-specific Balance Confidence ( ABC ) Scale . Results : Participants in the group-based RBT program improved their static balance scores more than those in the home-based program ; however , improvements in balance confidence were greater among participants in the home-based program ( all p < 0.05 ) . Discordance between static balance and balance confidence change scores was evident for up to 20 % of participants . Change in ABC score was weakly correlated with a change in the up- and -go test score . Conclusions : Exercise training can improve balance confidence and balance ability in retirement village residents . However , as has been shown previously , this study found that exercise interventions may improve balance ability without associated increases in balance confidence and vice versa . Whether the ABC score and balance ability can be enhanced by providing a tailored intervention to improve balance confidence in combination with a RBT program requires further study 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 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 Objective . To evaluate body composition changes , specifically skeletal muscle mass , in men receiving and rogen deprivation with luteinizing-hormone releasing hormone-agonist ( LHRH-A ) for prostate cancer ( PCa ) in comparison with healthy controls . Design . Retrospective analysis of body composition changes in men with prostate cancer receiving LHRH-A therapy from 2 clinical trials compared to men without prostate cancer serving as a placebo-control in another clinical trial . Setting . Clinical Research Center in Connecticut . Participants . Thirty men ( > 60 years ) receiving 6 months of LHRH-A therapy for PCa were compared to a healthy group of 25 men without PCa . Measurements . Appendicular skeletal muscle/height2 ( ASM/ht2 ) , lean and fat mass were assessed by dual energy x-ray absorptiometry . Total testosterone levels were assessed by enzyme immunoassay . Results . At baseline , 12/30 ( 40 % ) of the treatment group and 7/25 ( 28 % ) of the control group ( p = 0.11 ) met criteria for sarcopenia . There were no differences between control groups in ASM/ht2 or lean mass . The LHRH-A group had a higher percent body fat than the control group , 29.8 ± 6.3 versus 26.3 ± 4.6 ( p = 0.02 ) . ASM/ht2 and lean mass decreased in the LHRH-A group from 7.5 ± 0.9 kg to 7.3 ± 0.9 kg ( −2.3 % ± 0.03 ; p ⩽ 0.001 ) and 53.5 ± 5.4 kg to 52.3 ± 5.3 kg ( −2.1 % ± 0.03 ; p ⩽ 0.001 ) , respectively . There was no muscle loss in the control group . At 6 months , the LHRH-A group had increased percent body fat from 29.8 ± 6.4 to 32.2 ± 5.8 ( 9.5 % ± 0.13 ; p ⩽ 0.001 ) , whereas the control group had decreased in percent body fat from 26.6 ± 4.6 to 25.3 ± 5.0 ( −3.8 % ± 0.08 ; p = 0.02 ) . Conclusions . Men  undergoing LHRH-A treatment for PCa decreased appendicular skeletal muscle and lean tissue and increased body fat within 6 months of initiation of therapy . Lifestyle changes or medical interventions to minimize the effects of and rogen deprivation therapy for PCa deserve investigation PURPOSE To compare the effects of functional home exercise of repeated sit-to-st and s with low-intensity progressive resistance training , on performance measures in mobility-limited adults over 80 years of age . SETTING Participants ' homes . DESIGN Community-dwelling older adults > or = 80 years of age were invited to participate in a r and omised controlled clinical trial . Baseline and outcome measures were : comfortable gait velocity , 30-s chair-st and test , 15-s step test , Berg Balance Scale , Modified Falls Efficacy Scale and the Late-Life Function and Disability Instrument-function component . Participants r and omised to the intervention group performed repeated sit-to-st and s using a Gr and St and System ; a biofeedback device that recorded and displayed the number of repetitions performed . Participants r and omised to the control group performed knee extensions using ankle cuff weights . Both groups performed the exercises daily for 6 weeks . RESULTS Sixty-six older adults took part . The intervention group had a statistically significant improvement in Berg Balance Scale mean score , 1.67 + /- 2.64 points , P = 0.001 ( control group 0.73 + /- 3.63 points , P = 0.258 ) , indicating an improvement in balance over the 6-week exercise period . There was no statistically significant effect of either intervention on the other outcome measures . CONCLUSIONS In a highly variable population of older adults with mobility limitations , low-intensity functional home exercise of repeated sit-to-st and s using the Gr and St and System improved Berg Balance Scale score while low-intensity progressive resistance training did