Randomized Controlled Trial of a Behavior Change Intervention to Increase Physical Activity and Quality of Life in Prostate Cancer Survivors Efficacy of a referral and physical activity program for survivors of prostate cancer [ENGAGE]: Rationale and design for a cluster randomised controlled trial Associations of Postdiagnosis Physical Activity and Change from Prediagnosis Physical Activity with Quality of Life in Prostate Cancer Survivors Benefits of partnered strength training for prostate cancer survivors and spouses: results from a randomized controlled trial of the Exercising Together project Examining a Therapeutic Yoga Program for Prostate Cancer Survivors Main outcomes of the Move More for Life Trial: a randomised controlled trial examining the effects of tailored-print and targeted-print materials for promoting physical activity among post-treatment breast cancer survivors. Correspondence of physical activity and fruit/vegetable consumption among prostate cancer survivors and their spouses. A randomised controlled trial to evaluate the efficacy of a 6 month dietary and physical activity intervention for prostate cancer patients receiving androgen deprivation therapy Development of a computer-tailored physical activity intervention for prostate and colorectal cancer patients and survivors: OncoActive Football Compared with Usual Care in Men with Prostate Cancer (FC Prostate Community Trial): A Pragmatic Multicentre Randomized Controlled Trial Move more for life: the protocol for a randomised efficacy trial of a tailored-print physical activity intervention for post-treatment breast cancer survivors The Effects of Physical Activity on Health and Quality of Life in Adolescent Cancer Survivors: A Systematic Review Levels of fatigue and distress in senior prostate cancer survivors enrolled in a 12-week randomized controlled trial of Qigong Facilitating research participation and improving quality of life for African American prostate cancer survivors and their intimate partners Effects of home-based diet and exercise on functional outcomes among older, overweight long-term cancer survivors: RENEW: a randomized controlled trial. Five-year follow-up of participants in a randomised controlled trial showing benefits from exercise for breast cancer survivors during adjuvant treatment. Are there lasting effects? Is self-management feasible and acceptable for addressing nutrition and physical activity needs of cancer survivors? Leading the Way in Exercise and Diet (Project LEAD): intervening to improve function among older breast and prostate cancer survivors. A randomised controlled trial to evaluate the efficacy of a 6-month dietary and physical activity intervention for patients receiving androgen deprivation therapy for prostate cancer Detailed methods of two home-based vegetable gardening intervention trials to improve diet, physical activity, and quality of life in two different populations of cancer survivors. A Clinician Referral and 12-Week Exercise Training Program for Men With Prostate Cancer: Outcomes to 12 Months of the ENGAGE Cluster Randomized Controlled Trial. Physical activity, sedentary behavior, and health-related quality of life in prostate cancer survivors in the health professionals follow-up study A randomised controlled trial testing the feasibility and efficacy of a physical activity behavioural change intervention in managing fatigue with gynaecological cancer survivors.
Background Physical activity improves health in prostate cancer survivors ; however , participation rates are low . Purpose This study aims to determine the effects of an implementation intention intervention on physical activity and quality of life in prostate cancer survivors . Methods Prostate cancer survivors ( N = 423 ) were r and omly assigned to a st and ard physical activity recommendation , a self-administered implementation intention , or a telephone-assisted implementation intention .  Physical activity and quality of life were assessed at baseline , 1 , and 3 months . Results Analyses of covariance using multiple imputation showed that physical activity at 1 month increased by 86 min/week in the st and ard physical activity recommendation group compared with 168 min/week in the self-administered implementation intention group ( P = 0.023 ) and 105 min/week in the telephone-assisted implementation intention group ( P = 0.35 ) . Conclusions A self-administered implementation intention intervention result ed in a meaningful short-term increase in physical activity . Supplementation with additional intervention strategies and more frequent intervention may improve longer-term exercise . ( Clinical Trials.gov number NCT01410656 ) Abstract Background Despite evidence that physical activity improves the health and well-being of prostate cancer survivors , many men do not engage in sufficient levels of activity . The primary aim of this study ( ENGAGE ) is to determine the efficacy of a referral and physical activity program among survivors of prostate cancer , in terms of increasing participation in physical activity . Secondary aims are to determine the effects of the physical activity program on psychological well-being , quality of life and objective physical functioning . The influence of individual and environmental mediators on participation in physical activity will also be determined . Methods / Design This study is a cluster r and omised controlled trial . Clinicians of prostate cancer survivors will be r and omised into either the intervention or control condition . Clinicians in the intervention condition will refer eligible patients ( n = 110 ) to participate in an exercise program , comprising 12 weeks of supervised exercise sessions and unsupervised physical activity . Clinicians allocated to the control condition will provide usual care to eligible patients ( n = 110 ) , which does not involve the recommendation of the physical activity program . Participants will be assessed at baseline , 12 weeks , 6 months , and 12 months on physical activity , quality of life , anxiety , depression , self-efficacy , outcome expectations , goals , and socio-structural factors . Discussion The findings of this study have implication s for clinicians and patients with different cancer types or other chronic health conditions . It will contribute to our underst and ing on the potential impact of clinicians promoting physical activity to patients and the long term health benefits of participating in physical activity programs . Trial registration Australia and New Zeal and Clinical Trials Register ( ANZCTR ) : ACTRN12610000609055 Deakin University Human Research Ethics Approval 2011 - Background : This prospect i ve study examined the associations between postdiagnosis physical activity and change from prediagnosis physical activity with quality of life ( QoL ) in prostate cancer survivors . Methods : Prostate cancer survivors ( N = 830 ) who participated in a case – control study with invasive stage ≥II disease were followed up to 2007 to capture QoL outcomes . At baseline and three time points postdiagnosis ( 2000–2007 ) , interviews/ question naires were used to collect data on physical activity , general QoL measured by the SF-36 , and other treatment/lifestyle factors . Multivariable linear regression was used to test the relation between postdiagnosis physical activity and QoL as well as the change in physical activity over the diagnostic period and QoL. Results : Both total and recreational physical activities were positively associated with physical QoL. Furthermore , when comparing changes in physical activity levels from pre- to postdiagnosis , men who consistently met physical activity guidelines had significantly higher physical [ β = 6.01 ; 95 % confidence interval ( CI ) , 4.15–7.86 ] and mental ( β = 2.32 ; 95 % CI , 0.29–4.34 ) QoL scores compared with those who did not meet guidelines pre- or postdiagnosis . Furthermore , those who adopted and met guidelines had increased QoL , whereas those who relapsed experienced decreased QoL. Conclusions : Postdiagnosis recreational physical activity is associated with better physical QoL in prostate cancer survivors . Moreover , prostate cancer survivors who maintain or adopt physical activity after diagnosis report substantially higher QoL than men who never exercised or stopped exercising after diagnosis . Impact : Future intervention studies should focus on achieving and maintaining adherence to physical activity guidelines postdiagnosis in prostate cancer survivors . Cancer Epidemiol Biomarkers Prev ; 26(2 ) ; 179–87 . © 2016 AACR Background Prostate cancer can negatively impact quality of life of the patient and his spouse caregiver , but interventions rarely target the health of both partners simultaneously . We tested the feasibility and preliminary efficacy of a partnered strength training program on the physical and mental health of prostate cancer survivors ( PCS ) and spouse caregivers . Methods Sixty-four couples were r and omly assigned to 6 months of partnered strength training ( Exercising Together , N = 32 ) or usual care ( UC , N = 32 ) . Objective measures included body composition ( lean , fat and trunk fat mass ( kg ) , and % body fat ) by DXA , upper and lower body muscle strength by 1-repetition maximum , and physical function by the physical performance battery ( PPB ) . Self-reported measures included the physical and mental health summary scales and physical function and fatigue subscales of the SF-36 and physical activity with the CHAMPS question naire . Results Couple retention rates were 100 % for Exercising Together and 84 % for UC . Median attendance of couples to Exercising Together sessions was 75 % . Men in Exercising Together became stronger in the upper body ( p < 0.01 ) and more physically active ( p < 0.01 ) than UC . Women in Exercising Together increased muscle mass ( p = 0.05 ) and improved upper ( p < 0.01 ) and lower body ( p < 0.01 ) strength and PPB scores ( p = 0.01 ) more than UC . Conclusions Exercising Together is a novel couples-based approach to exercise that was feasible and improved several health outcomes for both PCS and their spouses . Implication s for cancer survivorsA couples-based approach should be considered in cancer survivorship programs so that outcomes can mutually benefit both partners . Trial registration Clinical Trials.gov Background . In the earlier stages of prostate cancer , effective treatments have created a need for research to focus on practice s that may improve quality of life throughout survivorship . Physical activity is a significant supportive care management strategy for prostate cancer survivors , though the optimal modality is not yet understood . Hypotheses . The authors hypothesized that yoga would be a feasible physical activity option for prostate cancer survivors and their support persons and that the incorporation of social support would increase physical activity adherence . Methods . This 14-week feasibility study involved a 7-week class-based yoga program ( adherence phase ) , followed by 7 weeks of self-selected physical activity ( maintenance phase ) . Demographic information , physical activity behavior , quality of life , fatigue , stress , mood , and fitness variables were assessed at 3 time points . Prostate cancer survivors ’  perceived social support was rated during yoga and after yoga . Results . Class attendance was 6.1 and 5.8 for prostate cancer survivors ( n = 15 ) and their support persons ( n = 10 ) , respectively , for the 7 classes . Levels of perceived social support were higher for those who brought a support person . Significant improvements with regard to stress , fatigue , and mood before and after yoga class ( all Ps < .05 ) were reported by all participants . No clinical ly significant changes were noted on prostate cancer survivor ’s quality of life or fatigue over the course of the 14-week study . Conclusions . Yoga is a feasible physical activity option for prostate cancer survivors . The program had a promising uptake rate , high program adherence rate , and there were acute program benefits with regard to stress , fatigue , and mood for all participants . Future examination is warranted with regard to chronic benefits and group cohesion influences on levels of perceived social