A pilot study of exercise in men with prostate cancer receiving androgen deprivation therapy

C Ellen Lee, William D Leslie, Y K James Lau, C Ellen Lee, William D Leslie, Y K James Lau

Abstract

Background: Androgen deprivation therapy (ADT) is the mainstay therapy for men with prostate cancer. However, there are musculoskeletal side effects from ADT that increase the risk for osteoporosis and fracture, and can compromise the quality of life of these individuals. The objectives of this study are to determine the efficacy of a home-based walking exercise program in promoting bone health, physical function and quality of life in men with prostate cancer receiving ADT.

Methods/design: A 12-month prospective, single-blinded, randomized controlled trial will be conducted to compare the Exercise Group with the Control Group. Sixty men with prostate cancer who will be starting ADT will be recruited and randomly assigned to one of the two groups: the Exercise Group will receive instructions in setting up an individualized 12-month home-based walking exercise program, while the Control Group will receive standard medical advice from the attending physician. A number of outcome measures will be used to assess bone health, physical function, and health-related quality of life. At baseline and 12 months, bone health will be assessed using dual-energy X-ray absorptiometry. At baseline and every 3 months up to 12 months, physical function will be evaluated using the Functional Assessment of Chronic Illness Therapy - Fatigue Scale, Activities-specific Balance Confidence Scale, Short Physical Performance Battery, and Six-Minute Walk Test; and health-related quality of life will be assessed using the Functional Assessment of Cancer Therapy Prostate Module and the Medical Outcomes Study 12-item Short Form Health Survey Version 2. A mixed multiple analysis of variance will be used to analyze the data.

Discussion: Musculoskeletal health management remains a challenge in men with prostate cancer receiving ADT. This study addresses this issue by designing a simple and accessible home-based walking exercise program that will potentially have significant impact on reducing the risk of fracture, promoting physical function, and ultimately improving the health-related quality of life in men with prostate cancer receiving ADT.

Trial registration: ClinicalTrials.gov: NCT00834392.