not . While statistically significant , the improvement in Berg Balance Scale score was modest raising the issue of what extent of change in score is clinical ly significant in this population OBJECTIVES To examine  dog walking among dog owners and the relationship between walking behavior of dog owners and non-dog owners and maintained gait speed over 3 years . DESIGN Cross-sectional and longitudinal analyses of a prospect i ve cohort study . SETTING Memphis , Tennessee , and Pittsburgh , Pennsylvania . PARTICIPANTS Two thous and five hundred thirty-three community-dwelling adults aged 71 to 82 at 36 months of the Health , Aging and Body Composition Study . MEASUREMENTS  Dog ownership , reported walking behavior , change in walking behavior , and usual and rapid gait speed  over 3 years . RESULTS Of 394 dog owners , only 36 % walked their dogs at least three times per week . Cross-sectionally , dog walkers were more likely to achieve 150 minutes of walking per week and had faster usual and rapid walking speeds ( 1.20 vs 1.14 m/s and 1.62 vs 1.52 m/s , respectively ; P < .01 for both ) than non-dog owners who did not walk at least three times per week and similar speeds as non-dog owners who walked at least 150 minutes per week ( P > .50 ) . Three years later , subjects who had been dog walkers at baseline were approximately twice as likely as any other group to achieve recommended walking levels , independent of covariates . Dog walkers experienced similar declines in usual and rapid walking speed as non-dog owners who walked at least three times per week but maintained their initial mobility advantage . CONCLUSION Although dog ownership appears to facilitate walking behavior , only a minority of older dog owners walk their dogs . The mobility advantage of dog ownership was seen only in dog walkers and was similar to that associated with any walking . Given suboptimal walking activity in older adults , examining the degree to which dog ownership promotes walking activity in persons who do little walking on their own appears worth pursuing OBJECTIVES To determine the feasibility of an eccentric resistance exercise training protocol in men with prostate cancer and to assess whether men with prostate cancer who are receiving and rogen deprivation therapy ( ADT ) have a blunted effect from the training as compared with prostate cancer survivors not receiving ADT . DESIGN Prospect i ve pilot study . SETTING Academic medical center . PARTICIPANTS Sixteen men with prostate cancer ( Gleason scores 3 + 3 to 4 + 4 ) were initially enrolled . Ten men ( mean age 66 , range 48 - 86 ) completed the study , 5 were currently receiving ADT . Analysis was performed on these 10 men . INTERVENTIONS Subjects were evaluated at baseline . All men underwent a 12-week resistance exercise training protocol using a recumbent , high-force eccentric , leg cycle ergometer 3 times per week at a " somewhat hard " perceived exertion for 12 to 15 minutes . Preexercise and postexercise training changes were examined within and between groups . MAIN OUTCOME MEASURES Quadriceps muscle volume ( magnetic resonance imaging ) , isometric knee extension strength , functional mobility ( Timed Up and Go Test [ TUG ] and 6-minute walk [ 6MW ] ) , health-related quality of life ( FACT-P ) , and fatigue ( FACIT-fatigue scale ) . RESULTS The ADT group demonstrated significant within-group improvements in the 6MW ( P = .01 ) and isometric knee extension strength ( P = .03 ) . This group also demonstrated a clinical ly relevant change in the FACT-P ; however , this did not meet statistical significance . The  non-ADT  group demonstrated significant within-group improvements in the physical subscale of the FACT-P ( P = .03 ) and an increase in muscle volume ( P = .04 ) . Their improvements in the TUG approached significance ( P = .08 ) . No between-group differences existed . CONCLUSIONS Eccentric resistance exercise was well tolerated , and both groups derived some benefits in strength and functional mobility .  Men receiving ADT  did not appear to have a blunted response to the exercise as compared with prostate cancer survivors not receiving ADT BACKGROUND Prostate cancer is the most common solid-tumor cancer in US males but is rare in Asian males . When Asian men adopt the US lifestyle , clinical prostate cancer increases greatly . Epidemiological data from men in the US indicate that regular activity may reduce the risk for prostate cancer . METHODS Serum was obtained from  three groups of similar-aged men , Control , Diet and Exercise , and Exercise alone were used to stimulate LNCaP cells in culture .  