support BACKGROUND Participation in physical activity can improve the health outcomes of breast cancer survivors . To impact public health , broad-reaching sustainable interventions that promote physical activity are needed . PURPOSE To evaluate the efficacy of two distance-based interventions for promoting physical activity among breast cancer survivors compared with a st and ard recommendation control . METHODS Breast cancer survivors who had finished ' active ' cancer treatment were eligible to participate . Participants ( n = 330 ) were r and omly assigned to receive one of the following mail-delivered interventions : three computer-tailored newsletters , a previously developed breast cancer-specific physical activity booklet or a pamphlet detailing the public health recommendations for physical activity ( control ) . Primary outcomes were self-reported moderate to vigorous aerobic activity and participant 's self-reported resistance training activity at 4 months post-baseline . Secondary outcomes were pedometer step counts , whether or not participants were meeting the physical activity guidelines , time spent in sedentary behaviour , fatigue and health-related quality of life . RESULTS Participants r and omised into the tailored-print intervention group were three times more likely to commence resistance training and meet the resistance-training guidelines immediately after the intervention than participants allocated to the control group . There were no other significant intervention effects . CONCLUSION Computer-tailored newsletters may be an effective strategy for enhancing resistance-based physical activity among breast cancer survivors . The null findings relating to other outcomes may be due to ceiling effects ( in the case of aerobic activity , fatigue and health-related quality of life ) or the sensitivity of the measure used ( in the case of sitting time ) . These issues require further exploration A healthy diet and physical activity are recommended for prostate cancer survivors . Interdependence theory suggests that the spousal relationship influences those health behaviours and the degree of correspondence may be an indicator of this influence . This study evaluated the correspondence between prostate cancer survivors and spouses regarding  physical activity and fruit/vegetable consumption .  Baseline data from an ongoing r and omised control trial were utilised . Men who had been treated for prostate cancer within the past year and their partners ( N = 132 couples ) completed self-report measures of physical activity , fruit/vegetable consumption , relationship satisfaction and support for partner 's healthy diet and physical activity .  Couples reported similar fruit/vegetable consumption and physical activity as indicated by high levels of correspondence . Greater fruit/vegetable correspondence was related to higher relationship satisfaction ( F = 4.14 , P = 0.018 ) and greater patient ( F = 13.29 , P < 0.001 ) and spouse-rated support ( F = 7.2 , P < 0.001 ) . Greater physical activity correspondence was related to greater patient ( F = 3.57 , P = 0.028 ) and spouse-rated support ( F = 4.59 , P = 0.031 ) . Prostate cancer survivors and spouses may influence each other 's  diet and exercise behaviours . Couple-based interventions may promote healthy behaviours among this population Background Treatment with And rogen Deprivation Therapy ( ADT ) for prostate cancer is associated with changes in body composition including increased fat and decreased lean mass ; increased fatigue , and a reduction in quality of life . No study to date has evaluated the effect of dietary and physical activity modification on the side-effects related to ADT . The aim of this study is to evaluate the efficacy of a 6-month dietary and physical activity intervention for prostate cancer survivors receiving ADT to minimise the changes in body composition , fatigue and quality of life , typically associated with ADT . Methods Men are recruited to this study if their treatment plan is to receive ADT for at least 6 months . Men who are r and omised to the intervention arm receive a home-based tailored intervention to meet the following guidelines a ) ≥ 5 servings vegetables and fruits/day ; b ) 30%-35 % of total energy from fat , and < 10 % energy from saturated fat/day ; c ) 10 % of energy from polyunsaturated fat/day ; d ) limited consumption of processed meats ; e ) 25 - 35 gm of fibre/day ; f ) alcoholic drinks ≤ 28 units/week ; g ) limited intake of foods high in salt and /or sugar . They are also encouraged to include at least 30 minutes of brisk walking , 5 or more days per week . The primary outcomes are change in body composition , fatigue and quality of life scores . Secondary outcomes include dietary intake , physical activity and perceived stress . Baseline information collected includes : socio-economic status , treatment duration , perceived social support and health status , family history of cancer , co-morbidities , medication and supplement use , barriers to change , and readiness to change their health behaviour . Data for the primary and secondary outcomes will be collected at baseline , 3 and 6 months from 47 intervention and 47 control patients . Discussion The results of this study will provide detailed information on diet and physical activity levels in prostate cancer patients treated with ADT and will test the feasibility and efficacy of a diet and physical activity intervention which could provide essential information to develop guidelines for prostate cancer patients to minimise the side effects related to ADT.Trial registration IS RCT N trial number Background Cancer and cancer treatment coincide with substantial negative physical , psychological and psychosocial problems .  