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Cagliari M, Bressi B, Bassi MC, Fugazzaro S, Prati G, Iotti C, Costi S. Feasibility and Safety of Physical Exercise to Preserve Bone Health in Men With Prostate Cancer Receiving Androgen Deprivation Therapy: A Systematic Review. Phys Ther 2022; 102:pzab288. [PMID: 34972863 PMCID: PMC8970430 DOI: 10.1093/ptj/pzab288] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 07/30/2021] [Accepted: 11/21/2021] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Men with prostate cancer (PCa) receiving androgen deprivation therapy (ADT) experience the loss of bone mineral density (BMD) and lean body mass, which can increase their risk of falls and fractures. Physical exercise programs with appropriate components and dosage are suggested to preserve BMD and muscle strength, thereby potentially reducing accidental falls and fractures and associated morbidity and mortality. These benefits can be obtained if exercise programs are feasible and safe and if patient adherence is adequate. This systematic review investigates the feasibility and safety of exercise programs aimed at preventing the risk of accidental falls and fractures and BMD loss in men with PCa undergoing ADT. METHODS MEDLINE, Embase, CINAHL, and the Cochrane Library were searched from database inception to June 7, 2021. Randomized controlled trials were included when they analyzed the feasibility and safety of experimental exercise programs targeting bone health in men with PCa receiving ADT. Two reviewers independently selected the studies, assessed their methodological quality, and extracted the data. Exercise feasibility was measured through recruitment, retention, and adherence rates. Exercise safety was measured through the number, type, and severity of adverse events. Furthermore, the components, setting, intensity, frequency, and duration of exercise programs were extracted. RESULTS Ten studies were included, with a total of 633 participants. Exercise consisted of a combination of aerobic, resistance, and impact-loading exercise or football training. Exercise is feasible in men with PCa undergoing ADT, although football training should be prescribed with caution for safety reasons. CONCLUSION Multicomponent exercise programs targeting bone health seem feasible and safe in this population; however, adverse events should be systematically documented according to current guidelines. IMPACT The study shows that men with PCa receiving ADT can safely perform exercise programs to preserve bone health and supports that those programs should become part of lifestyle habits. LAY SUMMARY Men with PCa who are receiving ADT can safely perform exercise programs to preserve bone health and should make exercise an important part of their lifestyle.
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Affiliation(s)
- Maribel Cagliari
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Barbara Bressi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Department of Neuromotor Physiopathology and Rehabilitation Medicine, Physical Medicine and Rehabilitation Unit, Azienda USL–IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maria Chiara Bassi
- Medical Library, Azienda USL–IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefania Fugazzaro
- Department of Neuromotor Physiopathology and Rehabilitation Medicine, Physical Medicine and Rehabilitation Unit, Azienda USL–IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Giuseppe Prati
- Department of Oncology and Advanced Technologies, Oncology Unit, Azienda USL–IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Cinzia Iotti
- Department of Oncology and Advanced Technologies, Radiotherapy Unit, Azienda USL–IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefania Costi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Scientific Directorate, Azienda USL–IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Bressi B, Cagliari M, Contesini M, Mazzini E, Bergamaschi FAM, Moscato A, Bassi MC, Costi S. Physical exercise for bone health in men with prostate cancer receiving androgen deprivation therapy: a systematic review. Support Care Cancer 2021; 29:1811-1824. [PMID: 33119791 PMCID: PMC7892525 DOI: 10.1007/s00520-020-05830-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 10/13/2020] [Indexed: 12/28/2022]
Abstract
PURPOSE Androgen deprivation therapy (ADT) is a treatment used in men with prostate cancer (PCa); however it is responsible for many adverse effects, with negative impact on quality of life. ADT causes loss of bone mineral density (BMD) and skeletal muscle mass, alteration of body composition, and cognitive function, which altogether lead to increased risk of accidental falls and fractures. This systematic review analyses the effectiveness of physical exercise (PE) in preventing accidental falls and fractures and reducing the loss of BMD in men with PCa receiving ADT. METHODS We searched MEDLINE, EMBASE, CINAHL, and the Cochrane Library for articles between database inception and September 2, 2020. Eligible studies included randomized controlled trials (RCTs) investigating the effects of exercise on bone health in men with PCa receiving ADT. RESULTS Nine RCTs were included. Experimental PE consisted in multicomponent programmes that involved aerobic, resistance, impact-loading exercise, and football training. None of the RCTs investigated the risk of accidental falls and fractures, while two trials reported beneficial effects of PE on lumbar spine, hip, and femoral shaft BMD. No further significant difference was detected in the outcomes investigated. CONCLUSION Evidence of the effectiveness of PE to prevent the risk of accidental falls and fractures and BMD loss is lacking. Nevertheless, clinical guidelines recommend PE as a part of the clinical management of men with PCa receiving ADT due to its known numerous health benefits. Research should focus on PE strategies to prevent accidental falls, a clinically relevant outcome in this vulnerable population. TRIAL REGISTRATION The study protocol was registered with International Prospective Register of Systematic Reviews (PROSPERO, number CRD 42020158444 ) on 04/28/2020.