Growth and apoptosis of tumor cells were measured . Serum sample s were also used to measure insulin , IGF-1 , IGFBP-1 . RESULTS The Diet and Exercise and the Exercise alone groups had lower serum insulin and IGF-1 but higher IGFBP-1 compared to Controls . LNCaP cell growth was reduced in both groups compared to Control and there was a major increase in apoptosis of tumor cells . CONCLUSIONS A low-fat diet and /or intensive exercise results in change in serum hormones and growth factors in vivo that can reduce growth and induce apoptosis of LNCaP prostate tumor cells in vitro OBJECTIVE To determine the effect of a home exercise program on strength , postural control , and mobility following hip fracture . DESIGN R and omized controlled trial of 1 month 's duration . SETTING Daily exercise carried out within the subjects ' home environments . PARTICIPANTS Forty-two people 64 to 94 years of age , 35 of whom were living independently in the community and 7 of whom were residing in institutional care . Subjects were recruited on average 7 months after a fall-related hip fracture and r and omly allocated to either the intervention or the control group ( n = 21 each ) . The groups were well matched in terms of medical conditions , medication use , disability , and activity levels . INTERVENTION A " home-based " program of weight-bearing exercise established at a visit by a physiotherapist . MAIN OUTCOME MEASURES Quadriceps strength , postural sway , functional reach , weight-bearing ability , walking velocity , and self-rated fall risk . The subjects undertook these assessment s at the beginning and end of the trial . RESULTS At pretest , exercisers and controls performed similarly in all tests . At the end of the trial , the intervention group showed significantly greater quadriceps strength in the affected ( hip-fractured ) leg and increased walking velocity . The intervention subjects also improved their weight-bearing ability and reported reduced subjective falls risk . In contrast , there were no significant improvements in any of the test measures in the controls . Within the intervention group , improvements in quadriceps strength were significantly associated with improved performances in the weight-bearing test measures and with increased walking velocity . CONCLUSIONS This exercise program improved strength and mobility following hip fracture . Further research is needed to ascertain whether the extent of this improvement in these fall risk factors is sufficient to prevent falls OBJECTIVES Previous research has demonstrated that patients with prostate cancer participating in the Prostate Cancer Lifestyle Trial had a reduction in prostate-specific antigen ( PSA ) levels , inhibition of LNCaP cell growth , and fewer prostate cancer-related clinical events at the end of 1 year compared with controls . The aim of this study was to examine the clinical events in this trial during a 2-year period . METHODS The Prostate Cancer Lifestyle Trial was a 1-year r and omized controlled clinical trial of 93 patients with early-stage prostate cancer ( Gleason score < 7 , PSA 4 - 10 ng/mL ) undergoing active surveillance . The patients in the experimental arm were encouraged to adopt a low-fat , plant-based diet , to exercise and practice stress management , and to attend group support sessions . The control patients received the usual care . RESULTS By 2 years of follow-up , 13 of 49 ( 27 % ) control patients and 2 of 43 ( 5 % ) experimental patients had undergone conventional prostate cancer treatment ( radical prostatectomy , radiotherapy , or and rogen deprivation , P < .05 ) . No differences were found between the groups in other clinical events ( eg , cardiac ) , and no deaths occurred . Three of the treated control patients but none of the treated experimental patients had a PSA level of > or=10 ng/mL , and 1 treated control patient but no treated experimental patients had a PSA velocity of > 2 ng/mL/y before treatment . No significant differences were found between the untreated experimental and untreated control patients in PSA change or velocity at the end of 2 years . CONCLUSIONS Patients with early-stage prostate cancer choosing active surveillance might be able to avoid or delay conventional treatment for at least 2 years by making changes in their diet and lifestyle OBJECTIVE To prospect ively evaluate the prevalence and severity of fatigue and its impact on quality of life ( QOL ) during and after radical external beam radiotherapy ( RT ) for prostate cancer . METHOD AND MATERIAL S Twenty-eight men with prostate cancer undergoing RT over 6 - 8 consecutive weeks were prospect ively accrued . The  Brief Fatigue Inventory ( BFI ) , a vali date d fatigue assessment tool , was administered at five time points : baseline ( week 1 ) , middle of RT ( week 3 - 4 ) , end of RT ( last week of