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ADT and Exercise

Erik D Hanson, André R Nelson, Daniel W D West, John A Violet, Lannie O'Keefe, Stuart M Phillips, Alan Hayes
Context: Androgen deprivation therapy (ADT) is a common prostate cancer (PCa) treatment but results in muscular atrophy. Periodic increases in muscle protein synthesis (MPS) that occur after resistance exercise or protein intake may ameliorate this muscle loss, but the impact of these anabolic stimuli during ADT is unclear. Objective: To determine the acute MPS response to whey protein supplementation with and without resistance exercise during ADT. Design: Acute response in PCa patients vs age-matched controls (CON)...
March 1, 2017: Journal of Clinical Endocrinology and Metabolism
Bradley A Wall, Daniel A Galvão, Naeem Fatehee, Dennis R Taaffe, Nigel Spry, David Joseph, Jeffrey J Hebert, Robert U Newton
INTRODUCTION: Prostate cancer is the most common cancer in men and patients treated with androgen deprivation therapy (ADT) experience unfavourbale changes in body composition and associated metabolic complications, which can increase the risk of cardiovascular disease. We examined the effect of a 6-month program of aerobic and resistance exercise aimed at improving body composition and cardiorespiratory health in this population. METHODS: Ninety-seven men (43-90 years) with localized prostate cancer receiving ADT were randomized to either exercise (EX, n=50) or usual care (CON, n=47)...
March 18, 2017: Medicine and Science in Sports and Exercise
Dennis R Taaffe, Robert U Newton, Nigel Spry, David Joseph, Suzanne K Chambers, Robert A Gardiner, Brad A Wall, Prue Cormie, Kate A Bolam, Daniel A Galvão
BACKGROUND: Physical exercise mitigates fatigue during androgen deprivation therapy (ADT); however, the effects of different exercise prescriptions are unknown. OBJECTIVES: To determine the long-term effects of different exercise modes on fatigue in prostate cancer patients undergoing ADT. DESIGN, SETTING, AND PARTICIPANTS: Between 2009 and 2012, 163 prostate cancer patients aged 43-90 y on ADT were randomised to exercise targeting the musculoskeletal system (impact loading+resistance training; ILRT; n=58), the cardiovascular and muscular systems (aerobic+resistance training; ART; n=54), or to usual care/delayed exercise (DEL; n=51) for 12 mo across university-affiliated exercise clinics in Australia...
February 26, 2017: European Urology
Niamh Liana Mundell, Robin M Daly, Helen Macpherson, Steve F Fraser
Androgen deprivation therapy (ADT) is an effective and widely prescribed treatment for prostate cancer (PCa), but it is associated with multiple treatment induced adverse effects that impact on various musculoskeletal and cardiometabolic health outcomes. Emerging research has shown that ADT is also associated with cognitive impairment, which has been linked to a loss of independence, increased falls and fracture risk and greater use of medical services. The aim of this review is to outline the evidence related to the effect of ADT use on cognitive function, and propose a role for exercise training as part of usual care to prevent and/or manage cognitive impairments for PCa survivors on ADT...
February 16, 2017: Endocrine-related Cancer
P J Owen, R M Daly, P M Livingston, S F Fraser
BACKGROUND: Men treated with androgen deprivation therapy (ADT) for prostate cancer are prone to multiple treatment-induced adverse effects, particularly with regard to a deterioration in bone health and altered body composition including decreased lean tissue mass and increased fat mass. These alterations may partially explain the marked increased risk in osteoporosis, falls, fracture and cardiometabolic risk that has been observed in this population. METHODS: A review was conducted that assessed standard clinical guidelines for the management of ADT-induced adverse effects on bone health and body composition in men with prostate cancer...
January 24, 2017: Prostate Cancer and Prostatic Diseases
M Keyes, G Merrick, S J Frank, P Grimm, M J Zelefsky
PURPOSE: Prostate brachytherapy (PB) has well-documented excellent long-term outcomes in all risk groups. There are significant uncertainties regarding the role of androgen deprivation therapy (ADT) with brachytherapy. The purpose of this report was to review systemically the published literature and summarize present knowledge regarding the impact of ADT on biochemical progression-free survival (bPFS), cause-specific survival (CSS), and overall survival (OS). METHODS AND MATERIALS: A literature search was conducted in Medline and Embase covering the years 1996-2016...
January 16, 2017: Brachytherapy
Katarzyna Hojan, Eliza Kwiatkowska-Borowczyk, Ewa Leporowska, Piotr Milecki
INTRODUCTION Previous studies have shown that physical exercise in cancer patients during radiation therapy (RT) and androgen deprivation therapy (ADT) improves cardiac fitness and quality of life (QoL), as well as reduces fatigue, but it is still not entirely known how it affects inflammation or metabolic factors and what its consequences are in patients with prostate cancer (PCa). OBJECTIVES The aim of the study was to assess the effect of a 12‑month physical exercise program on inflammatory and cardiometabolic parameters, as well as on functional status in patients with PCa undergoing RT and ADT...