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Affiliation(s)
- Barbara Bressi
- PhD Program in Clinical and Experimental Medicine, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Reggio Emilia, Italy.
- Physical Medicine and Rehabilitation Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
| | - Maribel Cagliari
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Massimiliano Contesini
- Human Resource Development - Training Radiographers and Radiations Terapist, Azienda USL-IRCCS di Reggio Emilia , Reggio Emilia, Italy
| | - Elisa Mazzini
- Medical Directorate Hospital Network, Azienda USL-IRCCS di Reggio Emilia , Reggio Emilia, Italy
| | - Franco Antonio Mario Bergamaschi
- Urology and Mininvasive Surgery, Department of General and Specialist Surgeries, Azienda USL-IRCCS di Reggio Emilia , Reggio Emilia, Italy
| | - Alfredo Moscato
- Urology and Mininvasive Surgery, Department of General and Specialist Surgeries, Azienda USL-IRCCS di Reggio Emilia , Reggio Emilia, Italy
| | - Maria Chiara Bassi
- Medical Library, Azienda USL-IRCCS di Reggio Emilia , Reggio Emilia, Italy
| | - Stefania Costi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Scientific Directorate , Azienda USL-IRCCS di Reggio Emilia , Reggio Emilia, Italy
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Saylor PJ, Rumble RB, Michalski JM. Bone Health and Bone-Targeted Therapies for Prostate Cancer: American Society of Clinical Oncology Endorsement Summary of a Cancer Care Ontario Guideline. JCO Oncol Pract 2020; 16:389-393. [PMID: 32074010 DOI: 10.1200/jop.19.00778] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Saylor PJ, Rumble RB, Tagawa S, Eastham JA, Finelli A, Reddy PS, Kungel TM, Nissenberg MG, Michalski JM. Bone Health and Bone-Targeted Therapies for Prostate Cancer: ASCO Endorsement of a Cancer Care Ontario Guideline. J Clin Oncol 2020; 38:1736-1743. [PMID: 31990618 DOI: 10.1200/jco.19.03148] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
PURPOSE In 2017, Cancer Care Ontario's Program in Evidence-Based Care released the Bone Health and Bone-Targeted Therapies for Prostate Cancer guideline. This guideline included recommendations across a relatively broad clinical spectrum within prostate cancer. Topics addressed ranged from management of osteoporotic fracture risk in nonmetastatic disease to management of men with castration-resistant prostate cancer metastatic to bone. ASCO has a policy and set of procedures for endorsing clinical practice guidelines that have been developed by other professional organizations. METHODS The Bone Health and Bone-Targeted Therapies for Prostate Cancer guideline was reviewed for developmental rigor by methodologists. An ASCO Expert Panel then reviewed the content and the recommendations. RESULTS The ASCO Expert Panel determined that the recommendations from the Bone Health and Bone-Targeted Therapies for Prostate Cancer guideline were clear, thorough, and based on the most relevant scientific evidence. ASCO wholly endorses the Bone Health and Bone-Targeted Therapies for Prostate Cancer guideline. RECOMMENDATIONS The ASCO Expert Panel endorses all the original guideline recommendations as written and offers a series of discussion points to guide practice for clinicians as they manage bone-related risks within this patient population.
