title: Recovery of overall exercise ability, quality of life, and continence after 12-week combined exercise intervention in elderly patients who underwent radical prostatectomy: a randomized controlled study. Prospective study of exercise intervention in prostate cancer patients on androgen deprivation therapy. Impact + resistance training improves bone health and body composition in prematurely menopausal breast cancer survivors: a randomized controlled trial Lifestyle Intervention in Men with Advanced Prostate Cancer Receiving Androgen Suppression Therapy: A Feasibility Study Resistance training and reduction of treatment side effects in prostate cancer patients. Lipoprotein profile in men with prostate cancer undergoing androgen deprivation therapy Reduced muscle strength and functional performance in men with prostate cancer undergoing androgen suppression: a comprehensive cross-sectional investigation The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. Effects of Strength Training on Physical Function: Influence of Power, Strength, and Body Composition Active for Life After Cancer: a randomized trial examining a lifestyle physical activity program for prostate cancer patients. Endurance training improves insulin sensitivity and body composition in prostate cancer patients treated with androgen deprivation therapy. Three independent factors predicted adherence in a randomized controlled trial of resistance exercise training among prostate cancer survivors. Exercise maintains sexual activity in men undergoing androgen suppression for prostate cancer: a randomized controlled trial Resistance exercise in men receiving androgen deprivation therapy for prostate cancer. Exercise effects on adipokines and the IGF axis in men with prostate cancer treated with androgen deprivation: A randomized study. Age and androgen-deprivation therapy on exercise outcomes in men with prostate cancer Adipocytokines, obesity, and insulin resistance during combined androgen blockade for prostate cancer. Testosterone suppression in men with prostate cancer leads to an increase in arterial stiffness and hyperinsulinaemia. Resistance training reduces disability in prostate cancer survivors on androgen deprivation therapy: evidence from a randomized controlled trial. Skeletal response to resistance and impact training in prostate cancer survivors. A randomized trial of aerobic versus resistance exercise in prostate cancer survivors. Practice-based evidence research in rehabilitation: an alternative to randomized controlled trials and traditional observational studies. Randomized controlled trial of resistance or aerobic exercise in men receiving radiation therapy for prostate cancer. Lifestyle changes for improving disease-specific quality of life in sedentary men on long-term androgen-deprivation therapy for advanced prostate cancer: a randomised controlled trial. A multicentre year-long randomised controlled trial of exercise training targeting physical functioning in men with prostate cancer previously treated with androgen suppression and radiation from TROG 03.04 RADAR.
abstract: OBJECTIVE To examine the changes from a combined exercise intervention after radical prostatectomy ( RP ) in elderly patients with prostate cancer , because r and omized controlled trials addressing exercise intervention after RP have been lacking . METHODS From May 2009 to May 2010 , all patients who underwent laparoscopic RP were assessed for eligibility . A total of 66 patients were r and omized to an exercise or a control group . The exercise group received a combined exercise intervention ( resistance , flexibility , and Kegel exercises ) twice a week for 12 weeks , and the control group received only Kegel exercises . The primary outcome was physical function , and the secondary outcomes were continence status and quality of life after the exercise intervention . RESULTS A total of 49 patients completed follow-up to the end of study . After the 12-week exercise intervention , except for grip strength , all physical functions were better in the exercise group than in the control group . The 24-hour pad test results ( 12.2 g in the exercise group , 46.2 g in the control group ) and continence rate ( 73.1 % in exercise group , 43.5 % in the control group ) recovered more promptly in the exercise group . On a question naire study using the International Consultation on Incontinence question naire , Beck Depression Inventory , and Medical Outcomes Study 36-item short-form health survey , only the exercise group showed improvement at the last follow-up visit . CONCLUSION A 12-week combined exercise intervention after RP results in improvement of physical function , continence rate , and quality of life . These results could help with prompt recovery of daily activities INTRODUCTION And rogen deprivation therapy ( ADT ) is an important component of modern prostate cancer treatment . Survival benefits from neo-adjuvant and adjuvant hormones may take years to manifest , and balancing this with potential morbidity of therapy can be challenging . This study aim ed to assess whether education and short-term combined aerobic and resistance exercises could help to ameliorate the adverse side effects of ADT . METHODS Eight hundred fifty-nine patients with relapsed or metastatic prostate cancer on leuprorelin acetate  were allocated to three interventional streams based