January 10, 2017: Polish Archives of Internal Medicine
Ada S Cheung, Hans Gray, Anthony G Schache, Rudolf Hoermann, Daryl Lim Joon, Jeffrey D Zajac, Marcus G Pandy, Mathis Grossmann
BACKGROUND: Although muscle mass declines with testosterone deficiency in men, previous studies of muscle function have not demonstrated consistent deficits, likely due to relatively insensitive methodology. Our objective was to determine the effects of testosterone deprivation on the biomechanical function of individual lower-limb muscles. METHODS: We conducted a 12-month prospective, observational case-control study of 34 men newly commencing androgen deprivation treatment (ADT) for prostate cancer and 29 age-matched prostate cancer controls...
February 2017: Journal of Cachexia, Sarcopenia and Muscle
Ada S Cheung, Casey de Rooy, Rudolf Hoermann, Daryl Lim Joon, Jeffrey D Zajac, Mathis Grossmann
OBJECTIVE: While androgen deprivation therapy (ADT) has been associated with decreased quality of life (QoL), controlled prospective studies are lacking. We aimed to assess QoL during ADT using two validated questionnaires and determine contributing factors. DESIGN: Prospective controlled study. PATIENTS: Sixty-three men with nonmetastatic prostate cancer newly commencing ADT (n = 34) and age- and radiotherapy-matched prostate cancer controls (n = 29)...
March 2017: Clinical Endocrinology
Mark A Moyad, Robert U Newton, Ulf W Tunn, Damian Gruca
Improved diagnosis and treatment regimens have resulted in greater longevity for men with prostate cancer. This has led to an increase in both androgen deprivation therapy (ADT) use and duration of exposure, and therefore to its associated adverse effects, such as sexual dysfunction, osteoporosis, reduced muscle mass, increased fat mass, and increased incidence of cardiovascular disease and type 2 diabetes. Given that the adverse effects of ADT are systemic, often debilitating, and difficult to treat, efforts continue in the development of new strategies for long-term management of prostate cancer...
2016: Research and Reports in Urology
J L Cameron, R Jain, M Rais, A E White, T M Beer, P Kievit, K Winters-Stone, I Messaoudi, O Varlamov
BACKGROUND/OBJECTIVES: Androgen deprivation therapy (ADT) is commonly used for treatment of prostate cancer but is associated with side effects, such as sarcopenia and insulin resistance. The role of lifestyle factors such as diet and exercise on insulin sensitivity and body composition in testosterone-deficient males is poorly understood. The aim of the present study was to examine the relationships between androgen status, diet and insulin sensitivity. SUBJECTS/METHODS: Middle-aged (11-12 years old) intact and orchidectomized male rhesus macaques were maintained for 2 months on a standard chow diet and then exposed for 6 months to a Western-style, high-fat/calorie-dense diet (WSD) followed by 4 months of caloric restriction (CR)...
December 2016: International Journal of Obesity: Journal of the International Association for the Study of Obesity
Peter Østergren, Anne-Mette Ragle, Henrik Jakobsen, Tobias Wirenfeldt Klausen, Anders Vinther, Jens Sønksen
INTRODUCTION: Level 1 evidence supports the use of supervised exercise to mitigate the adverse effects of androgen deprivation therapy (ADT) in men with prostate cancer. The data, however, have been generated in controlled research settings and might not be transferable to daily clinical practice. This article describes the design of an ongoing prospective observational study to evaluate the potential benefits of exercise in daily clinical practice. METHODS AND ANALYSIS: Men diagnosed with prostate cancer starting or already receiving ADT at our facility are invited to participate in a 12-week exercise programme implemented as the standard of care...
June 29, 2016: BMJ Open
J L Kiwata, T B Dorff, E T Schroeder, M E Gross, C M Dieli-Conwright
Androgen deprivation therapy (ADT), a primary treatment for locally advanced or metastatic prostate cancer, is associated with the adverse effects on numerous physiologic parameters, including alterations in cardiometabolic variables that overlap with components of the metabolic syndrome (MetS). As MetS is an established risk factor for cardiovascular mortality and treatment for prostate cancer has been associated with the development of MetS, interventions targeting cardiometabolic factors have been investigated in prostate cancer patients to attenuate the detrimental effects of ADT...
December 2016: Prostate Cancer and Prostatic Diseases
Irena Rot, Richard J Wassersug, Lauren M Walker
BACKGROUND: Androgen deprivation therapy (ADT) side effects are numerous and negatively impact prostate cancer patients' quality of life. There is considerable discrepancy though among Canadian urologists regarding what ADT side effects and side effect management strategies. Little is known about global differences in ADT patient education. METHODS: International respondents were recruited via online posting and at an international urology conference. Hypotheses suggest that economic and cultural differences influence patient education practices; therefore, international respondents were divided into 3 categories (high, medium, and low gross domestic product)...
April 2016: Translational Andrology and Urology
Peter Busch Østergren, Caroline Kistorp, Finn Noe Bennedbæk, Jens Faber, Jens Sønksen, Mikkel Fode
Androgen deprivation therapy (ADT) induces severe hypogonadism and is associated with several adverse effects that negatively affect health and quality of life in patients with prostate cancer. ADT changes body composition characterized by an increase in fat mass and a reduction in muscle mass and strength. Insulin sensitivity is also diminished and population-based studies indicate an increased risk of diabetes mellitus and cardiovascular disease in men receiving ADT. Particularly the first 6 months of treatment seem to hold an additional risk of new cardiovascular events for patients with already existing cardiovascular disease...
June 2016: Nature Reviews. Urology
Cadeyrn J Gaskin, Steve F Fraser, Patrick J Owen, Melinda Craike, Liliana Orellana, Patricia M Livingston
PURPOSE: The main purpose of this study was to investigate the effects of a 12-week, clinician-referred, community-based exercise training program with supervised and unsupervised sessions for men with prostate cancer. The secondary purpose was to determine whether androgen deprivation therapy (ADT) modified responses to exercise training. METHODS: Secondary analysis was undertaken on data from a multicentre cluster randomised controlled trial in which 15 clinicians were randomly assigned to refer eligible patients to an exercise training intervention (n = 8) or to provide usual care (n = 7)...
December 2016: Journal of Cancer Survivorship: Research and Practice
Saleha Sajid, William Dale, Karen Mustian, Ashwin Kotwal, Charles Heckler, Michelle Porto, Chunkit Fung, Supriya G Mohile
BACKGROUND: Androgen deprivation therapy (ADT) can decrease the physical performance (PP) of older men with prostate cancer (PC). METHODS: We conducted a three-arm randomized pilot study (n=19) comparing a home-based walking and resistance intervention (EXCAP) and a technology-mediated walking and resistance intervention using Wii-Fit to a usual-care arm in men ≥70 years with PC receiving ADT. The intervention lasted for 6 weeks, with follow-up at 12 weeks. The primary pre-specified outcome was change in Short Physical Performance Battery (SPPB) score...
March 2016: Journal of Geriatric Oncology
Katie Canalichio, Yasmeen Jaber, Run Wang
Prostate cancer (PC) is one of the most common cancers effecting men today. With earlier detection and improvements in available treatment modalities, there still remains significant morbidity associated with the treatment of PC. Male sexual health and erectile function are greatly impacted by these therapies and remain a concern to PC survivors. This article reviews the current literature on male sexual health following radical prostatectomy (RP) or androgen ablation therapy for PC. Each treatment modality affects male sexual function to an appreciable level, although certain patients have better outcomes if they have preoperative potency, are younger, or have nerve-sparing surgery...
April 2015: Translational Andrology and Urology
Stephen E Gilbert, Garry A Tew, Caroline Fairhurst, Liam Bourke, John M Saxton, Edward M Winter, Derek J Rosario
BACKGROUND: Treatment of prostate cancer with androgen deprivation therapy (ADT) is associated with metabolic changes that have been linked to an increase in cardiovascular risk. METHODS: This randomised controlled trial investigated the effects of a 12-week lifestyle intervention that included supervised exercise training and dietary advice on markers of cardiovascular risk in 50 men on long-term ADT recruited to an on-going study investigating the effects of such a lifestyle intervention on quality of life...
February 16, 2016: British Journal of Cancer
Laisa Teleni, Raymond J Chan, Alexandre Chan, Elisabeth A Isenring, Ian Vela, Warrick J Inder, Alexandra L McCarthy
Men receiving androgen deprivation therapy (ADT) for prostate cancer (PCa) are likely to develop metabolic conditions such as diabetes, cardiovascular disease, abdominal obesity and osteoporosis. Other treatment-related side effects adversely influence quality of life (QoL) including vasomotor distress, depression, anxiety, mood swings, poor sleep quality and compromised sexual function. The objective of this study was to systematically review the nature and effects of dietary and exercise interventions on QoL, androgen deprivation symptoms and metabolic risk factors in men with PCa undergoing ADT...
February 2016: Endocrine-related Cancer
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