References

    1. Canadian Cancer Society. Prostate Cancer Statistics. 2010 2010.
    1. Stat Fact Sheets: Prostate Cancer.
    1. Abraham J, Allegra C, Gulley J. Bethesda Handbook of Clinical Oncology. 2. Baltimore, MD: Lippincott Williams & Wilkins; 2005.
    1. Saad F, Perrotte P, Benard F, McCormack M, Karakiewicz PI. Bone health in men with prostate cancer: diagnostic and therapeutic considerations. Can J Urol. 2005;12(Suppl 2):9–15.
    1. Yaturu S, DjeDjos S, Alferos G, Deprisco C. Bone mineral density changes on androgen deprivation therapy for prostate cancer and response to antiresorptive therapy. Prostate Cancer Prostatic Dis. 2006;9(1):35–38. doi: 10.1038/sj.pcan.4500846.
    1. Melton LJ, Lieber MM, Atkinson EJ, Achenbach SJ, Zincke H, Therneau TM, Khosla S. Fracture risk in men with prostate cancer: a population-based study. J Bone Miner Res. 2011;26(8):1808–1815. doi: 10.1002/jbmr.405.
    1. Shahinian VB, Kuo YF, Freeman JL, Goodwin JS. Risk of fracture after androgen deprivation for prostate cancer. N Engl J Med. 2005;352(2):154–164. doi: 10.1056/NEJMoa041943.
    1. Lau YK, Lee CE, Prior HJ, Lix LM, Metge CJ, Leslie WD. Fracture risk in androgen deprivation therapy: a Canadian population based analysis. Can J Urol. 2009;16(6):4908–4914.
    1. Clay CA, Perera S, Wagner JM, Miller ME, Nelson JB, Greenspan SL. Physical function in men with prostate cancer on androgen deprivation therapy. PhysTher. 2007;87(10):1325–1333.
    1. Dacal K, Sereika SM, Greenspan SL. Quality of life in prostate cancer patients taking androgen deprivation therapy. J Am GeriatrSoc. 2006;54(1):85–90. doi: 10.1111/j.1532-5415.2005.00567.x.
    1. Chen AC, Petrylak DP. Complications of androgen-deprivation therapy in men with prostate cancer. CurrUrol Rep. 2005;6(3):210–216.
    1. Holzbeierlein JM, McLaughlin MD, Thrasher JB. Complications of androgen deprivation therapy for prostate cancer. CurrOpinUrol. 2004;14(3):177–183.
    1. Almeida OP, Waterreus A, Spry N, Flicker L, Martins RN. One year follow-up study of the association between chemical castration, sex hormones, beta-amyloid, memory and depression in men. Psychoneuroendocrinology. 2004;29(8):1071–1081. doi: 10.1016/j.psyneuen.2003.11.002.
    1. Shahinian VB, Kuo YF, Freeman JL, Goodwin JS. Risk of the "androgen deprivation syndrome" in men receiving androgen deprivation for prostate cancer. Arch Intern Med. 2006;166(4):465–471. doi: 10.1001/.465.
    1. Cawthon PM, Fullman RL, Marshall L, Mackey DC, Fink HA, Cauley JA, Cummings SR, Orwoll ES, Ensrud KE. Physical performance and risk of hip fractures in older men. J Bone Miner Res. 2008;23(7):1037–1044. doi: 10.1359/jbmr.080227.
    1. Malcolm JB, Derweesh IH, Kincade MC, DiBlasio CJ, Lamar KD, Wake RW, Patterson AL. Osteoporosis and fractures after androgen deprivation initiation for prostate cancer. Can J Urol. 2007;14(3):3551–3559.
    1. Nevitt MC, Cummings SR, Kidd S, Black D. Risk factors for recurrent nonsyncopal falls. A prospective study. JAMA. 1989;261(18):2663–2668. doi: 10.1001/jama.1989.03420180087036.
    1. Stel VS, Smit JH, Pluijm SM, Lips P. Balance and mobility performance as treatable risk factors for recurrent falling in older persons. J ClinEpidemiol. 2003;56(7):659–668.
    1. McNeely ML, Campbell KL, Rowe BH, Klassen TP, Mackey JR, Courneya KS. Effects of exercise on breast cancer patients and survivors: a systematic review and meta-analysis. CMAJ. 2006;175(1):34–41. doi: 10.1503/cmaj.051073.
    1. Holmes MD, Chen WY, Feskanich D, Kroenke CH, Colditz GA. Physical activity and survival after breast cancer diagnosis. JAMA. 2005;293(20):2479–2486. doi: 10.1001/jama.293.20.2479.
    1. Yamazaki S, Ichimura S, Iwamoto J, Takeda T, Toyama Y. Effect of walking exercise on bone metabolism in postmenopausal women with osteopenia/osteoporosis. J Bone Miner Metab. 2004;22(5):500–508.
    1. Segal RJ, Reid RD, Courneya KS, Malone SC, Parliament MB, Scott CG, Venner PM, Quinney HA, Jones LW, D'Angelo ME. et al.Resistance exercise in men receiving androgen deprivation therapy for prostate cancer. J ClinOncol. 2003;21(9):1653–1659. doi: 10.1200/JCO.2003.09.534.
    1. Thomas S, Reading J, Shephard RJ. Revision of the Physical Activity Readiness Questionnaire (PAR-Q) Can J Sport Sci. 1992;17(4):338–345.
    1. Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14(5):377–381.
    1. Esper P, Mo F, Chodak G, Sinner M, Cella D, Pienta KJ. Measuring quality of life in men with prostate cancer using the functional assessment of cancer therapy-prostate instrument. Urology. 1997;50(6):920–928. doi: 10.1016/S0090-4295(97)00459-7.
    1. Chang CH, Wright BD, Cella D, Hays RD. The SF-36 physical and mental health factors were confirmed in cancer and HIV/AIDS patients. J ClinEpidemiol. 2007;60(1):68–72.
    1. Yellen SB, Cella DF, Webster K, Blendowski C, Kaplan E. Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system. J Pain Symptom Manage. 1997;13(2):63–74. doi: 10.1016/S0885-3924(96)00274-6.
    1. Powell LE, Myers AM. The Activities-specific Balance Confidence (ABC) Scale. J Gerontol A BiolSci Med Sci. 1995;50A(1):M28–M34. doi: 10.1093/gerona/50A.1.M28.
    1. Guralnik JM, Ferrucci L, Pieper CF, Leveille SG, Markides KS, Ostir GV, Studenski S, Berkman LF, Wallace RB. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A BiolSci Med Sci. 2000;55(4):M221–M231. doi: 10.1093/gerona/55.4.M221.
    1. Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, Scherr PA, Wallace RB. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49(2):M85–M94.
    1. Enright PL. The six-minute walk test. Respir Care. 2003;48(8):783–785.
    1. Wallston KA, Stein MJ, Smith CA. Form C of the MHLC scales: a condition-specific measure of locus of control. J Pers Assess. 1994;63(3):534–553. doi: 10.1207/s15327752jpa6303_10.
    1. Hann D, Winter K, Jacobsen P. Measurement of depressive symptoms in cancer patients: evaluation of the Center for Epidemiological Studies Depression Scale (CES-D) J Psychosom Res. 1999;46(5):437–443. doi: 10.1016/S0022-3999(99)00004-5.
    1. Topolski TD, LoGerfo J, Patrick DL, Williams B, Walwick J, Patrick MB. The Rapid Assessment of Physical Activity (RAPA) among older adults. Prev Chronic Dis. 2006;3(4):A118.

Source: PubMed

Patrocinadores e Colaboradores

Condições médicas

Intervenções de drogas

3
Se inscrever