RT ) , and follow-up ( median 6.5 weeks after RT ) . The BFI contained nine questions , each using 0 - 10 ratings to quantify fatigue severity and interference with six QOL domains . The prevalence of moderate-severe fatigue was plotted as a function of time . Mean sum and subscale scores at each time point were compared to baseline scores using Wilcoxon tests . Linear regression analyses were performed to assess associations between fatigue scores and age , tumor and treatment characteristics . RESULTS The median age was 69 years ( range 57 - 84 ) , Gleason score 7 ( range 6 - 10 ) , and presenting PSA 9.0 ng/mL ( range 2.5 ng/mL-103.0 ng/mL ) . Patients were treated once daily to a median dose of 74 Gy ( range 60 Gy-78 Gy ) over a median of 37 fractions ( range 30 - 39 ) . Hormone therapy was used in all patients ( median duration 12.2 months ) . The prevalence of moderate-severe present fatigue increased from 7 % at baseline to 8 % at mid-RT and 32 % at RT completion . Compared to baseline ( mean score 11.5 ) , fatigue increased significantly mid-RT ( mean score 14.6 , p = 0.03 ) and peaked at the end of RT ( mean score 23.5 , p = 0.001 ) . Fatigue significantly interfered with walking ability , normal work , daily chores , and enjoyment of life only at the end of RT . After RT completion , fatigue improved but remained higher compared to baseline at 6.5 weeks of follow-up ( mean score 15.0 , p = 0.02 ) . On linear regression analysis , age , Gleason score , PSA , T-stage , hormone therapy duration , RT dose and fractions were not significantly associated with mean fatigue scores . CONCLUSION Patients undergoing 6 - 8 weeks of RT experienced significant fatigue adversely affecting QOL persisting after therapy completion . Since walking ability was not affected until the end of RT , a walking exercise intervention to combat fatigue is likely feasible and is being investigated PURPOSE Radiotherapy for prostate cancer ( PCa ) may cause unfavorable changes in fatigue , quality of life ( QOL ) , and physical fitness . We report results from the Prostate Cancer Radiotherapy and Exercise Versus Normal Treatment study examining the effects of 24 weeks of resistance or aerobic training versus usual care on fatigue , QOL , physical fitness , body composition , prostate-specific antigen , testosterone , hemoglobin , and lipid levels in men with PCa receiving radiotherapy . PATIENTS AND METHODS Between 2003 and 2006 , we conducted a r and omized controlled trial in Ottawa , Canada , where 121 PCa patients initiating radiotherapy with or without and rogen deprivation therapy  were r and omly assigned to usual care ( n = 41 ) , resistance ( n = 40 ) , or aerobic exercise ( n = 40 ) for 24 weeks . Our primary end point was fatigue assessed by the Functional Assessment of Cancer Therapy-Fatigue scale . RESULTS The follow-up assessment rate for our primary end point of fatigue was 92.6 % . Median adherence to prescribed exercise was 85.5 % . Mixed-model repeated measures analyses indicated both resistance ( P = .010 ) and aerobic exercise ( P = .004 ) mitigated fatigue over the short term . Resistance exercise also produced longer-term improvements ( P = .002 ) . Compared with usual care , resistance training improved QOL ( P = .015 ) , aerobic fitness ( P = .041 ) , upper- ( P < .001 ) and lower-body ( P < .001 ) strength , and triglycerides ( P = .036 ) , while preventing an increase in body fat ( P = .049 ) . Aerobic training also improved fitness ( P = .052 ) . One serious adverse event occurred in the group that performed aerobic exercise . CONCLUSION In the short term , both resistance and aerobic exercise mitigated  fatigue in men with PCa receiving radiotherapy  . Resistance exercise generated longer-term improvements and additional benefits for QOL , strength , triglycerides , and body fat
target: Grade B evidence also suggested that exercise may improve prostate cancer patients ' muscle mass , muscular strength , functional performance ( walking and sit to st and speed ) , as well as health-related , social and physical quality of life .
  These effects appeared greater for group-rather than home-based-exercise , especially if these programs included resistance training .
background: CONTEXT Prostate cancer patients , especially those on and rogen deprivation therapy ( ADT ) , experience many symptoms that make it difficult to maintain their independence and quality of life .
  Because ADT acts by means of reducing testosterone production , exercise may offset many of the ADT side effects and those of the cancer itself .
  OBJECTIVES This systematic review of the literature evaluates whether exercise could reduce symptoms and improve quality of life for prostate cancer patients .