Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Effects of high-intensity interval training compared with resistance training in prostate cancer patients undergoing radiotherapy: a randomized controlled trial

Abstract

Background

Exercise training has shown beneficial effects in the management of radiotherapy-related side effects in prostate cancer (PCa) patients undergoing radiation therapy (RT). However, the optimal modality of the exercise programs have not been yet determined. The aim of this randomized controlled trial was to investigate the effects of high-intensity interval training (HIIT) and resistance training (RES) compared to usual care (UC) on cancer-treatment-related fatigue (CTRF) (primary outcome), quality of life, depression, daytime sleepiness, insomnia, sleep quality, functional exercise capacity and executive function in PCa patients during RT.

Methods

PCa patients undergoing RT with or without ADT were randomized in HIIT, RES or UC. Both exercise programs included three sessions per week during 5–8 weeks. HIIT consisted of 8–15 × 60 s intervals (≥85% maximal heart rate). RES was performed with 1–3 sets of 8–12 repetitions for each large muscle groups. The primary outcome was changed in CTRF measured with the Functional Assessment of Chronic Illness Therapy–Fatigue.

Results

Seventy-two subjects (69.1 ± 8.2 years) completed the study. No exercise-related adverse events occurred. HIIT (p = 0.012) and RES (p = 0.039) training attenuated increases in CTRF compared to UC. Functional exercise capacity, evaluated by the 6-min walk test, increased after HIIT (p = 0 = 0.43) and RES (p = 0.041) compared to UC (+0.1%). No other secondary variables were different between groups.

Conclusions

Both intervention groups displayed beneficial effects on CTRF and functional exercise capacity in PCa patients undergoing RT. In addition, HIIT and RES are both safe with an excellent attendance rate to the exercise sessions.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.

from$8.99

All prices are NET prices.

Fig. 1: Overview of HIIT protocol of the first session.
Fig. 2: CONSORT flow diagram.

References

  1. 1.

    Parker C, Gillessen S, Heidenreich A, Horwich A. Cancer of the prostate: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2015;26:v69–77.

    PubMed  Google Scholar 

  2. 2.

    Bacon CG, Giovannucci E, Testa M, Kawachi I. The impact of cancer treatment on quality of life outcomes for patients with localized prostate cancer. J Urol. 2001;166:1804–10.

    CAS  PubMed  Google Scholar 

  3. 3.

    Potosky AL, Legler J, Albertsen PC, Stanford JL, Gilliland FD, Hamilton AS, et al. Health outcomes after prostatectomy or radiotherapy for prostate cancer: results from the Prostate Cancer Outcomes Study. J Natl Cancer Inst. 2000;92:1582–92.

    CAS  PubMed  Google Scholar 

  4. 4.

    Miaskowski C, Paul SM, Cooper BA, Lee K, Dodd M, West C, et al. Trajectories of fatigue in men with prostate cancer before, during, and after radiation therapy. J Pain Symptom Manag. 2008;35:632–43.

    Google Scholar 

  5. 5.

    Truong PT, Berthelet E, Lee JC, Petersen R, Lim JT, Gaul CA, et al. Prospective evaluation of the prevalence and severity of fatigue in patients with prostate cancer undergoing radical external beam radiotherapy and neoadjuvant hormone therapy. Can J Urol. 2006;13:3139–46.

    PubMed  Google Scholar 

  6. 6.

    Storey DJ, McLaren DB, Atkinson MA, Butcher I, Liggatt S, O’Dea R, et al. Clinically relevant fatigue in recurrence-free prostate cancer survivors. Ann Oncol. 2012;23:65–72.

    CAS  PubMed  Google Scholar 

  7. 7.

    Feng LR, Espina A, Saligan LN. Association of fatigue intensification with cognitive impairment during radiation therapy for prostate cancer. Oncology. 2018;94:363–72.

    PubMed  PubMed Central  Google Scholar 

  8. 8.

    Hess CB, Chen AM. Measuring psychosocial functioning in the radiation oncology clinic: a systematic review. Psychooncology. 2014;23:841–54.

    PubMed  Google Scholar 

  9. 9.

    Vena C, Parker K, Cunningham M, Clark J, McMillan S. Sleep-wake disturbances in people with cancer part I: an overview of sleep, sleep regulation, and effects of disease and treatment. Oncol Nurs Forum. 2004;31:735–46.

    PubMed  Google Scholar 

  10. 10.

    Gogou P, Tsilika E, Parpa E, Kouvaris I, Damigos D, Balafouta M, et al. The impact of radiotherapy on symptoms, anxiety and QoL in patients with cancer. Anticancer Res. 2015;35:1771–5.

    PubMed  Google Scholar 

  11. 11.

    Windsor PM, Nicol KF, Potter J. A randomized, controlled trial of aerobic exercise for treatment-related fatigue in men receiving radical external beam radiotherapy for localized prostate carcinoma. Cancer. 2004;101:550–7.

    PubMed  Google Scholar 

  12. 12.

    Monga U, Garber SL, Thornby J, Vallbona C, Kerrigan AJ, Monga TN, et al. Exercise prevents fatigue and improves quality of life in prostate cancer patients undergoing radiotherapy. Arch Phys Med Rehabil. 2007;88:1416–22.

