1
|
Yang U, Harikrishna A, Preda V, Chen J. Efficacy of multidisciplinary interventions in preventing metabolic syndrome and improving body composition in prostate cancer patients treated with androgen deprivation therapy: A systematic review and meta-analysis. Clin Nutr ESPEN 2023; 58:27-49. [PMID: 38057016 DOI: 10.1016/j.clnesp.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 09/01/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Exercise is known to reduce adverse side effects of androgen-deprivation therapy (ADT) on quality of life, bone health and fatigue for prostate cancer (PCa) patients. We conducted a systematic review with meta-analysis to evaluate the effect of multidisciplinary interventions on body composition and metabolic syndrome (MetS) in ADT-treated PCa patients. METHODS A systematic review and meta-analysis were conducted based on searches of EMBASE, MEDLINE, CENTRAL and Scopus databases from inception to March 2023. Participants included ADT-treated PCa patients who received multidisciplinary interventions including exercise, diet, nutrition, pharmacotherapy, bariatric surgery, or psychological/behavioural therapy. Primary outcomes were changes in body composition and MetS, with prostate-specific antigen (PSA) as a secondary outcome. After meta-analysis, results were reported in mean difference, 95% confidence interval and p-value, with forest plots. Additionally, we conducted subgroup analyses to compare the effect of different interventions. RESULTS Thirty-three articles met the eligibility criteria out of 1443 articles and 28 studies were included in meta-analysis. Of 33 studies, 17 included exercise-only interventions and 10 included exercise + diet/nutrition interventions, but no studies included diet/nutrition-only interventions. All studies employed multidisciplinary approaches in developing or delivering the interventions. Most studies (85%) had low-moderate risk of bias, thus providing good evidence to this review. Overall, interventions had a positive effect on body composition measures; lean mass (LM):0.82 kg (95% CI:0.47,1.17;p < 0.00001), body fat mass (BFM):-0.68 kg (95% CI:-1.12,-0.24;p = 0.002), fat-free mass:0.75 kg (95% CI:0.14,1.37;p = 0.02) and body fat percentage (BFP):-0.99% (95% CI:-1.29,-0.68;p < 0.00001), as well as on MetS; waist circumference:-1.95 cm (95% CI:-3.10,-0.79;p = 0.0009), systolic blood pressure:-3.43 mmHg (95% CI:-6.36,-0.50;p = 0.02) and diastolic blood pressure:-2.48 mmHg (95% CI:-4.19,-0.76;p = 0.005). Subgroup-analyses showed that a combined approach including exercise + diet/nutrition was most effective in improving BFP, WC, SBP and DBP whereas exercise was more effective in improving LM and BFM. CONCLUSIONS In ADT-treated PCa patients, multidisciplinary interventions, especially those combining exercise and diet/nutrition, can improve body composition and metabolic health.
Collapse
Affiliation(s)
- Uhjin Yang
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia.
