Maximal exercise testing of men with prostate cancer being treated with androgen deprivation therapy.
Exercise is being increasingly established as a key adjuvant therapy in clinical oncology. As research has demonstrated the beneficial effect of exercise for cancer management, a growing number of patients with cancer are undertaking structured exercise programs.


OBJECTIVE
This study aimed to determine the safety and feasibility of formal exercise testing in clinical settings as it is becoming increasingly used as a screening tool and for exercise prescription purposes.


METHODS
One hundred and twelve patients with prostate cancer undergoing androgen deprivation therapy (ADT) took part in a physician-supervised multistage maximal stress test (Bruce protocol). Sixty patients had been on ADT for <3 months (acute), whereas 52 had been on ADT for >3 months (chronic).


RESULTS
Of these men, 85% were able to meet the criteria for the attainment of V˙O2max, whereas three positive tests (3.2%) were observed. The three participants who recorded a positive stress test underwent further medical examination and were subsequently cleared of clinically significant cardiovascular disease. Apart from the relatively low V˙O2max (24.7 ± 6.0 mL·kg·min, 10th-15th percentile), compared with normative data in healthy age-matched controls, the cardiovascular response to exercise was similar in this cancer population. Moreover, treatment duration did not seem to influence cardiovascular responses to exercise. This early evidence suggests that risk of adverse events during maximal exercise testing is relatively low in this population and certainly no higher than that in ages-matched, apparently healthy individuals.


CONCLUSIONS
Maximal exercise testing was demonstrated to be feasible and safe, providing a direct assessment of V˙O2max. The relatively low number of positive tests in this study suggests that the risk of adverse events is relatively low in this population and certainly no higher than that in age-matched, apparently healthy individuals.
1School of Psychology and Exercise Science, Murdoch University, Murdoch, Western Australia, AUSTRALIA; 2Edith Cowan University Health and Wellness Institute, Edith Cowan University, Joondalup, Western Australia, AUSTRALIA; 3School of Environmental and Life Sciences, University of Newcastle, Ourimbah, New South Wales, AUSTRALIA; 4School of Human Movement Studies, University of Queensland, Brisbane, Queensland, AUSTRALIA; 5Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, AUSTRALIA; and 6Faculty of Medicine, University of Western Australia, Nedlands, Western Australia, AUSTRALIA.
Bradley A
BA
Wall
Daniel A
DA
Galvão
Naeem
N
Fatehee
Dennis R
DR
Taaffe
Nigel
N
Spry
David
D
Joseph
Robert U
RU
Newton
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000209:etiology; D004562:Electrocardiography; D005080:Exercise Test / Q000009:adverse effects; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000503:physiopathology*; D012307:Risk Factors
D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal