Physical exercise for bone health in men with prostate cancer receiving androgen deprivation therapy: a systematic review

Bressi, Barbara; Cagliari, Maribel; Contesini, Massimiliano; Mazzini, Elisa; Bergamaschi, F.; Moscato, Alfredo; Bassi, Maria Chiara; Costi, Stefania

doi:10.1007/s00520-020-05830-1

Cited by 16 publications

(23 citation statements)

References 60 publications

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“…In addition, exercise intervention will include impact-loading exercise to provide an effective bone osteogenic stimulus. This type of exercise has been considered an effective strategy to prevent loss of bone mineral density in elderly patients32 33 and has been applied in patients with prostate cancer receiving ADT in previous studies 14. Altogether, the components of this intervention should preserve muscle strength and improve fatigue, balance, and cognitive function,32 and eventually, it should prevent accidental falls and fractures.…”

Section: Methods and Analysismentioning

confidence: 99%

“…These exercise programmes should include moderate-high intensity activities that must be performed regularly to maintain exercise-related benefits 12 13. A recent systematic review of randomised controlled trials (RCTs) showed that to counteract the negative effects of ADT on bone, multicomponent physical exercise interventions involving aerobic, resistance and impact-loading exercise have been performed 14. Although these interventions were feasible for most participants in the RCT, those study protocols did not systematically record the adherence rate or adverse events associated with the experimented physical exercise interventions 12 13 15.…”

Section: Introductionmentioning

confidence: 99%

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Feasibility and safety of physical exercise in men with prostate cancer receiving androgen deprivation therapy and radiotherapy: a study protocol

et al. 2022

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IntroductionAndrogen deprivation therapy (ADT) and radiotherapy (RT) increase survival in selected patients with prostate cancer. Nevertheless, the side effects of these therapies are associated with an increased risk of accidental falls and fractures and a decreased quality of life. Preliminary evidence suggests that physical exercise can be a valid strategy to reduce the side effects of ADT and RT in men with prostate cancer. Despite this knowledge, most patients with prostate cancer are insufficiently active, and there is a lack of data on the safety and adherence to the recommended dose of physical exercise. This study protocol is designed to examine the feasibility and safety of a multicomponent experimental physical exercise intervention targeting psychophysical and cognitive functions and the quality of life in this population.Methods and analysisThis is a pilot feasibility study. Twenty-five men currently treated with ADT and RT for prostate cancer will be invited to participate in a 20-week, multicomponent physical exercise intervention, including supervised and unsupervised exercise sessions and meeting the current recommendation for exercise in cancer. The primary outcomes are physical exercise feasibility (recruitment, adherence and drop-out rates) and safety (adverse events related and unrelated to the intervention). The secondary outcomes are muscle strength, balance, fatigue, symptoms of anxiety and depression, cognitive function, quality of life, and patient satisfaction. We will also record the number of accidental falls and fractures occurring during the intervention and at 1 year of follow-up.Ethics and disseminationThe study has received ethics approval from The Area Vasta Nord Local Ethics Committee (Province of Reggio Emilia, 23 June 2020, Number 520/2020/SPER/IRCCSRE). Recruitment began in September 2020 and will be completed in September 2021. The results will be disseminated through scientific journals and conference presentations.Trial registration numberNCT04500080.

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Section: Methods and Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Feasibility and safety of physical exercise in men with prostate cancer receiving androgen deprivation therapy and radiotherapy: a study protocol

et al. 2022

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“…Experts recommend physical activity in patients with cancer due to its numerous health benefits. While there is no solid evidence that it specifically prevents the loss of BMD and the risk of fracture in patients receiving ADT [31], it is an effective strategy for generating significant benefits in general heath.…”

Section: Prevention and Therapeutic Strategies 221 Physical Exercisementioning

confidence: 99%

Bone health and therapeutic agents in advanced prostate cancer

Gómez-Aparicio¹,

López-Campos²,

Pelari-Mici³

et al. 2022

Front. Biosci. (Landmark Ed)