Physical activity ( PA ) can positively affect the negative effects of cancer and cancer treatment and thereby increase quality of life in CPS . Nevertheless , only a minority of CPS meet PA guidelines . We developed the OncoActive ( OncoActief in Dutch ) intervention : a computer-tailored PA program to stimulate PA  in prostate and colorectal CPS , because to our knowledge there are only a few PA interventions for these specific cancer types in the Netherl and s Methods The OncoActive intervention was developed through systematic adaptation of a proven effective , evidence -based , computer-tailored PA  intervention for adults over fifty , called Active Plus . The Intervention Mapping ( IM ) protocol was used to guide the systematic adaptation . A literature study and interviews with prostate and colorectal CPS and health care professionals revealed that both general and cancer-specific PA determinants are important and should be addressed . Change objectives , theoretical methods and applications and the actual program content were adapted to address the specific needs , beliefs and cancer-related issues of prostate and colorectal CPS . Intervention participants  received tailored PA advice three times , on internet and with printed material s , and a pedometer to set goals to improve PA .  Pre- and pilot tests showed that the intervention was highly appreciated ( target group ) and regarded safe and feasible ( healthcare professionals ) . The effectiveness of the intervention is being evaluated in a r and omized controlled trial ( RCT ) ( n = 428 ) , consisting of an intervention group and a usual care waiting-list control group , with follow-up measurements at three , six and twelve months . Participants are recruited from seventeen hospitals and with posters , flyers and calls in several media . Discussion Using the Intervention Mapping protocol result ed in a systematic ally adapted , theory and evidence -based intervention providing tailored PA advice to prostate and colorectal CPS . If the intervention turns out to be effective in increasing PA , as evaluated in a RCT , possibilities for nationwide implementation and extension to other cancer types will be explored . Trial registration The study is registered in the Dutch Trial Register ( NTR4296 ) on November 23rd 2013 and can be accessed at http://www.trialregister.nl/trialreg/admin/ rct view.asp?TC=4296 Background Physical activity has been shown to mitigate the unwanted psychological and physiological side effects of prostate cancer treatments , but sustainable exercise possibilities are limited . Objective Our objective was to examine whether football in a real-world setting ( i.e. , local football clubs ) was safe and feasible in practice and could improve quality of life , mitigate decline in muscle mass and bone density , and increase fat mass in patients with prostate cancer . Methods In this pragmatic , multicentre , parallel r and omized controlled trial , men diagnosed with prostate cancer were recruited from five Danish urological departments . Men ( N = 214 ) diagnosed with prostate cancer were r and omly allocated , using r and om generated lists ( block size 4–8 ) stratified for center and and rogen-deprivation therapy status , to either 1 h of football twice weekly in a local football club or to usual care , which was a 15- to 30-min telephone session covering their options for physical activity or free-of-charge rehabilitation delivered as st and ard in Denmark . Allocation was concealed from the trial investigator performing the r and omization , but — given the nature of the intervention — this was not possible for personnel and participants . Assessment s were performed at baseline , 12 weeks , and 6 months . The primary outcome was mean change difference in prostate cancer-specific quality of life at 12 weeks . Secondary outcomes were body composition , 12-Item Short Form Health Survey ( SF-12 ) physical and mental health , and safety — reported as fractures , falls , and serious adverse events . Results Attrition was 1 and 3 % at 12 weeks , and 5 % and 5 % at 6 months for the usual care and football groups , respectively . Prostate cancer-specific quality of life was equal between groups at 12 weeks ( mean difference + 1.9 points , 95 % confidence interval [ CI ] –1.0–4.8 ; P = 0.20 ) and at 6 months ( + 0.5 points , 95 % CI –2.8–3.8 ; P = 0.76 ) . Fractures were equally distributed , with two fractures in the usual care group and one in the football group . Likewise , body composition outcomes were equal . Mental health improved after 6 months of football ( mean difference + 2.7 points , 95 % CI 0.8–4.6 ; P = 0.006 ) . Conclusions In this trial , community-based football was a feasible exercise strategy for men with prostate cancer . Football did not improve prostate cancer-specific quality of life but did improve mental health ; the clinical significance of this is unclear . Trial registration Clinical Trials.gov : NCT02430792 Background Due to early detection and advances in treatment , the number of women surviving breast cancer is increasing . Whilst there are many positive aspects of improved survival , breast cancer survival is associated with many long-term health and psychosocial sequelae . Engaging in regular physical activity post-diagnosis can reduce this burden . Despite this evidence , the majority of breast cancer survivors do not engage in regular physical activity . The challenge is to provide breast cancer survivors with appealing and effective physical activity support in a sustainable and cost-effective way . This article describes the protocol for the Move More for Life Study , which aims to assess the relative efficacy of two promising theory-based , print interventions design ed to promote regular physical activity amongst breast cancer survivors . Method and design Breast cancer survivors were recruited from across Australia . Participants will be r and omised into one of three groups : ( 1 ) A tailored-print intervention group , ( 2 ) a targeted-print intervention group , or ( 3 ) a st and ard recommendation control group . Participants in the tailored-print intervention group will receive 3 tailored newsletters in the mail over a three month period . Participants in the targeted-print group will receive a previously developed physical activity guidebook design ed specifically for breast cancer survivors immediately after baseline . Participants in the st and ard recommendation control will receive a brochure detailing the physical activity