Taking Advantage of the Teachable Moment at Initial Diagnosis of Prostate Cancer—Results of a Pilot Randomized Controlled Trial of Supervised Exercise Training
Gerald Bastian Schulz, Jennifer A. Locke, Kristin L. Campbell, Kelcey A. Bland, Cheri L. Van Patten, Peter C. Black, S. Larry Goldenberg, Ryan Flannigan
Abstract
BACKGROUND: Increased physical activity (PA) levels are associated with improved prostate cancer (PCa) outcomes. Sustainable PA has been linked to improved health-related quality of life (QoL) in cancer patients. The time of diagnosis of PCa may offer a critical time point when patients might be more likely to consider lifestyle changes. This, in turn, may contribute to sustainable PA and its likely benefits. OBJECTIVE: The aims of this study were to determine if a structured PA intervention introduced at the time of diagnosis can (1) lead to sustainable PA and (2) help improve psychosocial and QoL outcomes as compared with usual PA. INTERVENTIONS/METHODS: This was a pilot randomized controlled trial enrolling patients with intermediate-risk PCa into either arm A (supervised 8- to 12-week physical exercise program; n = 10) or control arm B (usual PA; n = 10). Primary outcome was PA at 6 months. Secondary outcomes were QoL, psychological well-being, physical fitness, and functional outcomes postintervention. Change over time was compared using a nonparametric Wilcoxon test. RESULTS: Demographic variables were the same between arms. Comparing parameters at the start and 6 months post-radical prostatectomy, PA significantly improved in arm A (self-reported Godin score 24.7 vs 42.8 units, P < .01, objective number of chair stands [14-19, P < .01]), but not in arm B. There were no significant differences between arms in QoL and psychosocial outcomes. CONCLUSIONS: A preoperative supervised exercise training program increases long-term PA. IMPLICATIONS FOR PRACTICE: Future trials should evaluate PA sustainability beyond 6 months and if this leads to improved psychosocial and QoL outcomes.