    PubMed  Google Scholar 

  13. 13.

    Segal RJ, Reid RD, Courneya KS, Sigal RJ, Kenny GP, Prud’Homme DG, et al. Randomized controlled trial of resistance or aerobic exercise in men receiving radiation therapy for prostate cancer. J Clin Oncol. 2009;27:344–51.

    PubMed  Google Scholar 

  14. 14.

    Truong PT, Gaul CA, McDonald RE, Petersen RB, Jones SO, Alexander AS, et al. Prospective evaluation of a 12-week walking exercise program and its effect on fatigue in prostate cancer patients undergoing radical external beam radiotherapy. Am J Clin Oncol. 2011;34:350–5.

    PubMed  Google Scholar 

  15. 15.

    Hojan K, Kwiatkowska-Borowczyk E, Leporowska E, Gorecki M, Ozga-Majchrzak O, Milecki T, et al. Physical exercise for functional capacity, blood immune function, fatigue, and quality of life in high-risk prostate cancer patients during radiotherapy: a prospective, randomized clinical study. Eur J Phys Rehabil Med. 2016;52:489–501.

    PubMed  Google Scholar 

  16. 16.

    Piraux E, Caty G, Aboubakar Nana F, Reychler G. Effects of exercise therapy in cancer patients undergoing radiotherapy treatment: a narrative review. SAGE Open Med 2020; 8: 2050312120922657.

  17. 17.

    Weston KS, Wisloff U, Coombes JS. High-intensity interval training in patients with lifestyle-induced cardiometabolic disease: a systematic review and meta-analysis. Br J Sports Med. 2014;48:1227–34.

    PubMed  Google Scholar 

  18. 18.

    Gibala MJ, Little JP, Macdonald MJ, Hawley JA. Physiological adaptations to low-volume, high-intensity interval training in health and disease. J Physiol. 2012;590:1077–84.

    CAS  PubMed  PubMed Central  Google Scholar 

  19. 19.

    Eng L, Pringle D, Su J, Shen X, Mahler M, Niu C, et al. Patterns, perceptions, and perceived barriers to physical activity in adult cancer survivors. Support Care Cancer. 2018;26:3755–63.

    PubMed  Google Scholar 

  20. 20.

    Mugele H, Freitag N, Wilhelmi J, Yang Y, Cheng S, Bloch W, et al. High-intensity interval training in the therapy and aftercare of cancer patients: a systematic review with meta-analysis. J Cancer Surviv. 2019;13:205–23.

    PubMed  Google Scholar 

  21. 21.

    Moher D, Hopewell S, Schulz KF, Montori V, Gotzsche PC, Devereaux PJ, et al. CONSORT 2010 Explanation and Elaboration: Updated guidelines for reporting parallel group randomised trials. J Clin Epidemiol. 2010;63:e1–37.

    PubMed  Google Scholar 

  22. 22.

    Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14:377–81.

    CAS  PubMed  Google Scholar 

  23. 23.

    Yellen SB, Cella DF, Webster K, Blendowski C, Kaplan E. Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system. J Pain Symptom Manag. 1997;13:63–74.

    CAS  Google Scholar 

  24. 24.

    Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, et al. The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol. 1993;11:570–9.

    CAS  PubMed  Google Scholar 

  25. 25.

    Radloff LS. The CES-D scale: A self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1:385–401.

    Google Scholar 

  26. 26.

    Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14:540–5.

    CAS  Google Scholar 

  27. 27.

    Morin CM. Insomnia: psychological assessment and management. New-York: Guilford Press; 1993.

  28. 28.

    Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28:193–213.

    CAS  Google Scholar 

  29. 29.

    Holland AE, Spruit MA, Troosters T, Puhan MA, Pepin V, Saey D, et al. An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease. Eur Respir J. 2014;44:1428–46.

    PubMed  Google Scholar 

  30. 30.

    Spreen O, Strauss E. A compendium of neuropsychological tests: administration, norms and commentary. 2nd ed. New-York: Oxford University Press; 1998.

  31. 31.

    Cella D, Eton DT, Lai JS, Peterman AH, Merkel DE. Combining anchor and distribution-based methods to derive minimal clinically important differences on the Functional Assessment of Cancer Therapy (FACT) anemia and fatigue scales. J Pain Symptom Manag. 2002;24:547–61.

    Google Scholar 

  32. 32.

    Campbell KL, Winters-Stone KM, Wiskemann J, May AM, Schwartz AL, Courneya KS, et al. Exercise guidelines for cancer survivors: consensus statement from international multidisciplinary roundtable. Med Sci Sports Exerc. 2019;51:2375–90.

    PubMed  Google Scholar 

  33. 33.

    Mustian KM, Alfano CM, Heckler C, Kleckner AS, Kleckner IR, Leach CR, et al. Comparison of pharmaceutical, psychological, and exercise treatments for Cancer-Related Fatigue: a meta-analysis. JAMA Oncol. 2017;3:961–8.

    PubMed  PubMed Central  Google Scholar 

  34. 34.

