Effect of a Home-based Walking Intervention on Cardiopulmonary Fitness and Quality of Life Among Men with Prostate Cancer on Active Surveillance: The Active Surveillance Exercise Randomized Controlled Trial
Erin L. Van Blarigan, Stacey A. Kenfield, Adam B. Olshen, Neil Panchal, Katriel Encabo, Imelda Tenggara, Rebecca E. Graff, Alexander Bang, Katsuto Shinohara, Matthew R. Cooperberg, Peter R. Carroll, Lee W. Jones, Kerri M. Winters‐Stone, Anthony Luke, June M. Chan
Abstract
A 16-wk home-based walking program that included a nonlinear prescription, heart rate monitor, and weekly phone call with an exercise physiologist improved cardiorespiratory fitness, fear of cancer recurrence, and urinary obstruction/irritation among men on active surveillance for prostate cancer. Active surveillance (AS) is standard care for most men with low-risk prostate cancer (PC); yet, many men on AS eventually undergo curative therapy. Interventions to lower the risk of cancer progression and fear of recurrence among men on AS for PC are needed. To determine the effect of aerobic exercise on cardiorespiratory fitness, body size, and quality of life (QOL) among men on AS for PC. We conducted a 1:1 randomized controlled trial among 51 men with low-risk PC who elected AS. Participants were enrolled at the University of California, San Francisco. The 16-wk intervention included a home-based walking program with a nonlinear exercise prescription tailored to baseline fitness level, heart rate monitor, and weekly phone call with an exercise physiologist. Controls received printed materials. Cardiorespiratory fitness was measured using VO 2 peak; secondary outcomes included change in body size, anxiety, and QOL. Analyses were based on intention to treat. Between 2016 and 2021, we randomized 51 men to intervention ( n = 26) or control ( n = 25). Follow-up was 88% (45/51), 85% (22/26) in the intervention and 92% (23/25) in the control group. At 16 wk, the intervention group had a higher mean VO 2 peak than the control group (31.9 ± 4.7 vs 27.2 ± 4.8 ml/kg/min; group × time effect p value: <0.001). Additionally, the intervention group reported less fear of PC recurrence and urinary obstruction/irritation, while controls reported more of these two QOL measures, from 0 to 16 wk ( p = 0.04 and 0.03, respectively). Two participants discontinued the intervention, including one due to knee pain related to the study. A home-based walking program improved VO 2 peak and reduced urinary obstruction/irritation and fear of recurrence among men on AS for PC. Moderate to vigorous aerobic exercise improves fitness and quality of life among men on active surveillance for prostate cancer.