Timing of exercise for muscle strength and physical function in men initiating ADT for prostate cancer.
Journal
Prostate cancer and prostatic diseases
ISSN: 1476-5608
Titre abrégé: Prostate Cancer Prostatic Dis
Pays: England
ID NLM: 9815755
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
20
02
2019
accepted:
17
12
2019
revised:
12
12
2019
pubmed:
6
2
2020
medline:
27
5
2021
entrez:
6
2
2020
Statut:
ppublish
Résumé
Androgen deprivation therapy (ADT) in men with prostate cancer (PCa) results in adverse effects, including reduced muscle strength and physical function, potentially compromising daily functioning. We examined whether it was more efficacious to commence exercise at the onset of ADT rather than later in treatment to counter declines in strength and physical function. One-hundred-and-four men with PCa (68.3 ± 7.0 years) initiating ADT were randomised to immediate exercise (IMX, n = 54) or delayed exercise (DEL, n = 50) for 12 months. IMX comprised 6 months of supervised resistance/aerobic/impact exercise initiated at the onset of ADT with a 6-month follow-up. DEL comprised 6 months of usual care followed by 6 months of resistance/aerobic/impact exercise. Upper and lower body muscle strength and physical function were assessed at baseline, 6 and 12 months. There was a significant difference for all strength measures at 6 months favouring IMX (P < 0.001), with net differences in leg press, seated row and chest press strength of 19.9 kg (95% CI, 12.3-27.5 kg), 5.6 kg (3.8-7.4 kg) and 4.3 kg (2.7-5.8 kg), respectively. From 7 to 12 months, DEL increased in all strength measures (P < 0.001), with no differences between groups at 12 months. Similarly, physical function improved (P < 0.001) in IMX compared with DEL at 6 months for the 6-m fast walk (-0.2, 95% CI -0.3 to -0.1 s), 400-m walk (-9.7, -14.8 to -4.6 s), stair climb (-0.4, -0.6 to -0.2 s) and chair rise (-1.0, -1.4 to -0.7 s), with no differences between groups by 12 months, except for the 6-m fast walk (P < 0.001). Exercise either at the onset or after 6 months of ADT preserves/enhances muscle strength and physical function. However, to avoid initial treatment-related adverse effects on strength and function, exercise therapy should be implemented with initiation of ADT.
Sections du résumé
BACKGROUND
Androgen deprivation therapy (ADT) in men with prostate cancer (PCa) results in adverse effects, including reduced muscle strength and physical function, potentially compromising daily functioning. We examined whether it was more efficacious to commence exercise at the onset of ADT rather than later in treatment to counter declines in strength and physical function.
METHODS
One-hundred-and-four men with PCa (68.3 ± 7.0 years) initiating ADT were randomised to immediate exercise (IMX, n = 54) or delayed exercise (DEL, n = 50) for 12 months. IMX comprised 6 months of supervised resistance/aerobic/impact exercise initiated at the onset of ADT with a 6-month follow-up. DEL comprised 6 months of usual care followed by 6 months of resistance/aerobic/impact exercise. Upper and lower body muscle strength and physical function were assessed at baseline, 6 and 12 months.
RESULTS
There was a significant difference for all strength measures at 6 months favouring IMX (P < 0.001), with net differences in leg press, seated row and chest press strength of 19.9 kg (95% CI, 12.3-27.5 kg), 5.6 kg (3.8-7.4 kg) and 4.3 kg (2.7-5.8 kg), respectively. From 7 to 12 months, DEL increased in all strength measures (P < 0.001), with no differences between groups at 12 months. Similarly, physical function improved (P < 0.001) in IMX compared with DEL at 6 months for the 6-m fast walk (-0.2, 95% CI -0.3 to -0.1 s), 400-m walk (-9.7, -14.8 to -4.6 s), stair climb (-0.4, -0.6 to -0.2 s) and chair rise (-1.0, -1.4 to -0.7 s), with no differences between groups by 12 months, except for the 6-m fast walk (P < 0.001).
CONCLUSION
Exercise either at the onset or after 6 months of ADT preserves/enhances muscle strength and physical function. However, to avoid initial treatment-related adverse effects on strength and function, exercise therapy should be implemented with initiation of ADT.
