title: Exercise for Men with Prostate Cancer: A Systematic Review and Meta-analysis.
abstract: BACKGROUND
  Exercise could be beneficial for prostate cancer survivors. However, no systematic review across cancer stages and treatment types addressing potential benefits and harms exists to date.
  
  
  OBJECTIVE
  To assess the effects of exercise on cancer-specific quality of life and adverse events in prostate cancer trials.
  
  
  METHODS
  We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, AMED, CINAHL, PsycINFO, SPORTDiscus, and PEDro. We also searched grey literature databases, including trial registers. Searches were from database inception to March 2015. Standardised mean differences (SMDs) were calculated for meta-analysis.
  
  
  RESULTS
  We included 16 randomised controlled trials (RCTs) involving 1574 men with prostate cancer. Follow-up varied from 8 wk to 12 mo. RCTs involved men with stage I-IV cancers. A high risk of bias was frequently due to problematic intervention adherence. Seven trials involving 912 men measured cancer-specific quality of life. Pooling of the data from these seven trials revealed no significant effect on this outcome (SMD 0.13, 95% confidence interval [CI] -0.08 to 0.34, median follow-up 12 wk). Sensitivity analysis of studies that were judged to be of high quality indicated a moderate positive effect estimate (SMD 0.33, 95% CI 0.08-0.58; median follow-up 12 wk). Similar beneficial effects were seen for cancer-specific fatigue, submaximal fitness, and lower body strength. We found no evidence of benefit for disease progression, cardiovascular health, or sexual function. There were no deaths attributable to exercise interventions. Other serious adverse events (eg, myocardial infarction) were equivalent to those seen in controls.
  
  
  CONCLUSIONS
  These results support the hypothesis that exercise interventions improve cancer-specific quality of life, cancer-specific fatigue, submaximal fitness, and lower body strength.
  
  
  RESULTS
  This review shows that exercise/physical activity interventions can improve quality of life, fatigue, fitness, and function for men with prostate cancer.
authors.affiliation: Health and Wellbeing Research Institute, Centre for Sport and Exercise Science, Sheffield Hallam University, Sheffield, UK. Electronic address: l.bourke@shu.ac.uk.
authors.forename: Liam
authors.initials: L
authors.lastname: Bourke
authors.affiliation: Geography & Environment, University of Southampton, Southampton, UK.
authors.forename: Dianna
authors.initials: D
authors.lastname: Smith
authors.affiliation: Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
authors.forename: Liz
authors.initials: L
authors.lastname: Steed
authors.affiliation: Centre for 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: Health and Wellbeing Research Institute, Centre for Sport and Exercise Science, Sheffield Hallam University, Sheffield, UK.
authors.forename: Anouska
authors.initials: A
authors.lastname: Carter
authors.affiliation: Academic Urology Unit and Institute for Cancer Studies, The Medical School, University of Sheffield, Sheffield, UK.
authors.forename: James
authors.initials: J
authors.lastname: Catto
authors.affiliation: Department of Surgery, Division of Urology, University of Connecticut Health Center, Farmington, CT, USA.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Albertsen
authors.affiliation: University Clinics Saint Luc/Catholic University of Louvain, Brussels, Belgium.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Tombal
authors.affiliation: Department of Oncology, University College London Hospitals, London, UK.
authors.forename: Heather A
authors.initials: HA
authors.lastname: Payne
authors.affiliation: Department of Oncology, University of Sheffield, Sheffield, UK.
authors.forename: Derek J
authors.initials: DJ
authors.lastname: Rosario
mesh_terms: D016009:Chi-Square Distribution; D005081:Exercise Therapy / Q000009:adverse effects; D005221:Fatigue / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D006304:Health Status; D006801:Humans; D008297:Male; D053580:Muscle Strength; D009367:Neoplasm Staging; D016017:Odds Ratio; D010809:Physical Fitness; D011471:Prostatic Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Adverse effects; Exercise; Fatigue; Prostate cancer; Quality of life