Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2017

ADT in prostate cancer patients: prevention of adverse effects using a 6-month home-based progressive resistance training program (#174)

Teresa Lam 1 2 3 , Bobby Cheema 4 , Amy Hayden 5 6 , Howard Gurney 7 , Shivanjini Gounden 4 , Navneeta Reddy 2 , Glenn Stone 8 , Mark Mclean 2 , Vita Birzniece 2 9 10 11
  1. Department of Diabetes and Endocrinology, Westmead Hospital, Sydney, NSW, Australia
  2. Department of Diabetes and Endocrinology, Blacktown Hospital, Blacktown, NSW, Australia
  3. Department of Diabetes and Endocrinology, Blacktown Hospital, Sydney, NSW, Australia
  4. School of Science and Health, Western Sydney University, Penrith, NSW, Australia
  5. Department of Radiation Oncology, Westmead Hospital, Westmead, NSW, Australia
  6. Department of Radiation Oncology, Blacktown Hospital, Blacktown, NSW, Australia
  7. Department of Medical Oncology, Westmead Hospital, Westmead, NSW, Australia
  8. School of Computing, Engineering and Mathematics, Western Sydney University, Penrith, NSW, Australia
  9. Garvan Institute of Medical Research, Sydney, NSW, Australia
  10. School of Medicine, Western Sydney University, Penrith, NSW, Australia
  11. School of Medicine, University of New South Wales, Randwick, NSW, Australia

Introduction:

Androgen deprivation therapy (ADT) is a common treatment for men with prostate cancer, but it may result in adverse effects on body composition, insulin resistance and quality of life (QOL). Exercise interventions, including progressive resistance training (PRT), may ameliorate many of these adverse effects. However, existing studies have been aimed at reversing established ADT-induced metabolic changes utilizing heavily supervised exercise programs, which are difficult to implement in routine clinical practice. We investigated whether a home-based PRT program, instituted at the start of ADT, could prevent adverse effects over a 6-month period.

Patients and Methods:

Twenty-five patients with prostate cancer were randomly assigned to either usual care (UC) (n = 12) or PRT (n = 13) (3 sets of 8-9 exercises targeting all major muscle groups using 8-12 repetition maximal loads) starting immediately after their first ADT injection. Body composition, body cell mass (BCM; a functional component of lean body mass), insulin sensitivity, QOL and muscle function were measured at baseline, 6 weeks and 6 months. Data were analyzed by linear mixed model.

Results:

At 6-months, patients randomised to PRT preserved BCM compared to UC (-0.4±0.5kg vs -2.0±0.3kg; p<0.05). There were no significance differences between groups regarding changes in fat mass (1.3±0.7kg vs 2.7±0.5kg; p=0.1). Insulin sensitivity, as measured by the Matsuda Index (MI), increased at 6 weeks in PRT patients compared to a decline with UC (2.3±0.8 vs -0.3±0.5; p<0.01). This between-group difference in MI was not maintained at 6 months. QOL significantly improved in patients receiving PRT at 6 months compared to UC, particularly in the mental health (4.3±1.7 vs -2.6±1.9; p<0.05) and pain domains (8.3±4.5 vs -11.1±3.9; p<0.01).

Conclusion:

A home based PRT program initiated at the start of ADT exerts significant benefits over UC in maintaining muscle mass, glucose metabolism, and QOL.