Identifiants
pubmed: 32020032
doi: 10.1038/s41391-019-0200-z
pii: 10.1038/s41391-019-0200-z
pmc: PMC7423590
doi:
Substances chimiques
Androgen Antagonists
0
Antineoplastic Agents, Hormonal
0
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
457-464Références
Meng MV, Grossfeld GD, Sadetsky N, Mehta SS, Lubeck DP, Carroll PR. Contemporary patterns of androgen deprivation therapy use for newly diagnosed prostate cancer. Urology. 2002;60 (Suppl 1):7–11.
doi: 10.1016/S0090-4295(02)01560-1
McHugh DJ, Root JC, Nelson CJ, Morris MJ. Androgen-deprivation therapy, dementia, and cognitive dysfunction in men with prostate cancer: how much smoke and how much fire? Cancer. 2018;124:1326–34.
doi: 10.1002/cncr.31153
Spry NA, Kristjanson L, Hooton B, Hayden L, Neerhut G, Gurney H, et al. Adverse effects to quality of life arising from treatment can recover with intermittent androgen suppression in men with prostate cancer. Eur J Cancer. 2006;42:1083–92.
doi: 10.1016/j.ejca.2006.01.029
Nguyen PL, Alibhai SM, Basaria S, D’Amico AV, Kantoff PW, Keating NL, et al. Adverse effects of androgen deprivation therapy and strategies to mitigate them. Eur Urol. 2015;67:825–36.
doi: 10.1016/j.eururo.2014.07.010
Rhee H, Gunter JH, Heathcote P, Ho K, Stricker P, Corcoran NM, et al. Adverse effects of androgen-deprivation therapy in prostate cancer and their management. BJU Int. 2015;115 (Suppl 5):3–13.
doi: 10.1111/bju.12964
Galvao DA, Spry NA, Taaffe DR, Newton RU, Stanley J, Shannon T, et al. Changes in muscle, fat and bone mass after 36 weeks of maximal androgen blockade for prostate cancer. BJU Int. 2008;102:44–47.
doi: 10.1111/j.1464-410X.2008.07539.x
Smith MR, Saad F, Egerdie B, Sieber PR, Tammela TL, Ke C, et al. Sarcopenia during androgen-deprivation therapy for prostate cancer. J Clin Oncol. 2012;30:3271–6.
doi: 10.1200/JCO.2011.38.8850
Basaria S, Lieb J, Tang AM, DeWeese T, Carducci M, Eisenberger M, et al. Long-term effects of androgen deprivation therapy in prostate cancer patients. Clin Endocrinol (Oxf). 2002;56:779–86.
doi: 10.1046/j.1365-2265.2002.01551.x
Clay CA, Perera S, Wagner JM, Miller ME, Nelson JB, Greenspan SL. Physical function in men with prostate cancer on androgen deprivation therapy. Phys Ther. 2007;87:1325–33.
doi: 10.2522/ptj.20060302
Bylow K, Dale W, Mustian K, Stadler WM, Rodin M, Hall W, et al. Falls and physical performance deficits in older patients with prostate cancer undergoing androgen deprivation therapy. Urology. 2008;72:422–7.
doi: 10.1016/j.urology.2008.03.032
Galvão DA, Taaffe DR, Spry N, Joseph D, Turner D, Newton RU. Reduced muscle strength and functional performance in men with prostate cancer undergoing androgen suppression: a comprehensive cross-sectional investigation. Prostate Cancer Prostatic Dis. 2009;12:198–203.
doi: 10.1038/pcan.2008.51
Alibhai SM, Breunis H, Timilshina N, Johnston C, Tomlinson G, Tannock I, et al. Impact of androgen-deprivation therapy on physical function and quality of life in men with nonmetastatic prostate cancer. J Clin Oncol. 2010;28:5038–45.
doi: 10.1200/JCO.2010.29.8091
Segal RJ, Reid RD, Courneya KS, Malone SC, Parliament MB, Scott CG, et al. Resistance exercise in men receiving androgen deprivation therapy for prostate cancer. J Clin Oncol. 2003;21:1653–9.
doi: 10.1200/JCO.2003.09.534
Galvao DA, Nosaka K, Taaffe DR, Spry N, Kristjanson LJ, McGuigan MR, et al. Resistance training and reduction of treatment side effects in prostate cancer patients. Med Sci Sports Exerc. 2006;38:2045–52.
doi: 10.1249/01.mss.0000233803.48691.8b
Galvao DA, Taaffe DR, Spry N, Joseph D, Newton RU. Combined resistance and aerobic exercise program reverses muscle loss in men undergoing androgen suppression therapy for prostate cancer without bone metastases: a randomized controlled trial. J Clin Oncol. 2010;28:340–7.
doi: 10.1200/JCO.2009.23.2488
Cormie P, Galvao DA, Spry N, Joseph D, Chee R, Taaffe DR, et al. Can supervised exercise prevent treatment toxicity in patients with prostate cancer initiating androgen-deprivation therapy: a randomised controlled trial. BJU Int. 2015;115:256–66.