on patient preference and medical fitness : supervised group ( Face-to-Face ) exercise sessions , home-based ( At Home ) exercise or a support programme for those incapable of exercising ( Support ) . Patients enrolled onto Face to Face underwent measurement of body composition and cardiorespiratory fitness variables at baseline and programme completion . Patients in the exercise streams were surveyed to determine the programme 's impact on physical fitness and well-being . RESULTS Statistically significant improvements ( p < 0.001 ) were seen in all measured cardiorespiratory fitness and strength variables . Programme attrition rates were low ( 75/859 ; 8.7 % ) , the primary reason for withdrawal being discontinuation of hormones ( 70 % ) . Programme satisfaction was high , with 98 % of surveyed patients reporting a positive impact on fitness and 97 % planning to continue exercising after programme completion . At 6 months , improved physical and emotional well-being was reported by 93 and 79 % of patients , respectively . CONCLUSIONS A short-term structured exercise intervention results in high compliance and significant improvements in muscle strength and cardiorespiratory fitness in prostate cancer patients on ADT Summary Our r and omized controlled trial in prematurely menopausal breast cancer survivors showed that impact + resistance training prevented increases in percentage of body fat compared with controls and also improved BMD at the hip and prevented BMD loss at the spine among exercise-trained women who were menopausal for > 1 year . Introduction Cancer treatment-related menopause worsens bone health and body composition in breast cancer survivors ( BCS ) . We investigated whether impact + resistance training could improve bone mineral density ( BMD ) , reduce bone turnover , build muscle , and decrease fat mass in BCS with premature menopause . Methods We conducted a r and omized controlled trial in 71 BCS ( mean age , 46.5 years ) within 5 years of treatment-related menopause . Women were r and omly assigned to one of two groups : ( 1 ) impact + resistance training ( prevent osteoporosis with impact + resistance ( POWIR ) ) or ( 2 ) exercise placebo ( FLEX ) 3 × /week for 1 year . Outcomes were hip and spine BMD ( in grams per square centimeter ) and body composition ( percent body fat ( % BF ) and lean and fat mass ( in kilograms ) ) by DXA and bone turnover markers ( serum osteocalcin ( in nanograms per milliliter ) and urinary deoxypryrodinoline ( in nanomoles per milliliter ) . Results There were no significant group × time interactions for bone outcomes when using an intent-to-treat approach on the full sample . In analyses restricted to BCS who were menopausal for ≥1 year , POWIR increased BMD at the hip and slowed BMD loss at the spine compared with FLEX ( femoral neck — POWIR , 0.004 ± 0.093 g/cm2 vs. FLEX , −0.010 ± 0.089 g/cm2 ; p < 0.01 ; spine — POWIR , −0.003 ± 0.114 g/cm2 vs. FLEX , −0.020 ± 0.110 g/cm2 ; p = 0.03 ) . POWIR prevented increases in % BF ( POWIR , 0.01 % vs. FLEX , 1.3 % ; p < 0.04 ) . Women with attendance to POWIR at ≥64 % had better improvements in % BF than women attending less often ( p < 0.03 ) . Conclusion Impact + resistance training may effectively combat bone loss and worsening body composition from premature menopause in BCS Background : Healthy lifestyle behaviors could have a role in ameliorating some of the adverse effects of and rogen suppression therapy  ( AST ) in men with prostate cancer . The primary aim of this study was to assess the feasibility of a tapered supervised exercise program in combination with dietary advice in men with advanced prostate cancer receiving AST . Methods : Advanced prostate cancer patients receiving AST for a minimum of 6 months were r and omized to a 12-week lifestyle program comprising aerobic and resistance exercise , plus dietary advice ( n = 25 ) , or st and ard care ( n = 25 ) . Exercise behavior , dietary macronutrient intake , quality of life , fatigue , functional fitness , and biomarkers associated with disease progression were assessed at baseline , after the intervention , and at 6 months . Results : The lifestyle group showed improvements in exercise behavior ( P < 0.001 ) , dietary fat intake ( P = 0.001 ) , total energy intake ( P = 0.005 ) , fatigue ( P = 0.002 ) , aerobic exercise tolerance ( P < 0.001 ) , and muscle strength ( P = 0.033 ) compared with st and ard care controls . Although a high rate of attrition ( 44 % ) was observed at 6 months , the improvements in key health outcomes were sustained . No effects on clinical prostate cancer disease markers were observed . Conclusions : This preliminary evidence suggests that pragmatic lifestyle interventions have potential to evoke improvements in exercise and dietary behavior , in addition to other important health outcomes in men with advanced prostate cancer receiving AST . Impact : This study shows for the first time that pragmatic lifestyle interventions are feasible and could have a positive impact on health behaviors and other key outcomes in men with advanced prostate cancer receiving AST . Cancer Epidemiol Biomarkers Prev ; 20(4 ) ; 647–57 . © 2011 AACR 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 Sex steroids are known to modulate serum lipoproteins . Studies have suggested that serum testosterone levels are associated with a beneficial lipid profile . And rogen deprivation therapy ( ADT ) is employed in the treatment of recurrent and metastatic prostate cancer ( PCa ) , result ing in profound hypogonadism . As male hypogonadism unfavorably influences lipid profile and men with PCa have high cardiovascular mortality , we evaluated the effects of long-term ADT on fasting lipids . This Cross-sectional study was conducted in a university-based research institution . We evaluated 44 men , 16 undergoing ADT for at least 12 months before the study ( ADT group ) , 14 age-matched eugonadal men with non-metastatic PCa who were status post prostatectomy and /or radiotherapy and not on ADT ( non-ADT group ) and 14 age-matched eugonadal controls ( Control group ) . None of the men had known history of diabetes or dyslipidemia . Mean age was similar in the three groups ( P=0.37 ) . Serum total ( P<0.01 ) and free ( P<0.01 ) testosterone levels were lower in the ADT group compared to the other groups . Men on ADT had higher body mass index ( BMI ) compared to the other groups ( P<0.01 ) . Men in the ADT group had significantly higher levels of total cholesterol compared to the other two groups ( P=0.03 ) . After adjustment for BMI , men on ADT continued to have significantly higher fasting levels of total cholesterol ( P=0.02 ) , LDL cholesterol ( P=0.04 ) and non-HDL cholesterol ( P=0.03 ) compared to the control group . No significant differences were seen in the levels of other lipoproteins between the three groups . These data show that men undergoing long-term ADT have higher total and LDL cholesterol than age-matched controls . Long-term prospect i ve studies are needed to determine the time of onset of changes in these lipoproteins while on ADT and the influence of these changes on cardiovascular mortality 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 OBJECTIVE : To test the feasibility of creating a valid and reliable checklist with the following features : appropriate for assessing both r and omised and non-r and omised studies ; provision of both an overall score for study quality and a profile of scores not only for the quality of reporting , internal validity ( bias and confounding ) and power , but also for external validity . DESIGN : A pilot version was first developed , based on epidemiological principles , review s , and existing checklists for r and omised studies . Face and content validity were assessed by three experienced review ers and reliability was determined using two raters assessing 10 r and omised and 10 non-r and omised studies . Using different raters , the checklist was revised and tested for internal consistency ( Kuder-Richardson 20 ) , test-retest and inter-rater reliability ( Spearman correlation coefficient and sign rank test ; kappa statistics ) , criterion validity , and respondent burden . MAIN RESULTS : The performance of the checklist improved considerably after revision of a pilot version . The Quality Index had high internal consistency ( KR-20 : 0.89 ) as did the subscales apart from external validity ( KR-20 : 0.54 ) . Test-retest ( r 0.88 ) and inter-rater ( r 0.75 ) reliability of the Quality Index were good . Reliability of the subscales varied from good ( bias ) to poor ( external validity ) . The Quality Index correlated highly with an existing , established instrument for assessing r and omised studies ( r 0.90 ) . There was little difference between its performance with non-r and omised and with r and omised studies . Raters took about 20 minutes to assess each paper ( range 10 to 45 minutes ) . CONCLUSIONS : This study has shown that it is feasible to develop a checklist that can be used to assess the method ological quality not only of r and omised controlled trials but also non-r and omised studies . It has also shown that it is possible to produce a checklist that provides a profile of the paper , alerting review ers to its particular method ological strengths and weaknesses . Further work is required to improve the checklist and the training of raters in the assessment of external validity Hanson , ED , Srivatsan , SR , Agrawal , S , Menon , KS , Delmonico , MJ , Wang , MQ , and Hurley , BF . Effects of strength training on physical function : influence of power , strength , and body composition . J Strength Cond Res 23(9 ) : 2627 - 2637 , 2009-The purpose of this study was to determine ( a ) the effects of strength training ( ST ) on physical function and ( b ) the influence of strength , power , muscle volume ( MV ) , and body composition on physical function . Healthy , inactive adults ( n = 50 ) aged 65 years and older underwent strength , power , total body composition ( % fat and fat free mass [ FFM ] ) , and physical function testing before and after 22 weeks of ST . Physical function testing consisted of tasks design ed to mimic common physical activities of daily living ( ADL ) . To improve internal validity of the assessment of mid-thigh intermuscular fat , subcutaneous fat , and knee extensors MV , a 10-week unilateral ST program using the untrained leg as an internal control preceded 12 weeks of whole-body ST . Strength , power , and FFM increased significantly with ST ( all p < 0.05 ) , whereas rapid walk , 5 chair st and s , and get up and go time decreased significantly with ST in the overall group ( all p < 0.05 ) . Women improved significantly in both walking test times ( both p < 0.05 ) but