| | - Athulya Harikrishna
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Veronica Preda
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Juliana Chen
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia; Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| |
Collapse
|
2
|
Essential of Immediate Exercises on Cancer-Related Fatigue in Patients with Prostate Cancer Receiving Androgen Deprivation Therapy: A Meta-Analysis of Randomized Controlled Trials. Semin Oncol Nurs 2022:151368. [DOI: 10.1016/j.soncn.2022.151368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 12/12/2022]
|
3
|
Ligibel JA, Bohlke K, May AM, Clinton SK, Demark-Wahnefried W, Gilchrist SC, Irwin ML, Late M, Mansfield S, Marshall TF, Meyerhardt JA, Thomson CA, Wood WA, Alfano CM. Exercise, Diet, and Weight Management During Cancer Treatment: ASCO Guideline. J Clin Oncol 2022; 40:2491-2507. [PMID: 35576506 DOI: 10.1200/jco.22.00687] [Citation(s) in RCA: 161] [Impact Index Per Article: 80.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To provide guidance on exercise, diet, and weight management during active cancer treatment in adults. METHODS A systematic review of the literature identified systematic reviews and randomized controlled trials evaluating the impact of aerobic and resistance exercise, specific diets and foods, and intentional weight loss and avoidance of weight gain in adults during cancer treatment, on quality of life, treatment toxicity, and cancer control. PubMed and the Cochrane Library were searched from January 2000 to May 2021. ASCO convened an Expert Panel to review the evidence and formulate recommendations. RESULTS The evidence base consisted of 52 systematic reviews (42 for exercise, nine for diet, and one for weight management), and an additional 23 randomized controlled trials. The most commonly studied types of cancer were breast, prostate, lung, and colorectal. Exercise during cancer treatment led to improvements in cardiorespiratory fitness, strength, fatigue, and other patient-reported outcomes. Preoperative exercise in patients with lung cancer led to a reduction in postoperative length of hospital stay and complications. Neutropenic diets did not decrease risk of infection during cancer treatment. RECOMMENDATIONS Oncology providers should recommend regular aerobic and resistance exercise during active treatment with curative intent and may recommend preoperative exercise for patients undergoing surgery for lung cancer. Neutropenic diets are not recommended to prevent infection in patients with cancer during active treatment. Evidence for other dietary and weight loss interventions during cancer treatment was very limited. The guideline discusses special considerations, such as exercise in individuals with advanced cancer, and highlights the critical need for more research in this area, particularly regarding diet and weight loss interventions during cancer treatment.Additional information is available at www.asco.org/supportive-care-guidelines.
Collapse
Affiliation(s)
| | - Kari Bohlke
- American Society of Clinical Oncology, Alexandria, VA
| | - Anne M May
- University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | | | | | | | | | | | | | | | | | | | | | - Catherine M Alfano
- Northwell Health Cancer Institute and Feinstein Institutes for Medical Research, New York, NY
| |
Collapse
|
4
|
Mason SJ, Downing A, Wilding S, Hounsome L, Wright P, Watson E, Wagland R, Butcher H, Kind P, Selby P, Gavin A, Glaser AW. Stability of health-related quality of life and morbidity burden from 18 months after diagnosis of prostate cancer: results of a UK-wide population-based outcome cohort. Support Care Cancer 2021; 30:3151-3164. [PMID: 34904181 PMCID: PMC8857149 DOI: 10.1007/s00520-021-06650-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 10/25/2021] [Indexed: 11/30/2022]
Abstract
Objective To evaluate the dynamic nature of self-reported health-related quality of life (HRQL) and morbidity burden in men diagnosed with prostate cancer, we performed a follow-up study of the Life After Prostate Cancer Diagnosis (LAPCD) study cohort 12 months after initial survey. Methods The LAPCD study collected information from 35,823 men across the UK who were 18–42 months post-diagnosis of prostate cancer. Men who were still alive 12 months later were resurveyed. Generic HRQL (EQ-5D-5L plus self-assessed health rating) and prostate cancer-specific outcomes (EPIC-26) were assessed. Treatment(s) received was self-reported. Previously defined clinically meaningful differences were used to evaluate changes in outcomes over time. Results A total of 28,450 men across all disease stages completed follow-up surveys (85.8% response). Of the 21,700 included in this study, 89.7% reported no additional treatments since the first survey. This group experienced stable urinary and bowel outcomes, with good function for most men at both time points. On-going poor (but stable) urinary issues were associated with previous surgery. Sexual function scores remained low (mean: 26.8/100). Self-assessed health ratings were stable over time. The largest declines in HRQL and functional outcomes were experienced by men reporting their first active treatment between surveys. Discussion The results suggest stability of HRQL and most specific morbidities by 18–42 months for men who report no further treatment in the subsequent 12 months. This is reassuring for those with good function and HRQL but re-enforces the need for early intervention and support for men who experience poor outcomes. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-021-06650-7.