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Affiliation(s)
| | | | | | | | - Antonio Finelli
- Princess Margaret Cancer Center, University Health Network, and University of Toronto, Toronto, Ontario, Canada
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Newton RU, Galvão DA, Spry N, Joseph D, Chambers SK, Gardiner RA, Wall BA, Bolam KA, Taaffe DR. Exercise Mode Specificity for Preserving Spine and Hip Bone Mineral Density in Prostate Cancer Patients. Med Sci Sports Exerc 2019; 51:607-614. [PMID: 30395051 DOI: 10.1249/mss.0000000000001831] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Androgen deprivation therapy (ADT) in men with prostate cancer (PCa) is associated with an array of adverse effects, including reduced bone mineral density (BMD) predisposing patients to increased fracture risk. Our purpose was to examine the effects of targeted exercise modes on BMD in men with PCa undergoing ADT. METHODS Between 2009 and 2012, 154 PCa patients 43-90 yr old on ADT were randomized to exercise targeting the musculoskeletal system (impact loading + resistance training [ImpRes], n = 57) supervised for 12 months, cardiovascular and muscular systems (aerobic + resistance training, n = 50) supervised for 6 months followed by a 6-month home-based program, or delayed aerobic exercise (DelAer, n = 47) received exercise information for 6 months followed by 6 months of supervised aerobic exercise (stationary cycling). End points were lumbar spine, hip and whole-body BMD measured by dual-energy x-ray absorptiometry with secondary end points of lean and fat mass, appendicular skeletal muscle mass, and neuromuscular strength. ANOVA was used to compare the exercise groups with DelAer at 6 and 12 months. RESULTS There was a between-group difference in BMD for ImpRes and DelAer at the spine (6 months, P = 0.039; 12 months, P = 0.035) and femoral neck (6 months, P = 0.050), with decline attenuated in ImpRes (~-1.0% vs ~-2.0%). Compared with DelAer, ImpRes increased appendicular skeletal muscle at 6 months (0.3 kg, P = 0.045) and improved muscle strength at 6 and 12 months (P ≤ 0.012) by 9%-34%. A limitation was inclusion of well-functioning patients. CONCLUSION Combined impact loading and resistance exercise attenuates bone loss at the spine and enhances overall musculoskeletal function in PCa patients undergoing ADT.
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Affiliation(s)
- Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, AUSTRALIA.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, AUSTRALIA.,Institute of Human Performance, The University of Hong Kong, HONG KONG.,School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, AUSTRALIA
| | - Daniel A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, AUSTRALIA.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, AUSTRALIA
| | - Nigel Spry
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, AUSTRALIA.,Genesis CancerCare, Joondalup, WA, AUSTRALIA.,Faculty of Medicine, University of Western Australia, Nedlands, WA, AUSTRALIA
| | - David Joseph
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, AUSTRALIA.,Faculty of Medicine, University of Western Australia, Nedlands, WA, AUSTRALIA.,Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, AUSTRALIA
| | - Suzanne K Chambers
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, AUSTRALIA.,Menzies Health Institute Queensland, Griffith University, Gold Coast, AUSTRALIA.,Centre for Research in Cancer Control, Cancer Council Queensland, Brisbane, QLD, AUSTRALIA.,Prostate Cancer Foundation of Australia, Sydney, NSW, AUSTRALIA
| | - Robert A Gardiner
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, AUSTRALIA.,School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, AUSTRALIA.,Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, AUSTRALIA
| | - Brad A Wall
- School of Psychology and Exercise Science, Murdoch University, Murdoch, WA, AUSTRALIA
| | - Kate A Bolam
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, SWEDEN
| | - Dennis R Taaffe
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, AUSTRALIA.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, AUSTRALIA.,School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, AUSTRALIA
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Yannitsos D, Murphy RA, Pollock P, Di Sebastiano KM. Facilitators and barriers to participation in lifestyle modification for men with prostate cancer: A scoping review. Eur J Cancer Care (Engl) 2019; 29:e13193. [PMID: 31797478 DOI: 10.1111/ecc.13193] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 10/23/2019] [Accepted: 11/12/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE Diet and physical activity changes have been shown to improve quality of life and health outcomes for prostate cancer (PC) survivors; however, few survivors make lifestyle changes. We aimed to identify PC-specific facilitators and barriers to dietary and physical activity changes and participation in survivorship-based lifestyle management programmes. METHODS A scoping review investigating facilitators and barriers of PC survivor's participation in lifestyle management programmes was conducted in June 2018. A total of 454 studies were identified, 45 studies were assessed in full, and 16 were included in the scoping review. RESULTS Barriers to lifestyle change included perceived lack of evidence for lifestyle guidelines, treatment side effects, perception of change as unnecessary, time pressure and age. Facilitators for lifestyle change included advice from health professionals, support systems (family and peer), diagnosis as a time for change, lifestyle as a coping strategy to manage side effects and improve well-being. CONCLUSIONS Health professionals, peers and family have a significant role in lifestyle management for PC survivors to facilitate engagement. Specific and clear messaging of the benefits of lifestyle management is warranted. Treatment-related side effects, time pressure, current health perception and age should be considered when developing lifestyle management programmes for PC survivors.