not in the stair climb test , whereas men improved in the stair climb test ( p < 0.05 ) but not in walking test times . Multiple regression analysis revealed the highest R2 ( 0.28 ) for the change in chair st and s time , followed by stair climb and usual walk at 0.27 and 0.21 , respectively . ST improves performance in functional tasks important for ADLs . Changes in strength , power , and FFM are predictors of ST-induced improvements in these tasks 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 Insulin resistance and changes in body composition are side effects of and rogen deprivation therapy ( ADT ) given to prostate cancer patients . The present study investigated whether endurance training improves insulin sensitivity and body composition in ADT-treated prostate cancer patients . Nine men undergoing ADT for prostate cancer and ten healthy men with normal testosterone levels underwent 12  weeks  of endurance training . Primary endpoints were insulin sensitivity ( euglycemic-hyperinsulinemic clamps with concomitant glucose-tracer infusion ) and body composition ( dual-energy X-ray absorptiometry and magnetic resonance imaging ) . The secondary endpoint was systemic inflammation . Statistical analysis was carried out using two-way ANOVA . Endurance training increased VO2max ( ml(O2)/min per kg ) by 11 and 13 % in the patients and controls respectively ( P<0.0001 ) . The patients and controls demonstrated an increase in peripheral tissue insulin sensitivity of 14 and 11 % respectively ( P<0.05 ) , with no effect on hepatic insulin sensitivity ( P=0.32 ) . Muscle protein content of GLUT4 ( SLC2A4 ) and total AKT ( AKT1 ) was also increased in response to the training ( P<0.05 and P<0.01 respectively ) . Body weight ( P<0.0001 ) and whole-body fat mass ( FM ) ( P<0.01 ) were reduced , while lean body mass ( P=0.99 ) was unchanged . Additionally , reductions were observed in abdominal ( P<0.01 ) , subcutaneous ( P<0.05 ) , and visceral ( P<0.01 ) FM amounts . The concentrations of plasma markers of systemic inflammation were unchanged in response to the training . No group × time interactions were observed , except for thigh intermuscular adipose tissue ( IMAT ) ( P=0.01 ) , reflecting a significant reduction in the amount of IMAT in the controls ( P<0.05 ) not observed in the patients ( P=0.64 ) . In response to endurance training , ADT-treated prostate cancer patients exhibited improved insulin sensitivity and body composition to a similar degree as eugonadal men OBJECTIVE To examine predictors of adherence in a r and omized controlled trial of resistance exercise training ( RET ) in prostate cancer survivors receiving and rogen deprivation therapy . STUDY DESIGN AND SETTING A r and omized controlled trial conducted at fitness centers in Ottawa and Edmonton , Canada . Prostate cancer survivors ( n=155 ) completed measures of social cognitive variables , quality of life ( QOL ) , behavior , and fitness before being r and omized to either an exercise ( n=82 ) or control ( n=73 ) group . The exercise group was asked to perform supervised RET three times per week for 12 weeks . RESULTS The exercise group attended 28.2 of the 36 ( 78.3 % ) RET sessions . Univariate analyses revealed eight different significant ( Ps < .05 ) predictors of exercise adherence including exercise stage of change , intention , age , QOL , fatigue , subjective norm , leg-press test , and perceived behavioral control . A multivariate analysis indicated that there were three independent predictors of adherence that explained 20.4 % of the variance : exercise stage of change ( beta=0.26 ; P=.013 ) , age ( beta=-0.22 ; P=.037 ) , and intention ( beta=0.19 ; P=.073 ) . CONCLUSION Exercise adherence in the trial was very good but not optimal . Adherence was predicted by variables from many different categories including social cognitive , QOL , behavioral , fitness , and demographic . These findings may have important implication s for maximizing adherence during clinical trials of exercise in prostate cancer survivors Background : Previous research has shown exercise to be an effective method to mitigate many adverse treatment-related effects of and rogen suppression therapy ( AST ) but the potential impact of exercise on sexual activity remains unknown . The purpose of this investigation was to report the effect of a 12-week exercise program on sexual activity in prostate cancer patients undergoing AST . Methods : Fifty-seven prostate cancer patients undergoing AST were r and omly assigned to an exercise program ( resistance and aerobic modes ; n=29 ) or usual care control ( n=28 ) . Sexual activity was assessed by the European Organization for Research and Treatment of Cancer prostate cancer-specific quality of life question naire ( QLQ-PR25 ) . Results : QLQ-PR25 data were log transformed and analysis of covariance was used to compare sexual activity between groups following the intervention adjusted for baseline activity . No differences in sexual activity were observed between the exercise and control groups before the intervention . There was a significant ( P=0.045 ) adjusted group difference in sexual activity following the 12-week intervention . Patients undergoing usual care decreased sexual activity while patients in the exercise program maintained their level of sexual activity . At baseline , 20.6 and 22.2 % of participants in the exercise and control groups reported a major interest in sex ( that is , high libido ) . Following the intervention , the exercise group had a significantly higher percentage of participants reporting a major interest in sex ( exercise=17.2 % vs control=0 % ; P=0.024 ) . Conclusions : Participation in a short-term exercise program result ed in the maintenance of sexual activity in prostate cancer patients undergoing AST PURPOSE And rogen deprivation therapy is a common treatment in men with prostate cancer that may cause fatigue , functional decline , increased body fatness , and loss of lean body tissue . These physical changes can negatively affect health-related quality of life .  