Abstract CT171: Can supervised exercise impact on metabolic markers and physical activity during androgen-deprivation therapy in prostate cancer patients? - randomized controlled pilot trial
Authors: Rantaniemi Lauri , Siltari Aino , Harju Eeva , Murtola Teemu J. 
Published: June 2022

Introduction: Androgen-deprivation therapy (ADT) is standard in treatment of advanced prostate cancer (PCa). Common adverse effects include fatigue, weight gain, sarcopenia, and decreased libido leading to lowered quality of life (QoL). Supervised exercise improves overall QoL among PCa patients. Less is known, however, how it may affect metabolic adverse effects of ADT.The aim of the study was to explore the effect of exercise intervention on glucose and cholesterol levels, body composition, and to find out whether supervised exercise leads to greater physical activity in long-term compared to self-administered exercise in men with ADT.

Materials and methods: Altogether, 45 men were recruited. One man withdrew the consent at baseline and 5 dropped out during the study. Thus, 39 men completed the study. Subjects were randomly assigned into either supervised exercise for 3 months (n=27) or control group of self-administered exercise (n=17). In the supervised group, participants attended 1.5-hour group exercise session twice per week. Training program included both aerobic and muscle strength exercises. The 3-month intervention was followed by 3-month follow-up of self-administered exercise. Control group received the same introduction to exercise and training instruction as the supervised group but exercised independently for the entire study period. Fasting cholesterol, plasma glucose, and body composition were evaluated at the baseline, 3 months after randomization, and at the end of the study, 6 months after randomization. Physical activity during the study period was measured using activity bracelets (Polar A370). Study protocol was approved by Pirkanmaa hospital ethics committee (R18021) and registered to Clinicaltrials.gov (NCT04050397).

Results: Median total cholesterol increased during 6-month follow-up in both groups, but less in the supervised group compared to the control group (0.1 vs 0.4 mmol/l, respectively, p=0.02). LDL remained stable in supervised group but increased slightly in the control group (0 vs. 0.4 mmol/l, respectively, p=0.01). Fasting plasma glucose lowered slightly in both groups (-0.2 vs -0.4 mmol/l). Total active time per day was slightly higher in the supervised group compared to the control group after 3-month intervention (median 364 vs 293 min/day, respectively). This difference persisted after intervention stopped (median 331 vs 267 min/day, respectively). Median change in body fat percentage at 6 months was 0 in the supervised arm and -0.9 in the control arm. None of the participants dropped out due to exercise-related side-effects.

Conclusion: This pilot study showed that it is safe to perform strength exercise in men with ADT. Supervised exercise is likely more effective in mitigating metabolic adverse effect of ADT and inducing long-term changes in physical activity than self-administered exercise. Larger studies with longer follow-up are needed to investigate whether this leads to survival advantage.

Citation Format: Lauri Rantaniemi, Aino Siltari, Eeva Harju, Teemu J. Murtola. Can supervised exercise impact on metabolic markers and physical activity during androgen-deprivation therapy in prostate cancer patients? - randomized controlled pilot trial [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr CT171.