(UroToday.com) The 2025 GU ASCO annual meeting featured a prostate cancer session and a presentation by Dr. Benjamin Maughan discussing a prospective trial of a structured exercise program to lessen fatigue in patients with advanced prostate cancer undergoing androgen deprivation therapy (ADT). Cancer-related fatigue, one of the most significant issues affecting quality of life, is reported by up to 75% of men with advanced prostate cancer on ADT. Importantly, exercise may serve as a tool to improve fatigue in cancer patients. As such, Dr. Maughan and colleagues examined the effect of a structured exercise program on fatigue in men with advanced prostate cancer.
This prospective trial enrolled participants with advanced prostate cancer treated with an ADT-based regimen on a 12 week exercise program at a single institution. Patients with at least 4/10 tiredness, self-reported sedentary lifestyle (<90 min/week exercise), no evidence of disease progression, and no chemotherapy within 3 months were eligible. Participants underwent peak aerobic capacity, muscular strength and endurance testing before and after 12 weeks of structured, guided exercise through the institution’s hospital-based exercise oncology program (Personal Optimism With Exercise Recovery; POWER). Participants completed symptom questionnaires including the 7-item PROMIS fatigue at baseline and after 6 and 12 weeks. Participants had 45-60 minute supervised sessions weekly, either in person or virtually, and were instructed to work up to 150 min of moderate activity and two resistance training sessions weekly. The primary endpoint was change in fatigue, which was evaluated as a 4 point reduction in T score as a clinically important difference. The key secondary endpoint was change in relative peak aerobic capacity (ml/kg/min).
There were 119 participants with advanced prostate cancer enrolled, 92% of whom had metastatic disease, between 2018 and 2022. Nine patients withdrew from the study and 10 were lost to follow-up. Data were incomplete for 28 participants primarily due to inadequate follow-up during the COVID-19 pandemic. Of the 119 enrolled participants, 96% were white, 83% were married, 52% had at least a college degree, and 25% were currently employed. The mean age was 70.3 years and mean BMI was 30.5 kg/m2. There were 29 participants (24%) receiving treatment with ADT alone, and the rest were receiving a combination of ADT and targeted therapy. The primary endpoint was evaluable in 72 participants, for which there was a clinically significant reduction in fatigue of 5.1 points (95% CI 3.6-6.7) between baseline (56.7, 95% CI 55.1-58.0) and 12 weeks (51.4, 95% CI 49.8-53.1). Of those who completed both aerobic fitness assessments (n = 76), there was a 3.1 ml/kg/min (95% CI 2.1-4.0) improvement in relative peak aerobic capacity from a mean 27.5 (95% CI 25.8-29.2) at baseline to a mean 30.6 [95% CI 28.8-32.3] at 12 weeks.
Dr. Maughan concluded his presentation discussing a prospective trial of a structured exercise program to lessen fatigue in patients with advanced prostate cancer undergoing ADT with the following take-home points:
- Completion of a 12 week supervised exercise regimen led to a clinically significant improvement in fatigue and peak aerobic exercise capacity
- These findings support routinely recommending exercise for and examining symptom management in patients with metastatic cancer to improve quality of life
Presented by: Benjamin L. Maughan, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT
Written by: Zachary Klaassen, MD, MSc – Urologic Oncologist, Associate Professor of Urology, Georgia Cancer Center, Wellstar MCG Health, @zklaassen_md on Twitter during the 2025 Genitourinary (GU) American Society of Clinical Oncology (ASCO) Annual Meeting, San Francisco, CA, Thurs, Feb 13 – Sat, Feb 15, 2025.