Dietary factors and physical activity may alter prostate cancer progression. We explored the feasibility of lifestyle interventions following radical prostatectomy for localised prostate cancer.
Patients were recruited into a presurgical observational cohort; following radical prostatectomy, they were offered randomisation into a 2×3 factorial randomised controlled trial (RCT).
A single National Health Service trust in the South West of England, UK.
Those with localised prostate cancer and listed for radical prostatectomy were invited to participate.
Random allocation was performed by the Bristol Randomised Trial Collaboration via an online system.
Men were randomised into both a modified nutrition group (either increased vegetable and fruit, and reduced dairy milk; or lycopene supplementation; or control) and a physical activity group (brisk walking or control) for 6 months.
Only the trial statistician was blind to allocations.
Primary outcomes were measures of feasibility: randomisation rates and intervention adherence at 6 months. Collected at trial baseline, three and six months, with daily adherence reported throughout. Our intended adherence rate was 75% or above, the threshold for acceptable adherence was 90%.
108 men entered the presurgical cohort, and 81 were randomised into the postsurgical RCT (randomisation rate: 93.1%) and 75 completed the trial. Of 25 men in the nutrition intervention, 10 (40.0%; 95% CI 23.4% to 59.3%) adhered to the fruit and vegetable recommendations and 18 (72.0%; 95% CI 52.4% to 85.7%) to reduced dairy intake. Adherence to lycopene (n=28), was 78.6% (95% CI 60.5% to 89.8%), while 21/39 adhered to the walking intervention (53.8%; 95% CI 38.6% to 68.4%). Most men were followed up at 6 months (75/81; 92.6%). Three 'possibly related' adverse events were indigestion, abdominal bloating and knee pain.
Interventions were deemed feasible, with high randomisation rates and generally good adherence. A definitive RCT is proposed.
BMJ open. 2019 Nov 06*** epublish ***
Lucy E Hackshaw-McGeagh, Chris Penfold, Ellie Shingler, Luke A Robles, Claire M Perks, Jeff M P Holly, Edward Rowe, Anthony Koupparis, Amit Bahl, Raj Persad, Constance Shiridzinomwa, Lyndsey Johnson, Kalina M Biernacka, Aleksandra Frankow, Jayne V Woodside, Sarah Gilchrist, Jon Oxley, Paul Abrams, J Athene Lane, Richard M Martin
National Institute for Health Research (NIHR) Biomedical Research Centre (Nutrition Theme), University of Bristol, Bristol, UK., National Institute for Health Research (NIHR) Biomedical Research Centre (Surgical Innovation Theme), Musculoskeletal Research Unit, University of Bristol, Bristol, UK., Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK., Bristol Medical School: Translational Health Sciences, University of Bristol, Bristol, UK., Bristol Urology Institute, Department of Urology, North Bristol NHS Trust, Bristol, UK., Bristol Haematology and Oncology Centre, University Hospitals Bristol, Bristol, UK., Clinical Research Centre, North Bristol NHS Trust, Bristol, UK., Institute for Global Food Security, Queens University Belfast, Belfast, UK., Department of Cellular Pathology, North Bristol NHS Trust, Bristol, UK., Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK .