EURURO Vol. 72 No. 2

293 320

Prostate Cancer
Effects of Different Exercise Modalities on Fatigue in Prostate
Cancer Patients Undergoing Androgen Deprivation Therapy:
A Year-long Randomised Controlled Trial
Dennis R. Taaffe Robert U. Newton Nigel Spry David Joseph
Suzanne K. Chambers Robert A. Gardiner Brad A. Wall , Prue Cormie
Kate A. Bolam Daniel A. Galva˜o
a Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia; bSchool of Medical and Health Sciences, Edith Cowan University,
Joondalup, WA, Australia; c School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia; dInstitute of Human
Performance, The University of Hong Kong, Hong Kong, China; e University of Queensland Centre for Clinical Research, University of Queensland, Brisbane,
QLD, Australia; f Genesis CancerCare, Joondalup, WA, Australia; g Faculty of Medicine, University of Western Australia, Nedlands, WA, Australia; hDepartment
of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia; i Menzies Health Institute Queensland, Griffith University, Gold Coast,
Australia; j Centre for Research in Cancer Control, Cancer Council Queensland, Brisbane, QLD, Australia; k Prostate Cancer Foundation of Australia, Sydney,
NSW, Australia; l Department of Urology, Royal Brisbane and Women’s Hospital, Brisbane, QLD, Australia; m School of Psychology and Exercise Science,
Murdoch University, Murdoch, WA, Australia; n Institute for Health & Ageing, Australian Catholic University, Melbourne, VIC, Australia; oAstrand Laboratory
of Work Physiology, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
ava ilable at
journal homepage:
Article info
Article history:
Accepted February 9, 2017
Associate Editor:
James Catto
Keywords:
Exercise
Fatigue
Androgen deprivation therapy
Prostate cancer
Exercise prescription
Aerobic exercise
Resistance exercise
Abstract
Background: Physical exercise mitigates fatigue during androgen deprivation therapy
(ADT); however, the effects of different exercise prescriptions are unknown.
Objectives: To determine the long-term effects of different exercise modes on fatigue in
prostate cancer patients undergoing ADT.
Design, setting, and participants: Between 2009 and 2012, 163 prostate cancer patients
aged 43–90 y on ADT were randomised to exercise targeting the musculoskeletal system
(impact loading + resistance training; ILRT; n = 58), the cardiovascular and muscular
systems (aerobic + resistance training; ART; n = 54), or to usual care/delayed exercise
(DEL; n = 51) for 12 mo across university-affiliated exercise clinics in Australia.
Intervention: Supervised ILRT for 12 mo, supervised ART for 6 mo followed by a 6-mo
home program, and DEL received a printed booklet on exercise information for 6 mo
followed by 6-mo stationary cycling exercise.
Outcome measurements and statistical analysis: Fatigue was assessed using the Euro-
pean Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-
Core 36 and vitality using the Short Form-36. Analysis of variance was used to compare
outcomes for groups at 6 mo and 12 mo.
Results and limitations: Fatigue was reduced (p = 0.005) in ILRT at 6 mo and 12 mo ( 5
points), and in ART (p = 0.005) and DEL (p = 0.022) at 12 mo. Similarly, vitality increased
for all groups (p 0.001) at 12 mo ( 4 points). Those with the highest levels of fatigue
and lowest vitality improved the most with exercise (ptrend < 0.001). A limitation was
inclusion of mostly well-functioning individuals.
Conclusions: Different exercise modes have comparable effects on reducing fatigue and
enhancing vitality during ADT. Patients with the highest levels of fatigue and lowest
vitality had the greatest benefits.
* Corresponding author. Exercise Medicine Research Institute, School of Medical and Health Sciences,
Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia. Tel.: +61 8 63045476.
E-mail address: (D.R. Taaffe).
0302-2838/# 2017 European Association of Urology. Published by Elsevier B.V. This is an open access article under the CC
BY-NC-ND license ).