guidelines for Australian adults . All participants will be assessed at baseline , and at 4 and 10 months post-baseline . Intervention efficacy for changing the primary outcomes ( mins/wk aerobic physical activity ; sessions/exercises per week resistance physical activity ) and secondary outcomes ( steps per day , health-related quality life , compliance with physical activity guidelines , fatigue ) will be assessed . Mediation and moderation analyses will also be conducted . Discussion Given the growing number of cancer survivors , distance-based behaviour change programs addressing physical activity have the potential to make a significant public health impact . Trial registration Australian New Zeal and Clinical Trials Registry ( ANZCTR ) identifier : Background There are numerous published controlled trials assessing the safety and the benefits of physical activity ( PA ) for child and adult cancer survivors . However , trials exclusively comprised of adolescent cancer survivors aged 13 - 19 years , who may experience different health and quality of life ( QOL ) effects as a function of their developmental status , are lacking . Rather , some trials have included both adolescent and child cancer survivors together . Objective The aim of this systematic review was to synthesize the findings from r and omized controlled trails ( RCTs ) and controlled clinical trials ( CCTs ) investigating the effects of PA on health and QOL outcomes in sample s comprised of > 50 % adolescent cancer survivors to summarize the current state of evidence , identify knowledge gaps , and highlight areas in need of additional research within this population . Methods Using a search strategy developed for this review , 10 electronic data bases were search ed for RCTs and CCTs that reported on the effects of PA on at least 1 health and /or QOL outcome in sample s comprised of > 50 % adolescent cancer survivors . Results From the 2249 articles identified , 2 CCTs met the predetermined eligibility criteria and were included in this review . Combined , 28 adolescents ( of 41 participants ) who were receiving active treatment participated in the 2 studies review ed . A total of 4 health and QOL outcomes ( ie , bone mass , fatigue , grip strength , QOL ) were assessed pre- and post-PA intervention . Conclusions On the basis of the 2 studies review ed , PA appears to be safe and feasible .  PA also shows promise to mitigate reductions in bone mass and might be a viable strategy to improve fatigue , grip strength , and QOL . High- quality controlled trials with larger sample s exclusively comprised of adolescent cancer survivors that assess a wide range of outcomes are needed to determine the effects of PA on health and QOL outcomes in this population Purpose Fatigue is a commonly reported symptom by prostate cancer survivors and is associated with significant distress and declines in quality of life . Qigong is a mind – body activity that consists of both physical activity and meditative aspects . This 12-week r and omized controlled trial examined the feasibility and efficacy of a Qigong intervention for improving older prostate cancer survivors '  levels of fatigue and distress . Methods Forty older ( median age = 72 , range = 58–93 ) , fatigued ( cut-off value of ≥1 on the CTCAEv4.0 , > 20 on a fatigue grading scale ) , and sedentary ( < 150 min of moderate exercise/week ) prostate cancer survivors were r and omized to 12 weeks of Qigong or stretching classes . Primary outcomes were feasibility ( i.e. , retention and class attendance rates ) and fatigue [ Functional Assessment of Chronic Illness Therapy — Fatigue ( FACIT-Fatigue ) ] , and secondary outcome was distress [ Brief Symptom Inventory-18 ( BSI-18 ) ] . Results Study retention rates did not significantly differ between study groups ( Qigong = 80 % , stretching = 65 % , p = 0.48 ) . The Qigong group had significantly higher class attendance than the stretching group ( p = 0.04 ) . The Qigong group had significantly greater improvements in the FACIT-Fatigue ( p = 0.02 ) and distress ( i.e. , BSI-18 Somatization , Anxiety , & Global Severity Index , p 's < 0.05 ) , than the Stretching group . Conclusions This 12-week Qigong intervention was feasible and potentially efficacious in improving  senior prostate cancer survivors ' levels of fatigue and distress levels . Future , larger definitive r and omized controlled trials are needed to confirm these benefits in older prostate cancer survivors and in racially and ethnically diverse population s. Implication s for cancer survivorsQigong may be an effective nonpharmacological intervention for the management of senior prostate cancer survivors ' fatigue and distress African American men experience worse prostate cancer outcomes compared with those of Caucasian men , not only in incidence and mortality rates , but also in coping with the side effects of treatment . Unfortunately , African American men have been significantly under‐represented in research evaluating the efficacy of psychosocial interventions for improving coping in prostate cancer survivors . This pilot study explored the feasibility and efficacy of coping skills training ( CST ) , an intervention developed to enhance coping with treatment side effects in a sample of African American prostate cancer survivors and their intimate partners . The intervention was delivered in a telephone‐based format design ed to facilitate research participation . A total of 40 couples were r and omized to either 6 sessions of CST or usual care . Survivors completed measures of disease‐specific quality of life ( QOL ) related to urinary , sexual , bowel , and hormonal symptom domains , as well as measures of global QOL ( i.e. , physical functioning and mental health ) . Partners completed measures of caregiver strain , mood , and vigor . Analysis of data from 30 couples ( 12 couples in CST , 18 couples in usual care ) indicated that CST produced moderate to large treatment effects for QOL related to bowel , urinary , sexual , and hormonal symptoms .  