title: Lifestyle changes for improving disease-specific quality of life in sedentary men on long-term androgen-deprivation therapy for advanced prostate cancer: a randomised controlled trial.
abstract: BACKGROUND
  Prostate cancer is a key driver of cancer-related global disability-adjusted life-years. Androgen-deprivation therapy (ADT) for advanced disease is linked to fatigue, reduced physical function, and quality of life (QoL).
  
  
  OBJECTIVE
  To evaluate the effect of a lifestyle intervention on disease-specific QoL, diastolic blood pressure, and cancer-related fatigue in sedentary men receiving long-term ADT for advanced prostate cancer.
  
  
  METHODS
  A total of 100 hundred sedentary men with locally advanced or metastatic prostate cancer on long-term ADT were randomised to an intervention or usual care group.
  
  
  METHODS
  A 12-wk lifestyle intervention consisting of aerobic and resistance exercise with parallel dietary advice.
  
  
  METHODS
  Disease-specific QoL was measured using the Functional Assessment of Cancer Therapy-Prostate (FACT-P) and Functional Assessment of Cancer Therapy-Fatigue (FACT-F) questionnaires at 12 wk postintervention and at 6 mo following withdrawal of support. Analysis of covariance and mixed regression were conducted.
  
  
  CONCLUSIONS
  Clinically relevant improvements in FACT-P were seen at 12 wk in the intervention group compared with controls (mean difference: 8.9 points; 95% confidence interval [CI], 3.7-14.2; adjusted p=0.001). No difference was apparent at 6 mo (mean difference: 3.3 points; 95% CI, -2.6 to 9.3; adjusted p=0.27). No difference in diastolic blood pressure was seen at either follow-up (all p > 0.05). Clinically relevant improvements in FACT-F were seen at 12 wk (mean difference: 5.3 points; 95% CI, 2.7-7.9; adjusted p<0.001) and maintained following withdrawal of supervision (mean difference: 3.9 points; 95% CI, 1.1-6.8; adjusted p=0.007). Improvements in exercise tolerance and behaviour were maintained at 6 mo (adjusted p<0.001 and 0.038).
  
  
  CONCLUSIONS
  A lifestyle intervention resulted in a clinically meaningful improvement in disease-specific QoL that was not maintained postintervention. No effect on blood pressure occurred. Durability of response was seen in fatigue and exercise behaviour. Further evaluation of support structures is essential.
  
  
  BACKGROUND
  ISRCTN88605738.
authors.affiliation: Department of Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
authors.forename: Liam
authors.initials: L
authors.lastname: Bourke
authors.affiliation: Centre for Sport and Exercise Science, Sheffield Hallam University, Sheffield, UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: Gilbert
authors.affiliation: Department of Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Hooper
authors.affiliation: Department of Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
authors.forename: Liz A
authors.initials: LA
authors.lastname: Steed
authors.affiliation: Department of Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
authors.forename: Miland
authors.initials: M
authors.lastname: Joshi
authors.affiliation: Academic Urology Unit, Department of Oncology, Royal Hallamshire Hospital, University of Sheffield, Sheffield, UK.
authors.forename: Jim W F
authors.initials: JW
authors.lastname: Catto
authors.affiliation: School of Rehabilitation Sciences, University of East Anglia, Norwich, UK.
authors.forename: John M
authors.initials: JM
authors.lastname: Saxton
authors.affiliation: Academic Urology Unit, Department of Oncology, Royal Hallamshire Hospital, University of Sheffield, Sheffield, UK. Electronic address: d.j.rosario@sheffield.ac.uk.
authors.forename: Derek J
authors.initials: DJ
authors.lastname: Rosario
mesh_terms: D000368:Aged; D000726:Androgen Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D001794:Blood Pressure; D004032:Diet; D004041:Dietary Fats; D005081:Exercise Therapy; D017079:Exercise Tolerance / Q000502:physiology; D005221:Fatigue / Q000139:chemically induced / Q000628:therapy*; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000503:physiopathology; D011788:Quality of Life; D055070:Resistance Training; D057185:Sedentary Behavior; D016037:Single-Blind Method; D011795:Surveys and Questionnaires
chemical_list: D000726:Androgen Antagonists; D004041:Dietary Fats
keywords: Androgen deprivation therapy; Diastolic blood pressure; Diet; Exercise; Fatigue; Prostate cancer; Quality of life