Collapse
Affiliation(s)
- Samantha J Mason
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Amy Downing
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK. .,Leeds Institute for Data Analytics, University of Leeds, Level 11, Worsley Building, Leeds, LS2 9NL, UK.
| | - Sarah Wilding
- School of Psychology, University of Leeds, Leeds, UK
| | | | - Penny Wright
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - Eila Watson
- Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, UK
| | - Richard Wagland
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Hugh Butcher
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - Paul Kind
- Academic Unit of Health Economics, University of Leeds, Leeds, UK
| | - Peter Selby
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.,Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Anna Gavin
- Northern Ireland Cancer Registry, Queens University Belfast, Belfast, UK
| | - Adam W Glaser
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.,Leeds Institute for Data Analytics, University of Leeds, Level 11, Worsley Building, Leeds, LS2 9NL, UK
| |
Collapse
|
5
|
Association of Baseline Patient-reported Health-related Quality of Life Metrics with Outcome in Localised Prostate Cancer. Clin Oncol (R Coll Radiol) 2021; 34:e61-e68. [PMID: 34728131 DOI: 10.1016/j.clon.2021.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 09/13/2021] [Accepted: 10/14/2021] [Indexed: 11/22/2022]
Abstract
AIMS Although health-related quality of life (HR-QoL) outcomes are pivotal in oncology, the prognostic significance of patient-reported HR-QoL metrics is largely undefined in localised prostate cancer. We report the association of baseline HR-QoL metrics with overall survival and toxicity in localised prostate cancer. MATERIALS AND METHODS This was a secondary analysis of a phase III randomised controlled study conducted in a single-payer health system. Patients with Gleason score ≤7, clinical stage T1b-T3a and prostate-specific antigen <30 ng/ml were randomised to neoadjuvant and concurrent androgen deprivation therapy (ADT) for 6 months starting 4 months before prostate radiotherapy or concurrent and adjuvant ADT for 6 months starting simultaneously with prostate radiotherapy. HR-QoL scores were estimated using the European Organisation for Research and Treatment of Cancer QoL questionnaire. A multistate Markov model was used to determine the association of baseline HR-QoL metrics with overall survival and a multilevel multivariable Cox regression was used to determine the association with the incidence of delayed-onset grade ≥3 radiotherapy-related toxicities. To adjust for multiple analyses, P < 0.025 was considered as statistically significant. RESULTS Overall, 393 patients with baseline HR-QoL data were included in this analysis: 194 in the neoadjuvant arm and 199 in the adjuvant arm. Baseline financial difficulty (hazard ratio 1.020, 95% confidence interval 1.010-1.030, P = 0.02) and dyspnoea (hazard ratio 1.020, 95% confidence interval 1.003-1.030, P = 0.01) were associated with inferior overall survival. Baseline dyspnoea was associated with a higher incidence of grade ≥3 toxicity (hazard ratio 1.020, 95% confidence interval 1.010-1.030, P = 0.023). CONCLUSION In a cohort of localised prostate cancer patients treated with radiotherapy and short-term ADT, a 10-point higher baseline financial difficulty or dyspnoea was associated with a 20% increased risk of death. With each 10-point increase in baseline dyspnoea, we noted a 20% increase in the associated risk of grade ≥3 delayed-onset radiotherapy-related toxicity.
Collapse
|
6
|
García-Perdomo HA, Gómez-Ospina JC, Chaves-Medina MJ, Sierra JM, Gómez AMA, Rivas JG. Impact of lifestyle in prostate cancer patients. What should we do? Int Braz J Urol 2021; 48:244-262. [PMID: 34472770 PMCID: PMC8932020 DOI: 10.1590/s1677-5538.ibju.2021.0297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 05/20/2021] [Indexed: 12/24/2022] Open
Abstract
Objective: This review aimed to analyze interventions raised within primary and tertiary prevention concerning the disease's incidence, progression, and recurrence of Prostate Cancer (PCa). Priority was given to the multidisciplinary approach of PCa patients with an emphasis on modifiable risk factors. Materials and Methods: We conducted a comprehensive literature review in the following databases: Embase, Central, and Medline. We included the most recent evidence assessing cohort studies, case-control studies, clinical trials, and systematic reviews published in the last five years. We only included studies in adults and in vitro or cell culture studies. The review was limited to English and Spanish articles. Results: Preventive interventions at all levels are the cornerstone of adherence to disease treatment and progression avoidance. The relationship in terms of healthy lifestyles is related to greater survival. The risk of developing cancer is associated to different eating habits, determined by geographic variations, possibly related to different genetic susceptibilities. Discussion: PCa is the second most common cancer in men, representing a leading cause of death among men in Latin America. Prevention strategies and healthy lifestyles are associated with higher survival rates in PCa patients. Also, screening for anxiety and the presence of symptoms related to mood disorders is essential in the patient's follow-up concerning their perception of the condition.