Partners who underwent CST  reported less caregiver strain , depression , and fatigue , and more vigor , with moderate effect sizes observed that approached conventional levels of statistical significance . These preliminary findings suggest that telephone‐based CST is a feasible approach that can successfully enhance coping inAfrican American prostate cancer survivors and their intimate partners . Cancer 2007 . © 2006 American Cancer Society CONTEXT Five-year survival rates for early stage colorectal , breast , and prostate cancer currently exceed 90 % and are increasing . Cancer survivors are at greater risk for second malignancies , other comorbidities , and accelerated functional decline . Lifestyle interventions may provide benefit , but it is unknown whether long-term cancer survivors can modify their lifestyle behaviors sufficiently to improve functional status . OBJECTIVE To determine whether a telephone counseling and mailed print material -based diet and exercise intervention is effective in reorienting functional decline in older , overweight cancer survivors . DESIGN , SETTING , AND PARTICIPANTS R and omized controlled trial of 641 overweight ( body mass index > or = 25 and < 40 ) , long-term ( > or = 5 years ) survivors ( aged 65 - 91 years ) of colorectal , breast , and prostate cancer , who were r and omly assigned to an intervention group ( n = 319 ) or delayed intervention ( control ) group ( n = 322 ) in Canada , the United Kingdom , and 21 US states . Individuals were recruited for the Reach out to Enhance Wellness ( RENEW ) trial from July 1 , 2005 , through May 17 , 2007 . INTERVENTION A 12-month , home-based tailored program of telephone counseling and mailed material s promoting exercise , improved diet quality , and modest weight loss . The control group was wait-listed for 12 months . MAIN OUTCOME MEASURES Change in self-reported physical function on the Short-Form 36 physical function subscale ( score range , 0 - 100 ; a high score indicates better functioning ) from baseline to 12 months was the primary end point . Secondary outcomes included changes in function on the basic and advanced lower extremity function subscales of the Late Life Function and Disability Index ( score range , 0 - 100 ) , physical activity , body mass index , and overall health-related quality of life . RESULTS The mean baseline Short-Form 36 physical function score was 75.7 . At the 12-month follow-up , the mean function scores declined less rapidly in the intervention group ( -2.15 ; 95 % confidence interval [ CI ] , -0.36 to -3.93 ) compared with the control group ( -4.84 ; 95 % CI , -3.04 to -6.63 ) ( P = .03 ) . The mean baseline basic lower extremity function score was 78.2 . The mean changes in basic lower extremity function were 0.34 ( 95 % CI , -0.84 to 1.52 ) in the intervention group compared with -1.89 ( 95 % CI , -0.70 to -3.09 ) in the control group ( P = .005 ) . Physical activity , dietary behaviors , and overall quality of life increased significantly in the intervention group compared with the control group , and weight loss also was greater ( 2.06 kg [ 95 % CI , 1.69 to 2.43 kg ] vs 0.92 kg [ 95 % CI , 0.51 to 1.33 kg ] , respectively ; P < .001 ) . CONCLUSION Among older , long-term survivors of colorectal , breast , and prostate cancer , a diet and exercise intervention reduced the rate of self-reported functional decline compared with no intervention . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00303875 Purpose In an earlier r and omised controlled trial , we showed that early stage breast cancer patients who received a supervised exercise programme , with discussion of behaviour change techniques , had psychological and functional benefits 6 months after the intervention . The purpose of this study was to determine if benefits observed at 6 months persisted 18 and 60 months later . Methods Women who were in the original trial were contacted at 18 and 60 months after intervention . Original measures were repeated . Results Of the 148 women from the original study who agreed to be contacted again , 114 attended for follow-up at 18 months and 87 at 60 months . Women in the original intervention group reported more leisure time physical activity and more positive moods at 60 months than women in the original control group . Irrespective of original group allocation , women who were more active consistently reported lower levels of depression and increased quality of life compared to those who were less active . Conclusions We have shown that there are lasting benefits to an exercise intervention delivered during treatment to breast cancer survivors . Regular activity should be encouraged for women with early stage breast cancer as this can have lasting implication s for physical and psychological functioning BACKGROUND Self-management is recommended for patients with chronic conditions , but its use with cancer survivors is underexplored . Optimal strategies for achieving lifestyle changes in cancer survivors are not known . OBJECTIVE We aim ed to determine feasibility , acceptability and preliminary efficacy of self-management-based nutrition and physical activity interventions for cancer survivors . DESIGN , SETTING AND PARTICIPANTS Adult survivors ( n = 25 ) during ( Group 1 , n = 11 ) or post ( Group 2 , n = 14)-curative chemotherapy for solid tumours , most ( n = 20 , 80 % ) with breast cancer , were recruited prospect ively from a single clinical centre . INTERVENTION The Flinders Living Well Self-Management Program , a generic self-management care planning programme , was utilized to establish patient-led nutrition and exercise goals within a tailored 12-week intervention . Fortnightly progress review s occurred with assessment s at baseline , 6 and 12 weeks . RESULTS Most participants ( 84 % ) found the intervention acceptable/very acceptable . Both groups showed a trend towards significant improvement in the self-management capability ' knowledge about changing risk factors ' ( P = 0.047 ) ; Group 2 showed a trend towards significantly improved ' psychological impacts ' ( P = 0.007 ) . Goal ratings improved for both groups ( P = 0.001 ) . Quality of life improved for both groups for emotional functioning ( P = 0.03 ) . Physical functioning improved