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Affiliation(s)
- Demetra Yannitsos
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Rachel A Murphy
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Phil Pollock
- Prostate Cancer Supportive Care Clinic, Vancouver Prostate Centre, Vancouver General Hospital, Diamond Healthcare Centre, Vancouver, BC, Canada.,BC Cancer - Victoria, Victoria, BC, Canada
| | - Katie M Di Sebastiano
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.,School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
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Alibhai SMH, Santa Mina D, Ritvo P, Tomlinson G, Sabiston C, Krahn M, Durbano S, Matthew A, Warde P, O’Neill M, Timilshina N, Segal R, Culos-Reed N. A phase II randomized controlled trial of three exercise delivery methods in men with prostate cancer on androgen deprivation therapy. BMC Cancer 2019; 19:2. [PMID: 30606137 PMCID: PMC6318980 DOI: 10.1186/s12885-018-5189-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Accepted: 12/05/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Existing evidence demonstrates that 1:1 personal training (PT) improves many adverse effects of androgen deprivation therapy (ADT). Whether less resource-intensive exercise delivery models are as effective remains to be established. We determined the feasibility of conducting a multi-center non-inferiority randomized controlled trial comparing PT with supervised group (GROUP) and home-based (HOME) exercise programs, and obtained preliminary efficacy estimates for GROUP and HOME compared to PT on quality of life (QOL) and physical fitness. METHODS Men with prostate cancer on ADT were recruited from one of two experienced Canadian centres and randomized 1:1:1 to PT, GROUP, or HOME. Randomization was stratified by length of ADT use and site. Participants completed moderate intensity aerobic and resistance exercises 4-5 days per week for 6 months with a target 150 min per week of exercise. Exercise prescriptions were individualized and progressed throughout the trial. Feasibility endpoints included recruitment, retention, adherence, and participant satisfaction. The efficacy endpoints QOL, fatigue, and fitness (VO2 peak, grip strength, and timed chair stands) in GROUP and HOME were compared for non-inferiority to PT. Descriptive analyses were used for feasibility endpoints. Between-group differences for efficacy endpoints were examined using Bayesian linear mixed effects models. RESULTS Fifty-nine participants (mean age 69.9 years) were enrolled. The recruitment rate was 25.4% and recruitment was slower than projected. Retention was 71.2%. Exercise adherence as measured through attendance was high for supervised sessions but under 50% by self-report and accelerometry. Satisfaction was high and there was no difference in this measure between all three groups. Between-group differences (comparing both GROUP and HOME to PT) were smaller than the minimum clinically important difference on most measures of QOL, fatigue, and fitness. However, two of six outcomes for GROUP and four of six outcomes for HOME had a > 20% probability of being inferior for GROUP. CONCLUSIONS Feasibility endpoints were generally met. Both GROUP and HOME interventions in men with PC on ADT appeared to be similar to PT for multiple efficacy outcomes, although conclusions are limited by a small sample size and cost considerations have not been incorporated. Efforts need to be targeted to improving recruitment and adherence. A larger trial is warranted. TRIAL REGISTRATION ClinicalTrials.gov: NCT02046837 . Date of registration: January 20, 2014.