Collapse
Affiliation(s)
- Herney Andrés García-Perdomo
- Division of Urology/Uroooncology, Department of Surgery, School of Medicine, Universidad Del Valle, Cali, Colombia.,UROGIV Research Group, School of Medicine, Universidad Del Valle, Cali, Colombia
| | | | | | | | | | - Juan Gómez Rivas
- Department of Urology, Hospital Clínico San Carlos, Madrid, Spain
| |
Collapse
|
7
|
Lopez P, Taaffe DR, Newton RU, Buffart LM, Galvão DA. What is the minimal dose for resistance exercise effectiveness in prostate cancer patients? Systematic review and meta-analysis on patient-reported outcomes. Prostate Cancer Prostatic Dis 2021; 24:465-481. [PMID: 33219369 PMCID: PMC8134054 DOI: 10.1038/s41391-020-00301-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/22/2020] [Accepted: 11/04/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Active treatments for prostate cancer are well known to result in several adverse effects such as fatigue, depression and anxiety symptoms, impacting the overall quality of life (QoL) and wellbeing of a considerable proportion of patients. Resistance-based exercise interventions have shown positive effects to reduce or mitigate these treatment-related side effects. However, the minimal dosage required to derive these benefits is unknown. We systematically reviewed the resistance training effects in prostate cancer patients to determine the minimal dosage regarding the exercise components (mode, duration, volume and intensity) on fatigue, QoL, depression and anxiety. METHODS Using PRISMA guidelines, MEDLINE, CINAHL, EMBASE, SPORTDiscus and Web of Science databases were searched. Eligible randomised controlled trials examined prostate cancer patients undertaking resistance-based exercise programs during or following treatment. Meta-analysis was undertaken when more than three studies were included. Associations between resistance exercise components and its effects were tested by meta-regression analysis. RESULTS Eighteen trials involving 1112 men with prostate cancer were included. Resistance-based exercise programs resulted in significant effects on fatigue (effect size = -0.3, 95% CI: -0.4 to -0.2, P < 0.001) and QoL (effect size = 0.2, 95% CI: 0.0 to 0.4, P = 0.018), with significant effects in specific questionnaires and domains of these outcomes. Resistance-based exercise effects on depression (effect size = -0.3, 95% CI: -0.7 to 0.0) and anxiety symptoms (effect size = -0.3, 95% CI: -0.5 to 0.0) were positive but not significant (P = 0.071 to 0.077). Meta-regression indicated no significant association between resistance exercise components with fatigue and QoL outcomes (P = 0.186-0.689). CONCLUSIONS Low volume resistance exercise undertaken at a moderate-to-high intensity is sufficient to achieve significant fatigue and QoL benefits for men with prostate cancer and also mitigate depression and anxiety symptoms. A lower resistance exercise dosage than usually prescribed may help enhance adherence by reducing exercise barriers.
Collapse
Affiliation(s)
- Pedro Lopez
- Exercise Medicine Research Institute, Edith Cowan University, Perth, WA, Australia.