for Group 2 ( P = 0.05 ) ; however , most symptom domains worsened for Group 1 , as expected given their treatment stage . DISCUSSION AND CONCLUSIONS Self-management interventions are feasible for this population . In particular , building self-management capacity during the active phase of patients ' cancer treatment provides health and psychosocial benefits . Larger r and omized controlled trials are required to further determine efficacy . Further translational research is also needed to determine acceptability , feasibility , enablers and barriers for clinicians embedding this approach into routine cancer survivorship care The U.S. population is aging , bringing with it an increased prevalence of chronic disease and concomitant declines in physical function . The risk of developing cancer increases significantly with age , and functional decline is much more likely once a cancer diagnosis is rendered . Thus , functional status in later life is a key concern , one that is heightened among elders who have been diagnosed with cancer . To date , however , there have been few trials that have exclusively addressed issues related to cancer survivorship among older cancer patients , and to our knowledge , none has focused on preserving or enhancing physical functioning . This paper describes the study design and method ological considerations of a r and omized controlled trial to determine if a personally tailored workbook and telephone counseling program can positively affect physical activity and dietary behaviors and ultimately the physical functioning of up to 420 older men and women newly diagnosed with breast or prostate cancer . This trial is unique because the cancer diagnosis is used not only as a marker of risk for functional decline , but also as a " teachable moment " - an opportune time when elders may be more receptive to making beneficial lifestyle changes . Undoubtedly , as cure rates for cancer increase and intersect with ever-growing numbers of elderly , there will be numerous opportunities to provide and test interventions within this vulnerable population and to target functional status as a primary outcome . In reporting our methods , we hope to give others " a leg up , " so that they can hurdle with greater ease the barriers we experienced , and thus advance the field more rapidly Purpose Treatment of prostate cancer with and rogen deprivation therapy ( ADT ) is associated with an increased fat mass , decreased lean mass , increased fatigue and a reduction in quality of life ( QoL ) . The aim of this study was to evaluate the efficacy of a 6-month dietary and physical activity intervention for prostate cancer patients receiving ADT , to help minimise these side effects . Methods Patients ( n = 94 ) were recruited to this study if they were planned to receive ADT for prostate cancer for at least 6 months . Men r and omised to the intervention arm received a dietary and exercise intervention , commensurate with UK healthy eating and physical activity recommendations . The primary outcome of interest was body composition ; secondary outcomes included fatigue , QoL , functional capacity , stress and dietary change . Results The intervention group had a significant ( p < 0.001 ) reduction in weight , body mass index and percentage fat mass compared to the control group at 6 months ; the between-group differences were −3.3 kg ( 95 % confidence interval ( 95 % CI ) −4.5 , −2.1 ) , −1.1 kg/m2 ( 95 % CI −1.5 , −0.7 ) and −2.1 % ( 95 % CI −2.8 , −1.4 ) , respectively , after adjustment for baseline values . The intervention result ed in improvements in functional capacity ( p < 0.001 ) and dietary intakes but did not significantly impact fatigue , QoL or stress scores at endpoint . Conclusions A 6-month diet and physical activity intervention can minimise the adverse body composition changes associated with ADT . Implication s for Cancer SurvivorsThis study shows that a pragmatic lifestyle intervention is feasible and can have a positive impact on health behaviours and other key outcomes in men with prostate cancer receiving ADT BACKGROUND Cancer survivors suffer from long-term adverse effects that reduce health-related quality of life ( QOL ) and physical functioning , creating an urgent need to develop effective , durable , and disseminable interventions . Harvest for Health , a home-based vegetable gardening intervention , holds promise for these domains . METHODS This report describes the methods and recruitment experiences from two r and omized controlled feasibility trials that employ a waitlist-controlled design . Delivered in partnership with Cooperative Extension Master Gardeners , this intervention provides one-on-one mentorship of cancer survivors in planning and maintaining three seasonal vegetable gardens over 12months . The primary aim is to determine intervention feasibility and acceptability ; secondary aims are to explore effects on objective and subjective measures of diet , physical activity and function , and QOL and examine participant factors associated with potential effects . One trial is conducted exclusively among 82 female breast cancer survivors residing in the Birmingham , AL metropolitan area ( BBCS ) ; another broadly throughout Alabama among 46 older cancer survivors aged > 60 ( ASCS ) . RESULTS  Response rates were 32.6 % ( BBCS ) and 52.3 % ( ASCS ) . Both trials exceeded 80 % of their accrual target . Leading reasons for in eligibility were removal of > 10 lymph nodes ( lymphedema risk factor ) , lack of physician approval , and unwillingness to be r and omized to the waitlist . CONCLUSION To date , recruitment and implementation of Harvest for Health appears feasible . DISCUSSION Although both studies encountered recruitment challenges , lessons learned can inform future larger-scale studies . Vegetable gardening interventions are of interest to cancer survivors and may provide opportunities to gain life skills leading to improvements in overall health and QOL BACKGROUND The ENGAGE ( efficacy of a referral and physical activity program for survivors of prostate cancer ) study established that a clinician referral and 12-week exercise training program increased vigorous physical activity at 12 weeks among men with prostate cancer . Here , we report the 6- and 12-month outcomes . METHODS In this multicenter cluster r and omized controlled trial , we compared a clinician referral and exercise training program to usual care . Discounted gym membership was offered to men in the intervention condition on completion of the 12-week exercise program .  