Resistance exercise may help to counter some of these side effects by reducing fatigue , elevating mood , building muscle mass , and reducing body fat . METHODS In a two-site study , 155 men with prostate cancer who were scheduled to receive and rogen deprivation therapy for at least 3 months after recruitment were r and omly assigned to an intervention group that participated in a resistance exercise program three times per week for 12 weeks ( 82 men ) or to a waiting list control group ( 73 men ) . The primary outcomes were fatigue and disease-specific quality of life as assessed by self-reported question naires after 12 weeks . Secondary outcomes were muscular fitness and body composition . RESULTS Men assigned to resistance exercise had less interference from fatigue on activities of daily living ( P = .002 ) and higher quality of life ( P = .001 ) than men in the control group . Men in the intervention group demonstrated higher levels of upper body ( P = .009 ) and lower body ( P < .001 ) muscular fitness than men in the control group . The 12-week resistance exercise intervention did not improve body composition as measured by changes in body weight , body mass index , waist circumference , or subcutaneous skinfolds . CONCLUSION Resistance exercise reduces fatigue and improves quality of life and muscular fitness in men with prostate cancer receiving and rogen deprivation therapy .  This form of exercise can be an important component of supportive care for these patients BACKGROUND And rogen deprivation therapy ( ADT ) has significant deleterious effects on body composition that may be accompanied by unfavourable changes in adipokine levels . While exercise has been shown to improve a number of side effects associated with ADT for prostate cancer , no studies have assessed the effect of exercise on adiponectin and leptin levels , which have been shown to alter the mitogenic environment . METHODS Twenty-six men with prostate cancer treated with ADT were r and omized to home-based aerobic exercise training or resistance exercise training for 24 weeks . Adiponectin , leptin , insulin-like growth factor 1 ( IGF-1 ) , insulin-like growth factor binding protein 3 ( IGFBP-3 ) were analyzed by ELISA ( enzyme-linked immunosorbent assay ) , in addition to physical activity volume , peak aerobic capacity , and anthropometric measurements , at baseline , 3 months and 6 months . RESULTS Resistance exercise significantly reduced IGF-1 after 3 months ( p = 0.019 ) ; however , this change was not maintained at 6 months . At 6 months , IGFBP-3 was significantly increased compared to baseline for the resistance training group ( p = 0.044 ) . In an exploratory analysis of all exercisers , favourable changes in body composition and aerobic fitness were correlated with favourable levels of leptin , and favourable leptin : adiponectin and IGF-1:IGFBP-3 ratios at 3 and 6 months . CONCLUSIONS Home-based exercise is correlated with positive changes in adipokine levels and the IGF-axis that may be related to healthy changes in physical fitness and body composition . While the improvements of adipokine markers appear to be more apparent with resistance training compared to aerobic exercise , these findings must be considered cautiously and require replication from larger r and omized controlled trials to clarify the role of exercise on adipokines and IGF-axis proteins for men with prostate cancer Purpose The purpose of this study is to examine the effects of age ( ≤65 years or > 65 years ) and and rogen-deprivation therapy ( ADT , presence or absence ) as factors that may predict changes in body composition and fitness following a 24-week exercise program in prostate cancer patients . Methods One hundred twenty-one men were r and omly allocated to either : ( 1 ) aerobic exercise ( AE ) , ( 2 ) resistance exercise ( RE ) , or ( 3 ) usual care ( UC ) . Body composition was assessed by DXA . Aerobic fitness was assessed through a maximal treadmill test  . Muscular strength was assessed by leg extension and bench press using the eight-repetition maximum test . Responses were compared between younger ( ≤65 years ) and older ( > 65 years ) patients with or without ADT  . Results There did not appear to be an interaction between age and ADT on body composition or fitness , nor were there any significant changes in body composition for participants ≤65 years . In participants aged > 65 years , lean mass decreased in AE ( p = 0.013 ) and UC ( p = 0.006 ) , but was preserved in RE . In participants receiving ADT , there was a decrease in lean mass in AE ( p = 0.003 ) and UC ( p < 0.001 ) but not in RE . The non-ADT group did not show any changes in body composition but