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Prostate cancer is the most frequent genitourinary tumor worldwide. Maintaining an optimum bone health throughout the natural course of prostate cancer is an important aspect in the management of this disease, particularly in this at risk population of older and frail patients who experience bone loss related to androgen-deprivation therapy (ADT) and/or patients who develop bone metastases. The number of treatment options for advanced prostate cancer that combine ADT with docetaxel, new hormonal agents and/or radiotherapy has increased substantially in recent years. Bisphosphonates and other bone targeted agents such as denosumab have shown an improvement in bone mineral density and are suited for patients with treatment-related osteoporosis and/or bone metastases with an increased risk of skeletalrelated events (SREs). In this context, the aim of this review is to analyse key aspects of bone health and therapies that can prevent the occurrence of SREs throughout the clinical course of prostate cancer, and how to combine them with new available treatments in this setting.

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“…We10–17 and others18–23 have shown that exercise can counteract several treatment-related toxicities such as reducing or mitigating fatigue, improving muscle mass and strength, bone mass and physical function during or following ADT. However, the effects of exercise alone on fat mass are modest with reductions of ~0.7 kg observed in a recent meta-analysis of overweight men with prostate cancer17 compared with the substantial gains of ~2.3 kg that can be experienced during the first year of treatment 3.…”

Section: Introductionmentioning

confidence: 99%

Weight loss for overweight and obese patients with prostate cancer: a study protocol of a randomised trial comparing clinic-based versus Telehealth delivered EXercise and nutrition intervention (the TelEX trial)

et al. 2022

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IntroductionObese men with prostate cancer have an increased risk of biochemical recurrence, metastatic disease and mortality. For those undergoing androgen deprivation therapy (ADT), substantial increases in fat mass are observed in the first year of treatment. Recently, we showed that a targeted supervised clinic-based exercise and nutrition intervention can result in a substantial reduction in fat mass with muscle mass preserved in ADT-treated patients. However, the intervention needs to be accessible to all patients and not just those who can access a supervised clinic-based programme. The purpose of this study was to evaluate the efficacy of telehealth delivered compared with supervised clinic-based delivered exercise and nutrition intervention in overweight/obese patients with prostate cancer.Methods and analysisA single-blinded, two-arm parallel group, non-inferiority randomised trial will be undertaken with 104 overweight/obese men with prostate cancer (body fat percentage ≥25%) randomly allocated in a ratio of 1:1 to a telehealth-delivered, virtually supervised exercise and nutrition programme or a clinic-based, face-to-face supervised exercise and nutrition programme. Exercise will consist of supervised resistance and aerobic exercise performed three times a week plus additional self-directed aerobic exercise performed 4 days/week for the first 6 months. Thereafter, for months 7–12, the programmes will be self-managed. The primary endpoint will be fat mass. Secondary endpoints include lean mass and abdominal aortic calcification, anthropometric measures and blood pressure assessment, objective measures of physical function and physical activity levels, patient-reported outcomes and blood markers. Measurements will be undertaken at baseline, 6 months (post intervention), and at 12 months of follow-up. Data will be analysed using intention-to-treat and per protocol approaches.Ethics and disseminationEthics approval has been obtained from the Edith Cowan University Human Research Ethics Committee (ID: 2021–02157-GALVAO). Outcomes from the study will be published in academic journals and presented in scientific and consumer meetings.Trial registration numberACTRN12621001312831.

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Physical exercise for bone health in men with prostate cancer receiving androgen deprivation therapy: a systematic review

Cited by 16 publications

References 60 publications

Feasibility and safety of physical exercise in men with prostate cancer receiving androgen deprivation therapy and radiotherapy: a study protocol

Feasibility and safety of physical exercise in men with prostate cancer receiving androgen deprivation therapy and radiotherapy: a study protocol

Bone health and therapeutic agents in advanced prostate cancer

Weight loss for overweight and obese patients with prostate cancer: a study protocol of a randomised trial comparing clinic-based versus Telehealth delivered EXercise and nutrition intervention (the TelEX trial)

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