Effects of a 15-Month Supervised Exercise Program on Physical and Psychological Outcomes in Prostate Cancer Patients Following Prostatectomy

Abstract

Purpose. Despite advanced medical treatment options, many prostate cancer patients are still confronted with unfavorable physical and psychological burdens. Physical exercise has proven to be beneficial for prostate cancer patients, yet specific exercise offers are rare. The ProRehab Study aimed to evaluate the exercise program offered in rehabilitative prostate cancer sports groups in Germany and determine whether it is beneficial for patients following prostatectomy. Methods. Eighty-five prostate cancer patients were recruited for a multicenter, 2-armed, nonrandomized controlled trial 6 to 12 weeks after prostatectomy. The intervention group (n = 56) took part in a 15-month supervised multimodal exercise program. Exercise sessions took place once a week for 60 minutes at a moderate intensity (3.84-4.84 MET-hour). The control group (n = 29) received no intervention. Outcomes included aerobic fitness, activity levels, quality of life, disease-and treatment-related adverse effects, such as urinary incontinence and erectile dysfunction, and relapse-relevant blood values. Intention-to-treat analysis was performed. Results. A significant between-group difference was observed in the urinary symptom score (P = .027). Physical fitness, urinary incontinence, physical, role, emotional, and social functioning, as well as further disease-and treatmentrelated side effects (dyspnea, urinary, and bowel symptoms) significantly improved within the intervention group. Erectile dysfunction and physical activity levels improved similarly in both groups. Conclusions. The presented data hint at the potential of rehabilitative sports groups for prostate cancer patients. However, according to the current state of the art, exercise intensity and volume may need to be increased to enhance the effects. A number of shorter studies (8-24 weeks) have proven significant between-group differences in quality of life, incontinence, and fitness outcomes when patients exercised 2 to 3 times per week. This is the first exercise intervention study with prostate cancer patients that was conducted over 15 months. Further studies are necessary to investigate whether prostate cancer patients recover sooner when receiving a supervised exercise program.

Feasibility and Effects of a Postoperative Recovery Exercise Program Developed Specifically for Gastric Cancer Patients (PREP-GC) Undergoing Minimally Invasive Gastrectomy

“…Exercise intervention after surgery has been found to improve physical fitness and QOL and to reduce treatment-related side effects in several organ cancers, such as breast, colorectal, prostate, and hematological malignancies [ 3 4 5 6 7 8 ]. However, most studies have only assessed exercise intervention that is conducted after full recovery from surgery or on completion of treatment.…”

The Interplay between Vascular Function and Sexual Health in Prostate Cancer: The Potential Benefits of Exercise Training

“…Both the exercise and control groups experienced a significant improvement in sexual function as assessed by the EORTC QLQ-PR25 (+9.8, p = 0.008 and +15.6, p = 0.008, respectively), but not in the IIEF-5 (both p > 0.05). Interestingly, the number of men reported to be sexually active pre-to post-intervention increased from 14 to 16 men in the exercise group, whilst the number decreased from 10 to 8 men in the control group [36].…”

“…One of the above two articles which reported an improvement in sexual function post-intervention also observed improvements in self-reported quality of life [34]. However, the remaining articles did not observe improvements in quality of life or mental health outcomes [32,33,35,36]. Therefore, mental health is likely to play an important mediating role in exercise-induced changes in sexual health outcomes in men with prostate cancer.…”

“…There are a limited number of structured exercise interventional studies that have included assessments of sexual function in prostate cancer populations. The available evidence is limited to men who were either actively on radiation therapy [32,33] or ADT [34] throughout the study period, or who had completed active treatment prior to study initiation [35,36] (Table 1). Sexual function has been assessed in these studies using questionnaires shown to have good clinical validity and reliability [50][51][52], such as the simplified International Index of Erectile Function (IIEF-5), European Organisation for Research and Treatment of Cancer Prostate Cancer-specific Module (EORTC QLQ-PR25) and Expanded Prostate Cancer Index Composite (EPIC-26).…”

“…Compared to usual care, the home-based exercise did not have any significant effect on sexual function, as assessed by the EPIC-26 (p = 0.117). In addition, a longer 15-month intervention by Zopf and colleagues [36] was conducted in men who had completed active treatment (surgery, or surgery and radiation therapy) 6 to 12 weeks prior to study enrolment. They compared usual care to once-weekly low-to-moderate intensity supervised aerobic and resistance exercise training, combined with home-based aerobic exercise training for 60 min per week.…”