Prostate cancer treatment and fatigue
Prostate cancer patients often take androgen-deprivation drugs to slow the rate of cancer progression. However, such drugs have side-effects including increased levels of fatigue and lower quality of life. Exercise can reduce fatigue but which exercise regimes reduce fatigue the most was previously unknown. Researchers in Australia conducted a year-long randomized controlled trial to determine which of three exercise interventions would best diminish fatigue and increase vitality of prostate cancer patients. The exercise programs included 1) impact loading and resistance training (ILRT), 2) aerobic and resistance training (ART), and 3) usual care supplemented with information about the health benefits of exercise for six months followed by six months of delayed aerobic and flexibility exercise (DEL). Participants included 163 men with an average of 69 years with diagnosed prostate cancer and undergoing androgen-deprivation therapy. Supervised twice-weekly exercise sessions included a variety of movements that differed across the groups.
Fatigue significantly declined and vitality significantly increased in all three groups at 12 months with no significant differences among the groups. Both cardiovascular fitness and muscle strength increased significantly for ILRT and ART but only marginally for DEL. Patients with the highest levels of fatigue at baseline showed the greatest benefit from the exercise programs. Thus, prostate cancer patients undergoing androgen-depriving therapy may experience less fatigue and better quality of life by increasing their levels of exercise.
Prostate cancer treatment and bone mineral density
The list of adverse effects of androgen-depriving drug drugs for prostate cancer patients also includes diminished bone mineral density (BMD). Reduced BMD increases risks of osteoporosis and fractures. Bisphosphonates are widely prescribed to increase BMD but have their own serious drawbacks. Researchers in Australia also conducted a year-long randomized controlled trial to determine the ability of the same three exercise interventions to preserve or increase BMD. Participants in this study included 154 men with an average of 69 years with diagnosed prostate cancer and undergoing androgen-deprivation therapy. After one year, BMD at the lumbar spine and femoral neck and declined significantly by 0.5 to 3.0 percent in all three interventions. The ILRT group experienced the least amount of decline at both lumbar spine and femoral neck (0.5 and 2.0 percent, respectively). This study suggests that impact exercise, such as jumping, hopping, and leaping, slowed the decline in BMD more than aerobic or general exercise.
Exercise programs work for cancer patients
A recent review documented the benefits of combining exercise, particularly resistance training, with cancer treatment. Resistance exercise leads to increased muscle mass and strength, along with improved balance, mobility, and body composition, plus lower risk of falls. Ideally, resistance training would feature individualized, high-intensity movements align with normal mobility patterns and are suitable for the patient. Training should occur 2 or 3 times per week with sessions lasting up to an hour. An exercise specialist should develop a plan in consultation with the patient and supervise the exercise sessions, at least initially, to make sure the patient uses correct form. Evidence supports the idea that cancer survivors who follow a structured, supervised exercise plan can participate in resistance training and build muscle mass and strength, balance, mobility, and improve body composition with minimal risk of injury.
Cancer doctors weigh in on exercise and diet
Persons with obesity have elevated risks of cancer and other adverse health outcomes. The proven ability of GLP-1 inhibitors to induce substantial weight loss has prompted the medical establishment to recommend weight-loss drugs to accompany cancer treatment for patients with obesity. However, GLP-1 inhibitors can lead substantial loss of muscle mass, which increases risks of sarcopenia, frailty, falls, and mobility disability. Thus, solving one problem (reducing obesity) may lead to other problems. A trio of cancer doctors urges their colleagues to favor a different approach: increased physical activity, especially resistance training, and better diet, both of which effectively maintain muscle mass over time. The drawback of this approach lies in the reluctance of most patients to boost their physical activity and eat better as a new way of living. Thus, these doctors urge that GLP-1 inhibitors should be prescribed only when prescriptions to increase physical activity and improve diet have failed.
Surviving colon cancer with exercise
A new randomized trial confirmed previous studies that found that structured exercise following cancer treatment increased patient survival. The new trial included 889 patients with an average baseline age of 61 years at 55 medical centers mostly in Canada and Australia. All patients had finished their treatment following surgery to remove colon cancer within 2-6 months prior to the start of the trial. Patients were randomized into one of two groups. The health education group included materials that promoted physical activity and nutrition. The exercise group included the educational materials plus an exercise guidebook for cancer survivors and support from an exercise consultant for 3 years. The exercise program featured behavior-change techniques, supervised exercise sessions, and in-person or video support sessions. The goal of the exercise program was to increase progressively the amount of brisk walking over 3 years.
Adherence to the mandatory behavioral support sessions ranged from 83 percent during the first 6 months to 59 percent for the final 6 months. After a median follow-up of 7.9 years, patients in the exercise group had a significant 37 percent lower risk of dying compared to patients in the health education group. Exercise also significantly increased disease-free survival, thereby increasing quality of lifespan. Both groups increased their levels of physical activity, cardiorespiratory fitness and physical functioning over 3 years, although patients in the exercise program achieved much higher amounts of moderate to vigorous exercise than the patients in the health education program. Thus, simply providing information about the benefits of exercise and nutrition was less effective than providing information and long-term support.
Breast cancer, exercise, diet
Higher levels of body fat predict increased risk of breast cancer recurrence. Plus, women who gain weight during and after breast cancer treatment have increased risks of cancer recurrence, metastases, and death. Cancer researchers tested whether a 3-month, thrice-weekly program of progressive weight training coupled with a healthy low-carbohydrate diet would reduce body fat and increase muscle mass and strength in 44 breast cancer patients. Certified exercise specialists supervised the exercise sessions that used inexpensive free weights. The healthy low-carb diet mirrored the DIETFITS diet developed at Stanford University and included high amounts of fruits and colorful non-starchy vegetables and minimal amounts of sugar, refined carbohydrates, bread and pasta. Participants were also advised to eat at home with family as much as possible and avoid junk food.
In fact, the program accomplished its objectives. Over 3 months, body fat significantly decreased by 4 lbs., while muscle mass significantly increased by 1 lb. In addition, patients significantly improved three measures of quality of life. The researchers attributed the program’s success to its emphasis on encouraging participants to push themselves to lift higher loads to increase muscle mass and reduce fat mass without increased risk of injury in a closely supervised setting.
What to do
If you or someone you know is undergoing cancer treatment, you might mention to this person that more exercise and a better diet might help him or her life better and longer through the rigors of treatment.
