Exercise improves quality of life, but not metabolic risk factors in men with prostate cancer undergoing androgen deprivation therapy –results of a meta-analysis. (#170)
Background: Men receiving androgen deprivation therapy (ADT) for prostate cancer (PCa) are more likely to develop a range of metabolic conditions such as diabetes,3 cardiovascular disease,4 abdominal obesity and osteoporosis.1 Other treatment-related side effects that adversely influence quality of life (QoL) and function include vasomotor distress, depression and anxiety, mood swings, poor sleep quality and compromised sexual function (i.e., androgen deficiency symptoms).2
Aim: To systematically review the effects of exercise on the QoL, androgen deprivation symptoms and metabolic risk factors in men with PCa undergoing ADT.
Method: An online electronic search of CINAHL, Cochrane CENTRAL, Medline, PsychINFO and reference lists was performed to identify peer-reviewed publications from January 2004 and December, 2014 in English. Eligible study designs included randomised controlled trials with pre- and post-intervention data. Data abstraction and risk of bias assessment with the Cochrane approach was conducted by two independent reviewers. Data was extracted regarding participant and exercise characteristics as well as the effects of exercise on metabolic risk factors, androgen deprivation symptoms and QoL.
Results: Seven exercise studies were identified. Exercise significantly improved health-related QoL (SMD=0.29; 95%CI = 0.10, 0.49) and disease-related QoL (SMD=0.36; 95%CI = 0.11, 0.61). Exercise did not significantly improve metabolic risk factors including weight, waist circumferences, lean body mass, total or percentage fat mass, blood pressure or lipid profiles. No studies evaluated androgen-deficiency symptoms (i.e., libido, erectile function, sleep quality and insomnia, mood swings, depression or anxiety or bone mineral density).
Conclusion: The evidence from randomised controlled trials indicates that exercise has a small to moderate effect; significantly improving health- and disease-related quality of life, but not metabolic risk factors. Despite the known effects of ADT, there is a lack of data for the effects of exercise on bone mineral density and other androgen deficiency symptoms.
- Grossmann M, Hamilton EJ, Gilfillan C, et al: Bone and metabolic health in patients with non-metastatic prostate cancer who are receiving androgen deprivation therapy. Med J Aust 194:301-6, 2011
- Chipperfield K, Brooker J, Fletcher J, et al: The impact of physical activity on psychosocial outcomes in men receiving androgen deprivation therapy for prostate cancer: A systematic review. Health Psychology 33:1288-1297, 2014
- Saylor PJ, Smith MR: Metabolic complications of androgen deprivation therapy for prostate cancer. Journal of Urology 181:1998-2006
- Zhao J, Zhu S, Sun L, et al: Androgen deprivation therapy for prostate cancer is associated with cardiovascular morbidity and mortality: a meta-analysis of population-based observational studies. PloS one 9:e107516, 2014