did show improvements in muscular fitness following resistance training ( p < 0.001 ) . Conclusion Changes in body composition and physical fitness following a 24-week exercise program in men with prostate cancer are not influenced by age and /or ADT . Resistance training appears to attenuate the age-related decrease in lean mass and increase in body fat in older patients with prostate cancer and those  receiving ADT OBJECTIVES Gonadotropin-releasing hormone agonists increase fat mass , decrease insulin sensitivity , and increase serum triglycerides . To better characterize the metabolic effects of gonadotropin-releasing hormone agonist treatment , we prospect ively evaluated the changes in body composition , insulin sensitivity , and levels of adiponectin , resistin , C-reactive protein ( CRP ) , and plasminogen activator inhibitor type 1 ( PAI-1 ) . We also assessed the relationships among changes in adipocytokines , body composition , and insulin sensitivity . METHODS In this prospect i ve , 12-week study , 25 nondiabetic men with locally advanced or recurrent prostate cancer and no radiographic evidence of metastases were treated with leuprolide depot and bicalutamide . The outcomes studied included changes from baseline to week 12 in body composition , insulin sensitivity , and levels of adiponectin , resistin , CRP , and PAI-1 . RESULTS The mean + /- st and ard error percentage of fat body mass increased by 4.3 % + /- 1.3 % from baseline to week 12 ( P = 0.002 ) . The insulin sensitivity index decreased by 12.9 % + /- 7.6 % ( P = 0.02 ) . The serum adiponectin levels increased by 37.4 % + /- 7.2 % from baseline to week 12 ( P < 0.001 ) . In contrast , the resistin , CRP , and PAI-1 levels did not change significantly . Changes in body composition tended to be associated with changes in adiponectin , but not insulin sensitivity . CONCLUSIONS Combined and rogen blockade with leuprolide and bicalutamide significantly increased fat mass and adiponectin levels and decreased insulin sensitivity but did not alter the resistin , CRP , or PAI-1 levels . This pattern of metabolic changes appears distinct from the classic metabolic syndrome The role of and rogens in cardiovascular disease is uncertain . We aim ed to determine the vascular effects of and rogen suppression in men with prostate cancer .  Arterial stiffness ( or ' compliance ' ) was measured in 16 men ( 71+/-9 years , mean+/-S.D. ) prior to , and 3 months after , complete and rogen suppression with gonadotrophin-releasing hormone analogues as treatment for prostate cancer . Fifteen control men ( 70+/-7 years ) also had arterial stiffness studies at baseline and 3 months later . Two measures of arterial stiffness were employed : systemic arterial compliance ( SAC ) was measured by simultaneous recording of aortic flow and carotid artery pressure ( ' area method ' ) , and pulse wave velocities ( PWVs ) were recorded with the ' Complior ' system . The 16 cases underwent glucose-tolerance and fasting-lipids tests on both visits . After 3 months of testosterone suppression , there was a significant fall in SAC , which was not seen in the controls [ mean change+/-S.E.M. , -0.26+/-0.09 a.c.u . ( arbitrary compliance unit ) in the cases versus + 0.06+/-0.11 in the controls ; P = 0.03 ) . Central , but not peripheral , PWVs tended to increase in the cases ( mean change+/-S.E.M. for aorto-femoral PWV , + 0.5+/-0.4 m/s for cases versus -0.3+/-0.3 m/s for controls ; P = 0.08 ) . After testosterone suppression , fasting insulin levels increased from 6.89+/-4.84 m-units/l to 11.34+/-8.16 m-units/l ( mean+/-S.D. ) , total cholesterol increased from 5.32+/-0.77 mmol/l to 5.71+/-0.82 mmol/l and high-density lipoprotein cholesterol increased from 1.05+/-0.24 mmol/l to 1.26+/-0.36 mmol/l ; P < 0.005 for all . No significant change occurred in body-mass index , serum glucose , low-density lipoprotein cholesterol or triacylglycerol ( triglyceride ) levels . Our results indicate that loss of and rogens in men leads to an increase in aortic stiffness and serum insulin levels , and may therefore adversely affect cardiovascular risk OBJECTIVES To investigate whether functionally based resistance exercise could improve strength , physical function , and disability among prostate cancer survivors ( PCS ) on and rogen deprivation therapy ( ADT ) ; and to explore potential mediators of changes in outcomes from exercise . DESIGN R and omized controlled trial . SETTING Academic medical center . PARTICIPANTS PCS ( N=51 ; mean age , 70.2y ) on ADT . INTERVENTION PCS were r and omized to moderate to vigorous intensity resistance training or stretching ( placebo control ) for 1 year . MAIN OUTCOME MEASURES Maximal leg press and bench press strength , objective and self-reported physical function , and self-reported disability . Hierarchical linear modeling was used to test for significant group × time differences adjusting for covariates . RESULTS Retention in the study was 84 % , and median attendance to supervised classes was 84 % in the resistance group . No study -related injuries occurred . Maximal leg strength ( P=.032 ) and bench press strength ( P=.027 ) were improved after 1 year of resistance training , whereas little change occurred from stretching .  