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia.
| | - Dennis R Taaffe
- Exercise Medicine Research Institute, Edith Cowan University, Perth, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Perth, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Laurien M Buffart
- Exercise Medicine Research Institute, Edith Cowan University, Perth, WA, Australia
- Department of Physiology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Daniel A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, Perth, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| |
Collapse
|
8
|
LOPEZ PEDRO, TAAFFE DENNISR, NEWTON ROBERTU, GALVÃO DANIELA. Resistance Exercise Dosage in Men with Prostate Cancer: Systematic Review, Meta-analysis, and Meta-regression. Med Sci Sports Exerc 2021; 53:459-469. [PMID: 32890199 PMCID: PMC7886340 DOI: 10.1249/mss.0000000000002503] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE Resistance exercise improves an array of treatment-related adverse effects in men with prostate cancer; however, the minimal dosage required is unknown. We systematically reviewed the resistance training effects in prostate cancer patients to determine the minimal dosage regarding the exercise components (type, duration, volume, and intensity) on body composition, physical function, muscle strength, cardiorespiratory fitness, body mass index, and prostate-specific antigen. METHODS Using PRISMA guidelines, MEDLINE, CINAHL, EMBASE, SPORTDiscus, and Web of Science databases were searched. Eligible randomized controlled trials examined prostate cancer patients undertaking resistance-based exercise programs during or after treatment. Meta-analysis was undertaken when more than three studies were included. Associations between mean differences and exercise components were tested by univariate and multivariate meta-regression analysis. RESULTS Twenty-three articles describing 21 trials and involving 1748 prostate cancer patients were included. Exercise improved fat mass (-1% in body fat and -0.6 kg in fat mass), lean mass (~0.5 kg in lean and appendicular lean mass), functional capacity (i.e., chair rise, 400-m test, 6-m fast walk, and stair climb tests), and fitness outcomes (i.e., V̇O2peak and muscle strength) (P = 0.040-<0.001) with no change in body mass index or prostate-specific antigen (P = 0.440-0.735). Meta-regression indicated no association between exercise type, resistance training duration, weekly volume and intensity, and primary outcomes (P = 0.075-0.965). There was a significant association between exercise intensity and chest press muscle strength (favoring moderate intensity, P = 0.012), but not in other secondary outcomes. CONCLUSION In untrained older men with prostate cancer initiating an exercise program, lower volume at moderate to high intensity is as effective as higher volume resistance training for enhancing body composition, functional capacity, and muscle strength in the short term. A low exercise dosage may help reduce barriers to exercise and enhance adherence.
Collapse
Affiliation(s)
- PEDRO LOPEZ
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, AUSTRALIA
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, AUSTRALIA
| | - DENNIS R. TAAFFE
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, AUSTRALIA
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, AUSTRALIA
| | - ROBERT U. NEWTON
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, AUSTRALIA
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, AUSTRALIA
- School of Human Movement and Nutrition Sciences, University of Queensland, Queensland, AUSTRALIA
| | - DANIEL A. GALVÃO
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, AUSTRALIA
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, AUSTRALIA
| |
Collapse
|
9
|
Algotar A, Hsu CH, Sherry Chow HH, Dougherty S, Babiker HM, Marrero D, Abraham I, Kumar R, Ligibel J, Courneya KS, Thomson C. Comprehensive Lifestyle Improvement Program for Prostate Cancer (CLIPP): Protocol for a Feasibility and Exploratory Efficacy Study in Men on Androgen Deprivation Therapy. JMIR Res Protoc 2019; 8:e12579. [PMID: 30720441 PMCID: PMC6379812 DOI: 10.2196/12579] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 12/23/2018] [Accepted: 01/07/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Androgen deprivation therapy (ADT) for prostate cancer is associated with adverse cardiometabolic effects such as reduced libido, hot flashes, metabolic syndrome, diabetes, myocardial infarction, and stroke. This reduces quality of life and potentially increases mortality. Several large clinical trials have demonstrated improvements in cardiometabolic risk with comprehensive multimodality lifestyle modification. However, there is a lack of data for such interventions in men on ADT for prostate cancer, and existing studies have used non-standardized interventions or lacked data on metabolic risk factors. OBJECTIVE The Comprehensive Lifestyle Improvement Project for Prostate Cancer (CLIPP) is designed to address