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Affiliation(s)
- Shabbir M. H. Alibhai
- University Health Network, University of Toronto, Toronto, ON M5G 2C4 Canada
- Toronto General Hospital, 200 Elizabeth St Room EN14-214, Toronto, Ontario M5G 2C4 Canada
| | - Daniel Santa Mina
- University Health Network, University of Toronto, Toronto, ON M5G 2C4 Canada
- Cancer Care Ontario, York University, Toronto, ON M3J 1P3 Canada
| | - Paul Ritvo
- Cancer Care Ontario, York University, Toronto, ON M3J 1P3 Canada
| | - George Tomlinson
- University Health Network, University of Toronto, Toronto, ON M5G 2C4 Canada
- Cancer Care Ontario, York University, Toronto, ON M3J 1P3 Canada
| | | | - Murray Krahn
- University Health Network, University of Toronto, Toronto, ON M5G 2C4 Canada
- Cancer Care Ontario, York University, Toronto, ON M3J 1P3 Canada
| | - Sara Durbano
- University Health Network, University of Toronto, Toronto, ON M5G 2C4 Canada
| | - Andrew Matthew
- University Health Network, University of Toronto, Toronto, ON M5G 2C4 Canada
| | - Padraig Warde
- University Health Network, University of Toronto, Toronto, ON M5G 2C4 Canada
- Cancer Care Ontario, York University, Toronto, ON M3J 1P3 Canada
- University of Toronto, Toronto, ON M5S 2J7 Canada
| | - Meagan O’Neill
- University Health Network, University of Toronto, Toronto, ON M5G 2C4 Canada
| | - Narhari Timilshina
- University Health Network, University of Toronto, Toronto, ON M5G 2C4 Canada
| | - Roanne Segal
- The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa, ON K1N 6N5 Canada
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Alibhai SMH, Ritvo P, Santa Mina D, Sabiston C, Krahn M, Tomlinson G, Matthew A, Lukka H, Warde P, Durbano S, O’Neill M, Culos-Reed SN. Protocol for a phase III RCT and economic analysis of two exercise delivery methods in men with PC on ADT. BMC Cancer 2018; 18:1031. [PMID: 30352568 PMCID: PMC6199786 DOI: 10.1186/s12885-018-4937-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 10/10/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Androgen deprivation therapy (ADT) is commonly used to treat prostate cancer. However, side effects of ADT often lead to reduced quality of life and physical function. Existing evidence demonstrates that exercise can ameliorate multiple treatment-related side effects for men on ADT, yet adherence rates are often low. The method of exercise delivery (e.g., supervised group in-centre vs. individual home-based) may be important from clinical and economic perspectives; however, few studies have compared different delivery models. Additionally, long-term exercise adherence and an understanding of predictors of adherence are critical to achieving sustained benefits, but such data are lacking. The primary aim of this multi-centre phase III non-inferiority randomized controlled trial is to determine whether a home-based delivery model is non-inferior to a group-based delivery model in terms of benefits in fatigue and fitness in this population. Two other key aims include examining cost-effectiveness and long-term adherence. METHODS Men diagnosed with prostate cancer of any stage, starting or continuing on ADT for at least 6 months, fluent in English, and living close to a study centre are eligible. Participants complete five assessments over 12 months (baseline and every 3 months during the 6-month intervention and 6-month follow-up phases), including a fitness assessment and self-report questionnaires. Biological outcomes are collected at baseline, 6, and 12 months. A total of 200 participants will be randomized in a 1:1 fashion to supervised group training or home-based training supported by smartphones, health coaches, and Fitbit technology. Participants are asked to complete 4 to 5 exercise sessions per week, incorporating aerobic, resistance and flexibility training. Outcomes include fatigue, quality of life, fitness measures, body composition, biological outcomes, and program adherence. Cost information will be obtained using patient diary-based self-report and utilities via the EQ-5D. DISCUSSION To disseminate publicly funded exercise programs widely, clinical efficacy and cost-effectiveness have to be demonstrated. The goals of this trial are to provide these data along with an increased understanding of adherence to exercise among men with prostate cancer receiving ADT. TRIAL REGISTRATION The trial has been registered at clinicaltrials.gov (Registration # NCT02834416 ). Registration date was June 2, 2016.