Self-reported physical activity at 6 and 12 months was the primary outcome . Quality of life , anxiety , and depressive symptoms were secondary outcomes . RESULTS A total of 147 men meeting eligibility criteria agreed to participate ( 54 intervention , 93 control ) . A positive interaction effect for vigorous physical activity was observed at 6 months , but not 12 months . No significant effects for the secondary outcomes were found . CONCLUSIONS A clinician referral and community-based supervised and unsupervised exercise training program , along with discounted gym membership , had a positive short-term effect on vigorous physical activity levels , but did not improve quality of life , in men with prostate cancer Purpose Many prostate cancer survivors experience compromised health-related quality of life ( HRQOL ) as a result of prostate cancer . We examined relationships between types and intensities of activity and sedentary behavior  and prostate cancer-related HRQOL , overall , and by demographic , disease , and treatment characteristics . Methods Associations between post-diagnosis activity and sedentary behavior  and HRQOL domains ( urinary incontinence , urinary irritation/obstruction , bowel , sexual , and vitality/hormonal ) were prospect ively examined in men diagnosed with non-metastatic prostate cancer in the Health Professionals Follow-up Study ( n = 1917 ) using generalized linear models . Results After adjusting for potential confounders , higher duration of total , non-vigorous , and walking activity was associated with higher vitality/hormonal functioning scores ( p-trends , < 0.0001 ) . Effects were small ( d = 0.16–0.20 ) but approached clinical significance for men in the highest vs. lowest activity categories . Survivors who walked ≥90 min/week at a normal pace , or faster , reported higher hormone/vitality scores ( p = 0.001 ) than men walking < 90 min at an easy pace . Weightlifting was associated with increased urinary incontinence ( p-trend , 0.02 ) . Total activity was associated with higher hormone/vitality functioning in men who were ≥5 years post-treatment , had more advanced disease ( Gleason score ≥7 ) , and had ≥1 comorbid condition . No relationships were observed between vigorous activity or sedentary behavior and HRQOL . Conclusions Increased duration of  non-vigorous  activity and walking post-diagnosis was positively associated with better hormone/vitality functioning . Specifically , engaging in ≥5 h of non-vigorous activity or ≥3 h of walking per week may be beneficial . Implication s for Cancer SurvivorsEncouraging men to engage in non-vigorous activity and walking may be helpful for managing prostate cancer-related HRQOL OBJECTIVE To determine the feasibility and efficacy of a physical activity behavioural change intervention in managing cancer-related fatigue among gynaecological cancer survivors during and post anti-cancer treatments . METHODS A two arm , single blind , r and omised controlled trial was conducted within the Northern Irel and regional Cancer Centre . Thirty three sedentary gynaecological cancer survivors ( stage I-III ; ≤3 years post diagnosis ) , experiencing cancer-related fatigue ( mild-severe ) took part . Participants were r and omly assigned to a behavioural change , moderate intensity physical activity intervention ( n=16 ) or a Contact Control group ( n=17 ) . The primary outcome was fatigue ( Multidimensional Fatigue Symptom Inventory-Short Form and Functional Assessment in Chronic Illness Therapy-Fatigue subscale ) . Secondary outcomes included quality of life , physical functioning , positive and negative affect , depression , body composition , sleep dysfunction and self-reported physical activity . Feasibility was assessed based on the recruitment rate , programme and physical activity adherence and participants ' programme evaluation , including optional focus groups ( n=16 ) . RESULTS Twenty five percent of eligible women took part ( 33/134 ) . Participants were 8.7 ( SD=9.1 ) months post diagnosis , with a mean age of 53 ( SD=10.3 ) years . The majority of the sample had a diagnosis of ovarian ( n=12 ) or endometrial cancer ( n=11 ) . Significant differences favouring the intervention group were observed for fatigue at 12 weeks and 6 months follow-up ( 12 week : mean difference=-11.06 ; 95 % confidence interval (CI)=-21.89 to -0.23 ; effect size (d)=0.13 ; p=0.046 ; 6 month : mean difference=-19.48 ; 95 % CI=-19.67 to -19.15 ; effect size (d)=0.20 ; p=0.01 ) . A mean of 10 calls ( SD=1.2 calls ) were delivered to the Physical Activity Group , and 10 ( SD=1.6 calls ) to the CC group . The intervention was positively perceived based on exit question naire and focus group findings . CONCLUSIONS A physical activity behavioural change intervention for gynaecological cancer survivors is feasible in terms of participants ' programme adherence and evaluation , and the intervention demonstrates improvements in fatigue . However , confirmation in the form of a larger fully powered RCT is warranted
Conclusion There is preliminary evidence to suggest that a variety of physical activity behaviour change interventions targeting men with a history of prostate cancer can be efficacious , at least in the short term .
Purpose Men who are survivors of prostate cancer report a variety of psychological and physical factors contributing to a lower quality of life , and physical activity can assist to mitigate these issues .
This review aims to provide a summary of physical activity behaviour change trials targeting prostate cancer survivors , assess the feasibility of these interventions and , if possible , identify intervention and study characteristics associated with significant intervention effects .