Cardiovascular disease is the leading cause of death in men with prostate cancer. ADT is effective treatment, but can adversely impact MetS components, which may contribute to excess cardiac risk. We tested whether a resistance exercise program, designed to increase skeletal muscle mass during ADT, could offset adverse changes.
Prostate cancer patients on ADT were randomized to exercise (EX) or no exercise (noEX). EX was supervised, periodized resistance training followed by stretching 3x/week for 12 weeks, 45 min/session. noEX did home-based stretching 3x/week. Baseline and post-intervention measurements included weight, waist circumference (wCirc), lean body mass, lipids, insulin, glucose. Mean differences in changes were compared with intent-to-treat linear regression models adjusted for baseline values. Cohen’s D effect sizes were calculated for these pilot data to estimate effects for a fully powered trial.
Thirty-two men (EX n = 13, noEX n = 19) completed the protocol. Age (mean± SD) was 67.3 ± 8.7 yr (range 52 - 84). Mean duration ADT was 14.4 ± 13.4 months (range 3 – 57). EX patients had higher baseline BMI with 63% >25 kg/m2 compared to 25% in the NoEX group, p = 0.024. wCirc decreased significantly (p = 0.032) in EX (-1.18 cm 95%CI [-3.3, -1.0] cm) compared to NoEX (+1.97 cm [0.2, 3.7]). Lean mass increased and body fat decreased in EX compared to NoEX. Moderate effect sizes (D = 0.2-0.5) were seen between groups for other parameters (see Table).rnTable:
|Baseline mean||Week 12 mean||Mean change [95% CI]||p||Drn|
|wCirc (cm) EX NoEXrn||106.8 97.9rn||105.9 99.6rn||−1.18 [-3.3, -1.0] 1.97 [0.2, 3.7]rn||0.032rn||0.8rn|
|Lean Body Mass (kg) EX NoEXrn||48.5 kg 51.5 kgrn||43.2 kg 48.6 kgrn||1.07 [0.35, 1.79] 0.09 [-0.5, 0.68]rn||0.047rn||0.8rn|
|Body Fat EX NoEXrn||36.8% 33.9%rn||35.9% 34.5%rn||−0.9 [-1.78, -0.01] 0.49 [-0.24, 1.22]rn||0.022rn||1rn|
|Diastolic BP (mmHg) EX NoEXrn||76.9 79.0rn||75.4 79rn||−1.91 [-6.3, 2.5] 0.31 [-3.3, 4.0]rn||0.437rn||0.3rn|
|HDL-C (mg/dL) EX NoEXrn||46.5 61.3rn||49.0 61.5rn||3.83 [-1.9, 9.6] -0.32 [-4.8, 4.1]rn||0.270rn||0.4rn|
|HOMA-IR EX NoEXrn||2.56 1.34rn||1.42 1.82rn||−0.63 [-1.9, 0.6] -0.01 [-1.0, 1.0]rn||0.433rn||0.3rn|
Supervised resistance exercise for 12 weeks improves wCirc and body composition in men receiving ADT for prostate cancer with moderate effect on other MetS parameters.
Clinical trial identification
Legal entity responsible for the study
University of Southern California, Keck School of Medicine
National Strength and Conditioning Association, California State University Chancellor's Doctoral Incentive Program
All authors have declared no conflicts of interest.