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Affiliation(s)
- Shabbir M. H. Alibhai
- University Health Network, Toronto, ON M5G 2C4 Canada
- University of Toronto, Toronto, ON M5S 2J7 Canada
- Toronto General Hospital, 200 Elizabeth St Room EN14-214, Toronto, ON M5G 2C4 Canada
| | - Paul Ritvo
- Cancer Care Ontario, Toronto, ON M5G 2L3 Canada
| | - Daniel Santa Mina
- University Health Network, Toronto, ON M5G 2C4 Canada
- University of Toronto, Toronto, ON M5S 2J7 Canada
| | | | - Murray Krahn
- University Health Network, Toronto, ON M5G 2C4 Canada
- University of Toronto, Toronto, ON M5S 2J7 Canada
| | - George Tomlinson
- University Health Network, Toronto, ON M5G 2C4 Canada
- University of Toronto, Toronto, ON M5S 2J7 Canada
| | | | - Himu Lukka
- The Juravinski Cancer Centre, Hamilton, ON L8V 5C2 Canada
| | - Padraig Warde
- University Health Network, Toronto, ON M5G 2C4 Canada
- University of Toronto, Toronto, ON M5S 2J7 Canada
- Cancer Care Ontario, Toronto, ON M5G 2L3 Canada
| | - Sara Durbano
- University Health Network, Toronto, ON M5G 2C4 Canada
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Hallward L, Patel N, Duncan LR. Behaviour change techniques in physical activity interventions for men with prostate cancer: A systematic review. J Health Psychol 2018; 25:105-122. [PMID: 29446325 DOI: 10.1177/1359105318756501] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Physical activity interventions can improve prostate cancer survivors' health. Determining the behaviour change techniques used in physical activity interventions can help elucidate the mechanisms by which an intervention successfully changes behaviour. The purpose of this systematic review was to identify and evaluate behaviour change techniques in physical activity interventions for prostate cancer survivors. A total of 7 databases were searched and 15 studies were retained. The studies included a mean 6.87 behaviour change techniques (range = 3-10), and similar behaviour change techniques were implemented in all studies. Consideration of how behaviour change techniques are implemented may help identify how behaviour change techniques enhance physical activity interventions for prostate cancer survivors.
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Fox L, Cahill F, Burgess C, Peat N, Rudman S, Kinsella J, Cahill D, George G, Santaolalla A, Van Hemelrijck M. Real World Evidence: A Quantitative and Qualitative Glance at Participant Feedback from a Free-Response Survey Investigating Experiences of a Structured Exercise Intervention for Men with Prostate Cancer. BIOMED RESEARCH INTERNATIONAL 2017; 2017:3507124. [PMID: 28758113 PMCID: PMC5512116 DOI: 10.1155/2017/3507124] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 05/02/2017] [Accepted: 05/31/2017] [Indexed: 11/29/2022]
Abstract
AIM To explore patient experiences of a structured exercise intervention for men with prostate cancer (PCa). SAMPLE 41 men with either localised or advanced PCa who had been referred for a structured exercise programme by their physician and then subsequently consented to a telephone survey. METHOD Participants underwent a 10-week supervised exercise programme within a large cancer centre hospital consisting of 8 sessions. They then completed a short multiple choice telephone survey, elaborating on their responses where appropriate. Views expressed by participants were analysed using an affinity diagram and common themes were identified. RESULTS Feedback from our telephone surveys was consistently positive and suggests that the structured exercise intervention provides exercise confidence, motivation to exercise, and social support and promotes positive health behaviour change in the context of exercise. Individual differences arose amongst participants in their perceived utility of the intervention, with 73.3% expressing a preference for structured exercise classes and 19.5% expressing a preference for exercising independently. CONCLUSION Design of a structured exercise intervention for patients with PCa should embrace the positive aspects outlined here but consider patients' individual differences. Ongoing feedback from patients should be utilised alongside traditional study designs to inform intervention design in this area.
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Affiliation(s)
- L. Fox
- Cancer Epidemiology Group, Division of Cancer Studies, King's College London, London, UK
| | - F. Cahill
- Cancer Epidemiology Group, Division of Cancer Studies, King's College London, London, UK
| | - C. Burgess
- Cancer Epidemiology Group, Division of Cancer Studies, King's College London, London, UK
| | - N. Peat
- Physiotherapy, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - S. Rudman
- Medical Oncology, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - J. Kinsella
- Cancer Epidemiology Group, Division of Cancer Studies, King's College London, London, UK
- Royal Marsden, London, UK
| | | | - G. George
- Cancer Epidemiology Group, Division of Cancer Studies, King's College London, London, UK
| | - A. Santaolalla
- Cancer Epidemiology Group, Division of Cancer Studies, King's College London, London, UK
| | - M. Van Hemelrijck
