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Feasibility of home-based exercise training in men with metastatic castration-resistant prostate cancer

Prostate Cancer and Prostatic Diseases volume 26, pages 302–308 (2023)Cite this article

Subjects

Abstract

Background

Home-based training increases accessibility to exercise and mitigates the side effects of hormone therapy for prostate cancer (PC). However, it is unknown if men with more advanced disease are willing to partake in such interventions.

Purpose

To determine the feasibility of a home-based exercise intervention in men with metastatic castration-resistant prostate cancer (mCRPC).

Methods

mCRPC patients on androgen receptor signaling inhibitors (ARSI) were prescribed a 12-week, home-based exercise intervention using resistance bands and walking. Feasibility was assessed using recruitment, retention, adherence, and outcome capture. Physiological changes and patient reported outcomes were assessed before and after the intervention.

Results

Of the 62 referrals, 47 were eligible with 22 men performing baseline testing (47% recruitment rate) and 16 completing the intervention (73% retention). Task completion was >86% for all physiological tests. Walking adherence was 80% and resistance training was 63%, the latter falling short of the study target (75%). Training increased thigh muscle cross-sectional area by 22%, time to exhaustion by 19% (both p < 0.05) and peak oxygen uptake by 6% (p = 0.057). Improvements in short physical performance battery scores and 400 m walk demonstrated moderate effect sizes that did not reach significance.

Conclusions

Home-based exercise is feasible during ARSI treatment for mCRPC. Greater endurance capacity and localized hypertrophy appear as the primary improvements following training. These preliminary findings suggest home-based training may increase exercise accessibility, with important lessons that will inform subsequent trials investigating the efficacy of home-based exercise interventions during mCRPC.

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Fig. 1
Fig. 2: Exercise Adherence and Step Counts.
Fig. 3: Training Induced Changes.

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Data availability

The datasets analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

This study was supported by funding from the Physical Activity and Cancer Survivorship pilot funding from the UNC Lineberger Comprehensive Cancer Center, Duke Cancer Institute, and the Wake Forest Baptist Comprehensive Cancer Center.

Author information

Authors and Affiliations

  1. Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Erik D. Hanson, Mohamdod Alzer, Jackson Carver, Cameron K. Stopforth, Lee Stoner, A. C. Hackney & Claudio L. Battaglini

  2. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Erik D. Hanson, Young E. Whang, Matthew I. Milowsky, Allison M. Deal & Claudio L. Battaglini

  3. Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, NC, USA

    Alexander R. Lucas & Rhonda L. Bitting

  4. Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA

    Alexander R. Lucas

  5. Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Young E. Whang & Matthew I. Milowsky

  6. Division of Medical Oncology, Duke Cancer Institute, Duke University, Durham, NC, USA

    David B. Bartlett & Michael R. Harrison

  7. School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK

    David B. Bartlett

  8. Department of Nutrition, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    A. C. Hackney

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  1. Erik D. Hanson
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Contributions

Study design & conception: EH, AH, CB, MM. Recruitment: EH, JC, MA, YW, MM, RB, MH, DB, AL. Data collection: EH, JC, MA, AL, CS. Statistical analysis: EH, AD. Drafted the manuscript: EH, LS, CB. Edited the manuscript: MA, JC, CS, AL, YW, MM, DB, MH, RL, AD, AH.

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Correspondence to Erik D. Hanson.

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Hanson, E.D., Alzer, M., Carver, J. et al. Feasibility of home-based exercise training in men with metastatic castration-resistant prostate cancer. Prostate Cancer Prostatic Dis 26, 302–308 (2023). https://doi.org/10.1038/s41391-022-00523-8

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