No abstract

Androgen deprivation therapy (ADT) remains a cornerstone in the management of patients with prostate cancer (PCa) despite adverse effects on body composition and functional parameters. We compared the effects of football training with standard care in PCa patients managed with ADT (> 6 months). Fifty-seven men aged 67 (range: 43-74) were randomly assigned to a football group (FG, n = 29) or a usual care control group (CON, n = 28). The primary outcome was change in lean body mass (LBM) assessed by dual-energy X-ray absorptiometry scanning. Secondary outcomes included changes in knee-extensor muscle strength (one repetition maximum), fat percentage, and maximal oxygen uptake (VO 2max). Mean heart rate during training was 137.7 (standard deviation 13.7) bpm or 84.6 (3.9)% HRmax. In FG, LBM increased by 0.5 kg [95% confidence interval (CI) 0.1-0.9; P = 0.02] with no change in CON (mean group difference 0.7 kg; 95% CI 0.1-1.2; P = 0.02). Also, muscle strength increased in FG (8.9 kg; 95% CI 6.0-11.8; P < 0.001) with no change in CON (mean group difference 6.7 kg; 95% CI 2.8-10.7; P < 0.001). In FG, VO 2max increased (1.0 mL/kg/min; 95% CI 0.2-1.9; P = 0.02) and fat percentage tended to decrease (0.7%; 95%CI 1.3-0.0; P = 0.06), but these changes were not significantly different from CON. In conclusion, football training over 12 weeks improved LBM and muscle strength compared with usual care in men with prostate cancer receiving ADT.

Evidence is accumulating that exercise-based rehabilitation improves physical capacity and quality of life in cancer survivors. However, recruitment and persistence of male cancer patients in rehabilitation and physical activity are low and novel health promotion strategies are warranted. The purpose of this study was to gain an understanding of the meaning of recreational football as a team and interaction-oriented health-promoting activity in men with prostate cancer (n = 26). Qualitative data were collected through six focus group interviews (n = 4-6) and 20 h of participant observations. The two data sets were analyzed using framework analysis. The analysis produced 11 subthemes that were structured into three overarching themes: (a) motivational drivers; (b) united in sport; and (c) confirmation of own capacity. The findings indicated that participants regarded football as a welcome opportunity to regain control and acquire a sense of responsibility for own health without assuming the patient role, and football training legitimized and promoted mutual caring behavior in a male-oriented context. In conclusion, the study suggests that football, due to its cultural representation of masculine ideals, may be a potent and unique strategy for increasing recruitment and adherence to physical activity in prostate cancer patients.Prostate cancer is the most frequently diagnosed malignancy in men (Siegel et al., 2012) and due to early diagnosis and continued advances in multi-modality treatment options, the number of prostate survivors continues to increase. Approximately 50% of men diagnosed with prostate cancer undergo androgen deprivation treatment (ADT) at some point, either in combination with radiotherapy with curative intent or as continuous palliative treatment for disseminated disease (Mottet et al., 2011). Although ADT contributes to improved life expectancy, it is also associated with significant adverse effects, including impaired physical (Galvao et al., 2009), psychosocial distress, sexual dysfunction, and body feminization (Elliott et al., 2010), which may reduce quality of life and may be perceived as a threat to masculinity (Hoyt et al., 2013). Evidence is accumulating that physical activity has a beneficial impact on physical capacity and quality of life in prostate cancer patients (Galvao et al., 2010) and recent epidemiological research suggests that regular, moderateintensity physical activity may have a positive effect on disease progression (Richman et al., 2011) and survival . However, less than half of prostate cancer patients are meeting the recommended levels for physical activity (41.9%) (Chipperfield et al., 2013) and unlike other male cancer patients (e.g., colorectal cancer patients and lung cancer patients), men with prostate cancer do not spontaneously change health behavior in a beneficial way following diagnosis (Karlsen et al., 2012). In addition, male cancer survivors in general are underrepresented in the cancer rehabilitation research (15% men vs 85% women) (Hoybye et al., 2008)...