doi: 10.1111/bju.12646
Campbell KL, Neil SE, Winters-Stone KM. Review of exercise studies in breast cancer survivors: attention to principles of exercise training. Br J Sports Med. 2012;46:909916.
doi: 10.1136/bjsports-2010-082719
Taaffe DR, Galvão DA, Spry N, Joseph D, Chambers SK, Gardiner RA, et al. Immediate versus delayed exercise in men initiating androgen deprivation: effects on bone density and soft tissue composition. BJU Int. 2019;123:261–9.
doi: 10.1111/bju.14505
Newton RU, Taaffe DR, Spry N, Cormie P, Chambers SK, Gardiner RA, et al. Can exercise ameliorate treatment toxicity during the initial phase of testosterone deprivation in prostate cancer patients? Is this more effective than delayed rehabilitation? BMC Cancer. 2012;12:432.
doi: 10.1186/1471-2407-12-432
Taaffe DR, Duret C, Wheeler S, Marcus R. Once-weekly resistance exercise improves muscle strength and neuromuscular performance in older adults. J Am Geriatr Soc. 1999;47:1208–14.
doi: 10.1111/j.1532-5415.1999.tb05201.x
Galvão DA, Taaffe DR. Resistance exercise dosage in older adults: single versus multiset effects on physical performance and body composition. J Am Geriatr Soc. 2005;53:2090–7.
doi: 10.1111/j.1532-5415.2005.00494.x
Godin G, Shephard RJ. A simple method to assess exercise behaviour in the community. Can J Appl Sport Sci. 1985;10:141–6.
pubmed: 4053261
Kilgour RD, Vigano A, Trutschnigg B, Lucar E, Borod M, Morais JA. Handgrip strength predicts survival and is associated with markers of clinical and functional outcomes in advanced cancer patients. Support Care Cancer. 2013;21:3261–70.
doi: 10.1007/s00520-013-1894-4
Versteeg KS, Blauwhoff-Buskermolen S, Buffart LM, de van der Schueren MAE, Langius JAE, Verheul HMW, et al. Higher muscle strength is associated with prolonged survival in older patients with advanced cancer. Oncologist. 2018;23:580–5.
doi: 10.1634/theoncologist.2017-0193
Ruiz JR, Sui X, Lobelo F, Morrow JR Jr, Jackson AW, Sjöström M, et al. Association between muscular strength and mortality in men: prospective cohort study. BMJ. 2008;337:a439.
doi: 10.1136/bmj.a439
McLeod M, Breen L, Hamilton DL, Philp A. Live strong and prosper: the importance of skeletal muscle strength for healthy ageing. Biogerontology. 2016;17:497–510.
doi: 10.1007/s10522-015-9631-7
Levy ME, Perera S, van Londen GJ, Nelson JB, Clay CA, Greenspan SL. Physical function changes in prostate cancer patients on androgen deprivation therapy: a 2-year prospective study. Urology. 2008;71:735–9.
doi: 10.1016/j.urology.2007.09.018
Simonsick EM, Fan E, Fleg JL. Estimating cardiorespiratory fitness in well-functioning older adults: treadmill validation of the long distance corridor walk. J Am Geriatr Soc. 2006;54:127–32.
doi: 10.1111/j.1532-5415.2005.00530.x
Newman AB, Simonsick EM, Naydeck BL, Boudreau RM, Kritchevsky SB, Nevitt MC, et al. Association of long-distance corridor walk performance with mortality, cardiovascular disease, mobility limitation, and disability. JAMA. 2006;295:2018–26.
doi: 10.1001/jama.295.17.2018
Cesari M, Kritchevsky SB, Newman AB, Simonsick EM, Harris TB, Penninx BW, et al. Added value of physical performance measures in predicting adverse health-related events: results from the health, aging and body composition study. J Am Geriatr Soc. 2009;57:251–9.
doi: 10.1111/j.1532-5415.2008.02126.x
Verweij NM, Schiphorst AH, Pronk A, van den Bos F, Hamaker ME. Physical performance measures for predicting outcome in cancer patients: a systematic review. Acta Oncol. 2016;55:1386–91.
doi: 10.1080/0284186X.2016.1219047
Newton RU, Taaffe DR, Chambers SK, Spry N, Galvão DA. Effective exercise interventions for patients and survivors of cancer should be supervised, targeted, and prescribed with referrals from oncologists and general physicians. J Clin Oncol. 2018;36:927–8.
doi: 10.1200/JCO.2017.76.7400