Integrating diet and exercise into care of prostate cancer patients on androgen deprivation therapy

Abstract

Improved diagnosis and treatment regimens have resulted in greater longevity for men with prostate cancer. This has led to an increase in both androgen deprivation therapy (ADT) use and duration of exposure, and therefore to its associated adverse effects, such as sexual dysfunction, osteoporosis, reduced muscle mass, increased fat mass, and increased incidence of cardiovascular disease and type 2 diabetes. Given that the adverse effects of ADT are systemic, often debilitating, and difficult to treat, efforts continue in the development of new strategies for long-term management of prostate cancer. The PubMed database was searched to select trials, reviews, and meta-analyses in English using such search terms as “prostate cancer” and “androgen deprivation therapy”, “cardiovascular risk”, “lean body mass”, “exercise”, and “diet”. The initial searches produced 379 articles with dates 2005 or more recent. Articles published after 2004 were favored. This review utilizes the latest data to provide a status update on the effects of exercise and diet on patients with prostate cancer, focusing on ADT-associated side effects, and it discusses the evidence for such interventions. Since the evidence of large-scale trials in patients with prostate cancer is missing, and an extrapolation of supporting data to all patient subgroups cannot be provided, individualized risk assessments remain necessary before the initiation of exercise and diet programs. Exercise, diet, and nutritional supplementation interventions have the potential to provide effective, accessible, and relatively inexpensive strategies for mitigating ADT-associated toxicities without introducing additional adverse effects.

Trajectories in muscular strength and physical function among men with and without prostate cancer in the health aging and body composition study

“…Additionally, while we did not find specific associations between BMI and trajectories of physical function over time, the use of more precise measures of body composition may have provided better information. Finally, we did not evaluate diet or nutrition, a critical factor contributing to changes in body composition in men who begin hormone therapy [35].…”

Clinical pathway improves implementation of evidence‐based strategies for the management of androgen deprivation therapy‐induced side effects in men with prostate cancer

“…One of the side effects of ADT is the increase in fat mass and the development of metabolic syndrome . At onset of ADT, the majority of patients already have a diagnosis of overweight, therefore, proper diet counselling is indicated , but was rarely given as standard practice before pathway implementation. In addition to the positive effects of a diet intervention on cardiometabolic health, it can also support bone health .…”

Availability of prostate cancer exercise rehabilitation resources and practice patterns in Belgium: Results of a cross-sectional study

“…Studies demonstrated that only the minority of PCa patients performs sufficient physical activity according to exercise cancer guidelines (Forbes, Blanchard, Mummery, & Courneya, ; Galvão et al., ). Therefore, strategies to enhance physical activity are indicated (Moyad, Newton, Tunn, & Gruca, ; Nguyen et al., ; Taaffe et al., ). PCa patients show a positive attitude towards exercise programmes (Cormie et al., , Green, Steinnagel, Morris, & Laakso, ).…”