Randomized Controlled Trial Of Resistance Or Aerobic Exercise In Men Receiving Radiation Therapy For Prostate Cancer

Fatigue is the most common complaint among patients undergoing radiotherapy (XRT) for prostate cancer (CaP) and occurs in 60-80% of these men. It persists after treatment is completed and can decrease quality-of-life and functional capacity. In the December 2008 issue of the Journal of Clinical Oncology, Dr. Segal and colleagues report on the benefit of an exercise program during XRT with the hypothesis that it would improve patient related fatigue and quality-of-life. Modest benefits were observed.

A total of 325 eligible patients were approached and 121 agreed to randomization for this prospective study. Three arms comprised the study, usual care (n=41), resistance exercise training (n=40), and aerobic exercise training (=40). Both exercise groups were under the supervision of an exercise specialist and had a warm up period followed by exercise regimens that increased over the 24-week period. Resistance training was 3 times per week performing 2 sets of difference resistance exercises. Aerobic training was 3 times per week and ultimately increased to 45 minutes per session. Patients rated outcomes pertaining to fatigue, CaP-specific and cancer specific QOL.

Objective measured outcomes such as strength, body weight, body fat percentage, and serum lipids were assessed. Participants completed a median of 88% of resistance and 83% of aerobic scheduled sessions. Only one significant morbidity occurred - a non-fatal myocardial infarction. Fifteen percent of participants also reported regular exercise outside of the study.

Regarding fatigue, no main effect was found for the group, but fatigue was improved with resistance and aerobic training compared with usual care from baseline to 12 weeks. From baseline to 24 weeks, only resistance exercise was superior to usual care. CaP-specific QOL declined over time, but no difference between groups was found. VO2peak was superior with both exercise programs compared to usual care, and resistance training attenuated increases in body fat percentage and triglycerides. Thus, a resistance exercise program has both short and long term benefits on fatigue associated with XRT for CaP.

Segal RJ, Reid RD, Courneya KS, Sigal RJ, Kenny GP, Prud'homme DG, Malone SC, Wells GA, Scott CG, Slovinec D'Angelo ME
J Clin Oncol. 2009 Jan 20;27(3):344-51
10.1200/JCO.2007.15.4963