these gaps by using an intervention modeled on the Diabetes Prevention Program, a standardized multicomponent intervention with demonstrated effectiveness in reducing cardiometabolic risk factors that has been successfully adapted for multiple disease types including breast cancer. METHODS A single-arm unblinded clinical trial will be conducted to determine the feasibility of conducting a 24-week comprehensive lifestyle modification intervention that targets weight loss and increased physical activity modeled on the Diabetes Prevention Program in 30 men on ADT for prostate cancer. Secondary aims are to determine the effect of the intervention on cardiometabolic markers and quality of life. The tertiary aim is to determine the effect of the intervention on markers of inflammation and angiogenesis, important mechanisms for prostate cancer progression. Participants will be recruited from the University of Arizona Cancer Center and the surrounding community. The intervention will be delivered weekly in person and over the phone for 16 weeks. For Weeks 16-24, participants receive weekly phone calls from the study health coach to motivate them to continue their lifestyle modification. Questionnaire and biological data are collected at baseline, 12 weeks, and 24 weeks. Body composition using dual-energy x-ray absorptiometry scans will be performed at baseline and end of study. RESULTS Based on a sample size of 30, the two-sided 95% confidence interval will not be wider than 0.373 standard deviations for the adherence rate and will not be wider than 0.374 for the retention rate. In addition, the study will have a power of 80% to detect a change of 0.47 standard deviations from baseline for each of the markers investigated in the secondary and tertiary aims assuming a within-subject correlation of 0.20 at a significance level of 5%. The recruitment period is from October 2018 to April 2019. CONCLUSIONS The aim of CLIPP is to determine the feasibility of conducting a Diabetes Prevention Program-style comprehensive lifestyle modification intervention in men with ADT for prostate cancer and its effects on cardiometabolic adverse effects, quality of life, as well as markers of inflammation and angiogenesis. Results will inform the development of future clinical trials in this population. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/12579.
Collapse
Affiliation(s)
- Amit Algotar
- University of Arizona, Tucson, AZ, United States
| | | | | | | | | | | | - Ivo Abraham
- University of Arizona, Tucson, AZ, United States
| | - Rachit Kumar
- University of Arizona, Tucson, AZ, United States
| | | | | | | |
Collapse
|
10
|
Roeh A, Kirchner SK, Malchow B, Maurus I, Schmitt A, Falkai P, Hasan A. Depression in Somatic Disorders: Is There a Beneficial Effect of Exercise? Front Psychiatry 2019; 10:141. [PMID: 30949079 PMCID: PMC6435577 DOI: 10.3389/fpsyt.2019.00141] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 02/26/2019] [Indexed: 12/13/2022] Open
Abstract
Background: The beneficial effects of exercise training on depressive symptoms are well-established. In the past years, more research attention has been drawn to the specific effects of exercise training on depressive symptoms in somatically ill patients. This reviews aims at providing a comprehensive overview of the current findings and evidence of exercise interventions in somatic disorders to improve depressive symptoms. Methods: We systematically searched PubMed and Cochrane databases and extracted meta-analyses from somatically ill patients that underwent exercise interventions and provided information about the outcome of depressive symptoms. Results: Of the 4123 detected publications, 39 were selected for final analysis. Various diseases were included (breast-cancer, prostate cancer, mixed-cancer, cardiovascular disease, coronary heart disease, hemodialysis, fibromyalgia syndrome, acute leukemia, other hematological malignancies, heart failure, HIV, multiple sclerosis, mixed neurological disorders, Parkinson's disease, stroke, ankylosing spondylitis, traumatic brain injury, lupus erythematodes). Most meta-analyses (33/39) found beneficial effects on depressive symptoms, but quality of the included studies as well as duration, intensity, frequency, and type of exercise varied widely. Conclusion: Exercise training has the potential to improve depressive symptoms in patients with somatic disorders. For specific training recommendations, more high quality studies with structured exercise programs and better comparability are needed.
Collapse
Affiliation(s)
- Astrid Roeh
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Sophie K Kirchner
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Berend Malchow
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Jena, Jena, Germany
| | - Isabel Maurus
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany.,Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Alkomiet Hasan
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| |
Collapse
|