Self-reported physical function improved with resistance training , whereas decreases occurred from stretching ( P=.016 ) . Disability lessened more with resistance training than stretching ( P=.018 ) . One-year change in leg press strength mediated the relation between groups ( resistance or stretching ) and 1-year change in self-reported disability ( P<.05 ) . CONCLUSIONS One year of resistance training improved muscle strength in and rogen-deprived PCS . Strengthening muscles using functional movement patterns may be an important feature of exercise programs design ed to improve perceptions of physical function and disability . Findings from this study contribute to the mounting evidence that exercise should become a routine part of clinical care in older men with advanced prostate cancer INTRODUCTION And rogen deprivation therapy ( ADT ) is associated with significant bone loss and an increase in fracture risk among prostate cancer survivors ( PCS ) . We investigated whether impact + resistance training could stop ADT-related declines in bone mineral density ( BMD ) among PCS on ADT . METHODS We r and omized 51 PCS ( mean age , 70.2 yr ) currently prescribed ADT to participate in 1 yr of impact + resistance training ( Prevent Osteoporosis with Impact + Resistance ( POWIR ) )  or in an exercise placebo program of stretching exercise ( FLEX ) . Outcomes were proximal femur ( total hip , femoral neck , and greater trochanter ) and spine ( L1-L4 ) BMD ( g·cm ) and bone turnover markers ( serum osteocalcin ( ng·mL ) and urinary deoxypyrodinoline cross-links ( nmol·mmol Cr ) ) . RESULTS Retention in the 1-yr study was 84 % and median attendance to supervised classes was 84 % in POWIR and 74 % in FLEX . No study -related injuries were reported . There were no significant differences between groups for average L1-L4 BMD or for BMD at any hip site . When examining individual vertebrae , POWIR has a significant effect on preservation of BMD ( -0.4 % ) at the L4 vertebrae compared with losses ( -3.1 % ) in FLEX ( P = 0.03 ) . CONCLUSION Impact + resistance training was a safe and acceptable form of exercise for older PCS on ADT . Among our limited sample , POWIR did not appear to have a clinical ly meaningful effect on hip or spine BMD , but some evidence of skeletal adaptation to resistance + impact training in an and rogen-deprived state was apparent . Future studies need to be conducted on a larger sample of patients and should consider modifications to POWIR that could further enhance loading across the spine and at the hip to preserve BMD at these clinical ly relevant sites And rogen-deprivation therapy ( ADT ) for prostate cancer ( PCa ) has side effects that significantly impair health-related quality of life ( HRQOL ) . Exercise ameliorates many side effects of ADT , but different modalities , particularly in the home-based setting , have not been well studied . In this study the authors r and omly assigned 66 PCa survivors receiving ADT to 6 mo of home-based aerobic or resistance training .  Psychosocial well-being and physical fitness were measured at baseline , 3 and 6 mo , and then 6 mo postintervention . Intention-to-treat analyses showed that fatigue and HRQOL were not significantly different between groups ; however , in a per- protocol analysis the resistance-exercise training group demonstrated clinical ly significant improvements in HRQOL . Differential within-group effects on physical fitness were also observed at various time points . At all time points , the aerobic-training group engaged in significantly more physical activity than the resistance-training group , a finding that should be further examined given evidence -based guidelines for activity volume in cancer survivors Sound rigorous methods are needed by research ers and providers to address practical questions about risks , benefits , and costs of interventions as they occur in routine clinical practice such as : Are treatments used in daily practice associated with intended outcomes ? For whom does an intervention work best ? With limited clinical re sources , what are the best interventions to use for specific types of patients ? Answers to such questions can help clinicians , patients , research ers , and health care administrators learn from , and improve , real-world everyday clinical practice . In this article , we describe existing research design s to demonstrate clinical usefulness and comparative effectiveness of  rehabilitation treatments .  We compare r and omized controlled trials and observational cohort studies of various types , including those that use instrumental variables or propensity scores to control for potential patient or treatment selection effects . We argue that practice -based evidence ( PBE ) study design s include features that address limitations inherent in both r and omized trials and traditional observational studies , and also reduce the need for instrumental variables and propensity scores methods . We give examples of how PBE design s have been used in various rehabilitation areas to determine better treatments for specific types of patients 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 BACKGROUND Prostate cancer is a key driver of cancer-related global disability-adjusted life-years . And rogen-deprivation therapy ( ADT ) for advanced disease is linked to fatigue , reduced physical function , and quality of life ( QoL ) . OBJECTIVE To evaluate the effect of a lifestyle intervention on disease-specific QoL , diastolic blood pressure , and