Improving Quality of Life during Androgen Deprivation Therapy in Prostate Adenocarcinoma Patients: Effect of Prescribed Clinic-Based Exercise Program

Abstract

Context: The mainstay of treatment of advanced prostate adenocarcinoma is androgen deprivation therapy (ADT). ADT invariably results in a progressive loss of bone density and muscle mass and diminishing cardiopulmonary and cognitive function. Exercise is beneficial as adjuvant treatment during ADT.

Aim: This study seeks to identify the benefit of prescribed exercise programs beyond routine physical activities of daily living in low‑income patients on ADT. Settings and Design: Men on ADT for 12 months who were in the remission phase of the disease were recruited for a 6 week supervised aerobic and resistive exercise program.

Subjects and Methods: The effects of the prescribed exercise on muscle strength (MS), peak expiratory flow rate ( PEFR), maximum  oxygen uptake (MOU) and brief fatigue inventory (BFI) were assessed. 10R max test was deployed for MS while the modified Young Men Christian Association protocol for bicycle ergometer was used for PEFR and MOU. All measures were taken pre‑ and post‑intervention with a check for adverse events at week 3. Statistical Analysis Used: Simple frequency in SPSS version 21 was used.

Results: Only 5 of 34 recruited subjects completed the study. There was 34.0% improvement in MOU, 34.9% improvement in PEFR, 130.0% increase in exercise duration, and 29.2% reduction in reported BFI. Improvement in parameters was more among those that had lower values at recruitment. Compliance with exercise prescription was a major challenge. All participants reported improvement in activities of daily living.

Conclusions: Prescribed aerobic and resistive exercise program is beneficial during ADT for prostate adenocarcinoma. Those with poorer reserves tend to benefit more.

Keywords: Androgen deprivation therapy, muscle strength, peak exploratory flow rate, prescribed exercise, prostate adenocarcinoma