    Taaffe DR, Newton RU, Spry N, Joseph D, Chambers SK, Gardiner RA, et al. Effects of different exercise modalities on fatigue in prostate cancer patients undergoing androgen deprivation therapy: a year-long randomised controlled trial. Eur Urol. 2017;72:293–9.

    PubMed  Google Scholar 

  35. 35.

    Galvão DA, Taaffe DR, Spry N, Joseph D, Newton RU. Combined resistance and aerobic exercise program reverses muscle loss in men undergoing androgen suppression therapy for prostate cancer without bone metastases: a randomized controlled trial. J Clin Oncol. 2010;28:340–7.

    PubMed  Google Scholar 

  36. 36.

    Segal RJ, Reid RD, Courneya KS, Malone SC, Parliament MB, Scott CG, et al. Resistance exercise in men receiving androgen deprivation therapy for prostate cancer. J Clin Oncol. 2003;21:1653–9.

    PubMed  Google Scholar 

  37. 37.

    LaVoy EC, Fagundes CP, Dantzer R. Exercise, inflammation, and fatigue in cancer survivors. Exerc Immunol Rev. 2016;22:82–93.

    PubMed  PubMed Central  Google Scholar 

  38. 38.

    Devin JL, Sax AT, Hughes GI, Jenkins DG, Aitken JF, Chambers SK, et al. The influence of high-intensity compared with moderate-intensity exercise training on cardiorespiratory fitness and body composition in colorectal cancer survivors: a randomised controlled trial. J Cancer Surviv. 2016;10:467–79.

    PubMed  Google Scholar 

  39. 39.

    Bourke L, Smith D, Steed L, Hooper R, Carter A, Catto J, et al. Exercise for men with prostate cancer: a systematic review and meta-analysis. Eur Urol. 2016;69:693–703.

    PubMed  Google Scholar 

  40. 40.

    Horgan S, O’Donovan A. The impact of exercise during radiation therapy for prostate cancer on fatigue and quality of life: a systematic review and meta-analysis. J Med Imaging Radiat Sci. 2018;49:207–19.

    PubMed  Google Scholar 

  41. 41.

    Miaskowski C, Paul SM, Cooper BA, Lee K, Dodd M, West C, et al. Predictors of the trajectories of self-reported sleep disturbance in men with prostate cancer during and following radiation therapy. Sleep. 2011;34:171–9.

    PubMed  PubMed Central  Google Scholar 

  42. 42.

    Zelefsky MJ, Ginor RX, Fuks Z, Leibel SA. Efficacy of selective alpha-1 blocker therapy in the treatment of acute urinary symptoms during radiotherapy for localized prostate cancer. Int J Radiat Oncol Biol Phys. 1999;45:567–70.

    CAS  PubMed  Google Scholar 

  43. 43.

    Kapur G, Windsor PM, McCowan C. The effect of aerobic exercise on treatment-related acute toxicity in men receiving radical external beam radiotherapy for localised prostate cancer. Eur J Cancer Care (Engl). 2010;19:643–7.

    CAS  Google Scholar 

  44. 44.

    Gonzalez BD, Small BJ, Cases MG, Williams NL, Fishman MN, Jacobsen PB, et al. Sleep disturbance in men receiving androgen deprivation therapy for prostate cancer: the role of hot flashes and nocturia. Cancer. 2018;124:499–506.

    CAS  PubMed  Google Scholar 

  45. 45.

    Courneya KS, Segal RJ, Mackey JR, Gelmon K, Reid RD, Friedenreich CM, et al. Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: a multicenter randomized controlled trial. J Clin Oncol. 2007;25:4396–404.

    PubMed  Google Scholar 

  46. 46.

    Riebe D, Ehrman J, Liguori G, Magal M. ACSM’s guidelines for exercise testing and prescription, 10th edn. Philadelphia: Lippincott Williams and Wilkins; 2018.

  47. 47.

    Murnane A, Geary B, Milne D. The exercise programming preferences and activity levels of cancer patients undergoing radiotherapy treatment. Support Care Cancer. 2012;20:957–62.

    PubMed  Google Scholar 

  48. 48.

    Demark-Wahnefried W, Peterson B, McBride C, Lipkus I, Clipp E. Current health behaviors and readiness to pursue life-style changes among men and women diagnosed with early stage prostate and breast carcinomas. Cancer. 2000;88:674–84.

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors would like to thank the participants of the studies, Laura Danneaux for her help in recruiting participants. EP was supported by a grant from the Fonds National de la Recherche Scientifique (FRIA - FNRS). GR was supported by a grant from the Institut de Recherche Expérimentale et Clinique (Université catholique de Louvain, Brussels, Belgium).

Author information

Affiliations

Authors

Corresponding author

Correspondence to Elise Piraux.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Piraux, E., Caty, G., Renard, L. et al. Effects of high-intensity interval training compared with resistance training in prostate cancer patients undergoing radiotherapy: a randomized controlled trial. Prostate Cancer Prostatic Dis 24, 156–165 (2021). https://doi.org/10.1038/s41391-020-0259-6

Download citation

Search

Quick links