cancer-related fatigue in sedentary men receiving long-term ADT for advanced prostate cancer . DESIGN , SETTING , AND PARTICIPANTS A total of 100 hundred sedentary men with locally advanced or metastatic prostate cancer on long-term ADT were r and omised to an intervention or usual care group . INTERVENTION A 12-wk lifestyle intervention consisting of aerobic and resistance exercise with parallel dietary advice . OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Disease-specific QoL was measured using the Functional Assessment of Cancer Therapy-Prostate ( FACT-P ) and Functional Assessment of Cancer Therapy-Fatigue ( FACT-F ) question naires at 12 wk postintervention and at 6 mo following withdrawal of support . Analysis of covariance and mixed regression were conducted . RESULTS AND LIMITATIONS Clinical ly relevant improvements in FACT-P were seen at 12 wk in the intervention group compared with controls ( mean difference : 8.9 points ; 95 % confidence interval [ CI ] , 3.7 - 14.2 ; adjusted p=0.001 ) . No difference was apparent at 6 mo ( mean difference : 3.3 points ; 95 % CI , -2.6 to 9.3 ; adjusted p=0.27 ) . No difference in diastolic blood pressure was seen at either follow-up ( all p > 0.05 ) . Clinical ly relevant improvements in FACT-F were seen at 12 wk ( mean difference : 5.3 points ; 95 % CI , 2.7 - 7.9 ; adjusted p<0.001 ) and maintained following withdrawal of supervision ( mean difference : 3.9 points ; 95 % CI , 1.1 - 6.8 ; adjusted p=0.007 ) . Improvements in exercise tolerance and behaviour were maintained at 6 mo ( adjusted p<0.001 and 0.038 ) . CONCLUSIONS A lifestyle intervention result ed in a clinical ly meaningful improvement in disease-specific QoL that was not maintained postintervention . No effect on blood pressure occurred . Durability of response was seen in fatigue and exercise behaviour . Further evaluation of support structures is essential . TRIAL REGISTRATION IS RCT N88605738 BACKGROUND Long-term prostate cancer ( PCa ) survivors are at increased risk for comorbidities and physical deconditioning . OBJECTIVE To determine the effectiveness of a year-long r and omised controlled trial of exercise training in PCa survivors > 5 yr postdiagnosis on physical functioning . DESIGN , SETTING , AND PARTICIPANTS Between 2010 and 2011 , 100 long-term PCa survivors from Trans-Tasman Radiation Oncology Group 03.04 R and omised And rogen Deprivation and Radiotherapy previously treated with and rogen-deprivation therapy and radiation therapy were r and omly assigned to 6 mo of supervised exercise followed by 6 mo of a home-based maintenance programme ( n=50 ) or printed educational material about physical activity ( n=50 ) for 12 mo across 13 university-affiliated exercise clinics in Australia and New Zeal and . INTERVENTION Supervised resistance and aerobic exercise or printed educational material about physical activity . OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The primary end point was a 400-m walk as a measure of cardiovascular fitness . Secondary end points were physical function , patient-reported outcomes , muscle strength , body composition , and biomarkers . Analysis of covariance was used to compare outcomes for groups at 6 and 12 mo adjusted for baseline values . RESULTS AND LIMITATIONS Participants undergoing supervised exercise showed improvement in cardiorespiratory fitness performance at 6 mo ( -19 s [ p=0.029 ] ) and 12 mo ( -13 s [ p=0.028 ] ) and better lower-body physical function across the 12-mo period ( p<0.01 ) . Supervised exercise also improved self-reported physical functioning at 6 ( p=.006 ) and 12 mo ( p=0.002 ) , appendicular skeletal muscle at 6 mo ( p=0.019 ) , and objective measures of muscle strength at 6 and 12 mo ( p<0.050 ) . Limitations included the restricted number of participants undertaking body composition assessment , no blinding to group assignment for physical functioning measures , and inclusion of well-functioning individuals . CONCLUSIONS Supervised exercise training in long-term PCa survivors is more effective than physical activity educational material for increasing cardiorespiratory fitness , physical function , muscle strength , and self-reported physical functioning at 6 mo . Importantly , these benefits were maintained in the long term with a home-based programme with follow-up at 12 mo . CLINICAL TRIAL REGISTRY The effect of an exercise intervention on cardiovascular and metabolic risk factors in prostate cancer patients from the RADAR study , ACTRN : ACTRN12609000729224
target: Results The majority of studies demonstrated RE as an effective and safe intervention to improve muscular strength and performance , fatigue and quality of life ( QoL ) in PCaPs , while there is inconclusive evidence concerning cardiovascular performance , body composition , blood lipids , bone mineral density ( BMD ) , and immune response .
background: Purpose Physical exercise has been shown to be an effective , safe , and quite inexpensive method to reduce cardiovascular and metabolic risk factors and is currently in the process of establishing its relevance for cancer specific morbidity and mortality .
  The aim of this systematic review was to focus on specific effects of resistance exercise ( RE ) in the adjuvant therapy and rehabilitation of prostate cancer patients ( PCaPs ) receiving or having received and rogen deprivation therapy ( ADT ) .