- Cancer Epidemiology Group, Division of Cancer Studies, King's College London, London, UK
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Norris MK, Bell GJ, North S, Courneya KS. Effects of resistance training frequency on physical functioning and quality of life in prostate cancer survivors: a pilot randomized controlled trial. Prostate Cancer Prostatic Dis 2015; 18:281-7. [DOI: 10.1038/pcan.2015.28] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 04/10/2015] [Accepted: 05/10/2015] [Indexed: 01/04/2023]
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Alibhai SMH, Santa Mina D, Ritvo P, Sabiston C, Krahn M, Tomlinson G, Matthew A, Segal R, Warde P, Durbano S, O'Neill M, Culos-Reed N. A phase II RCT and economic analysis of three exercise delivery methods in men with prostate cancer on androgen deprivation therapy. BMC Cancer 2015; 15:312. [PMID: 25908311 PMCID: PMC4415317 DOI: 10.1186/s12885-015-1316-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 04/13/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Androgen deprivation therapy is commonly used to treat prostate cancer, the most common visceral cancer in men. However, various side effects often worsen physical functioning and reduce well-being among men on this treatment. Based on existing evidence, both resistance and aerobic training provide benefits for this population yet adherence rates are often low. The method of exercise delivery (supervised in-center or home-based) may be important, yet few studies have compared different models. Additionally, long-term exercise adherence is critical to achieve sustained benefits but long-term adherence data and predictors of adherence are lacking. The primary aim of this phase II, non-inferiority randomized controlled trial is to determine whether three exercise training delivery models are equivalent in terms of benefits in quality of life and physical fitness in this population. Secondary aims include examination of long-term adherence and cost-effectiveness. DESIGN Men diagnosed with prostate cancer, starting or continuing on androgen deprivation therapy for at least 6 months, fluent in English, and living close to one of two experienced Canadian study centers are eligible. Participants complete five assessments over one year, including a fitness assessment and self-report questionnaires. Socio-demographic and clinical data collection occur at baseline, bone mineral density testing at two time points, and blood work is performed at three time points. Participants are randomized in a 1:1:1 fashion to supervised personal training, supervised group training, or home-based smartphone- and health coach-supported training. Each participant receives a detailed exercise manual, including illustrations of exercises and safety precautions. Participants are asked to complete 4 to 5 exercise sessions per week, incorporating aerobic, resistance and flexibility training. Participant intensity levels will be monitored. The intervention duration is 6 months, with 6 months additional follow-up. Outcomes include: body composition, fitness testing, quality of life and fatigue, biological outcomes, and program adherence. Cost information will be obtained using patient diary-based self-report. DISCUSSION The goals of this study are to gain a better understanding of health benefits and costs associated with commonly used yet currently not compared exercise delivery models as well as an increased understanding of adherence to exercise. TRIAL REGISTRATION The trial has been registered at clinicaltrials.gov (Registration # NCT02046837), registered January 20(th), 2014.
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Affiliation(s)
- Shabbir M H Alibhai
- University Health Network, Toronto, ON, M5G 2C4, Canada.
- University of Toronto, Toronto, ON, M5S 2J7, Canada.
- Toronto General Hospital, 200 Elizabeth St Room EN14-214, Toronto, ON, M5G 2C4, Canada.
| | - Daniel Santa Mina
- University Health Network, Toronto, ON, M5G 2C4, Canada.
- University of Guelph Humber, Toronto, ON, M9W 5L7, Canada.
| | - Paul Ritvo
- University Health Network, Toronto, ON, M5G 2C4, Canada.
- York University, Toronto, ON, M3J 1P3, Canada.
| | | | - Murray Krahn
- University Health Network, Toronto, ON, M5G 2C4, Canada.
- University of Toronto, Toronto, ON, M5S 2J7, Canada.
| | - George Tomlinson
- University Health Network, Toronto, ON, M5G 2C4, Canada.
- University of Toronto, Toronto, ON, M5S 2J7, Canada.
| | - Andrew Matthew
- University Health Network, Toronto, ON, M5G 2C4, Canada.
- University of Toronto, Toronto, ON, M5S 2J7, Canada.
| | - Roanne Segal
- University of Ottawa, Ottawa, ON, K1N 6N5, Canada.
| | - Padraig Warde
- University Health Network, Toronto, ON, M5G 2C4, Canada.
- University of Toronto, Toronto, ON, M5S 2J7, Canada.
| | - Sara Durbano
- University Health Network, Toronto, ON, M5G 2C4, Canada.
| | - Meagan O'Neill
- University Health Network, Toronto, ON, M5G 2C4, Canada. Meagan.O'
- University of Toronto, Toronto, ON, M5S 2J7, Canada. Meagan.O'
| | - Nicole Culos-Reed
- University of Calgary, Calgary, AB, T2N 1N4, Canada.
- Tom Baker Cancer Centre, Calgary, AB, T2N 4N2, Canada.
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