Prostate cancer patients on androgen deprivation therapy (ADT) experience adverse effects such as lean mass loss, known as sarcopenia, fat gain, and changes in cardiometabolic factors that increase risk of metabolic syndrome (MetS). Resistance training can increase lean mass, reduce body fat, and improve physical function and quality of life, but no exercise interventions in prostate cancer patients on ADT have concomitantly improved body composition and MetS. This pilot trial investigated 12 weeks of resistance training on body composition and MetS changes in prostate cancer patients on ADT. An exploratory aim examined if a combined approach of training and protein supplementation would elicit greater changes in body composition.
Prostate cancer patients on ADT were randomized to resistance training and protein supplementation (TRAINPRO), resistance training (TRAIN), protein supplementation (PRO), or control stretching (STRETCH). Exercise groups (EXE = TRAINPRO, TRAIN) performed supervised exercise 3 days per week for 12 weeks, while non-exercise groups (NoEXE = PRO, STRETCH) performed a home-based stretching program. TRAINPRO and PRO received 50 g⋅day- 1of whey protein. The primary outcome was change in lean mass assessed through dual energy x-ray absorptiometry. Secondary outcomes examined changes in sarcopenia, assessed through appendicular skeletal mass (ASM) index (kg/m2), body fat %, strength, physical function, quality of life, MetS score and the MetS components of waist circumference, blood pressure, glucose, high-density lipoprotein-cholesterol, and triglyceride levels.
A total of 37 participants were randomized; 32 participated in the intervention (EXE n = 13; NoEXE n = 19). At baseline, 43.8% of participants were sarcopenic and 40.6% met the criteria for MetS. Post-intervention, EXE significantly improved lean mass (d = 0.9), sarcopenia prevalence (d = 0.8), body fat % (d = 1.1), strength (d = 0.8-3.0), and prostate cancer-specific quality of life (d = 0.9) compared to NoEXE (p < 0.05). No significant differences were observed between groups for physical function or MetS-related variables except waist circumference (d = 0.8).
A 12-week resistance training intervention effectively improved sarcopenia, body fat %, strength and quality of life in hypogonadal prostate cancer patients, but did not change MetS or physical function. PRO did not offer additional benefit in improving body composition.
ClinicalTrials.gov: NCT01909440 . Registered 24 July 2013.
BMC cancer. 2018 Apr 03*** epublish ***
Jacqueline K Dawson, Tanya B Dorff, E Todd Schroeder, Christianne J Lane, Mitchell E Gross, Christina M Dieli-Conwright
Divison of Biokinesiology and Physical Therapy, Ostrow School of Dentistry, University of Southern California, 1540 Alcazar Street, CHP-155, Los Angeles, CA, 90033, USA. ., Norris Comprehensive Cancer Center, Keck School of Medicine (KSOM), Los Angeles, CA, USA., Divison of Biokinesiology and Physical Therapy, Ostrow School of Dentistry, University of Southern California, 1540 Alcazar Street, CHP-155, Los Angeles, CA, 90033, USA., Department of Preventive Medicine, KSOM, Los Angeles, CA, USA., Ellison Institute for Transformative Medicine, KSOM, Los Angeles, CA, USA.