Prevention of the adverse effects of androgen deprivation therapy for prostate cancer using a 12-month home-based progressive resistance training program: a randomised controlled study

Background In men with prostate cancer, androgen deprivation therapy (ADT) has detrimental effects on body composition and quality of life (QOL), which can be ameliorated with exercise interventions including progressive resistance training (PRT). Existing studies focus on reversing established changes using supervised programs. We investigated whether a home-based PRT program, instituted at the start of ADT, could prevent adverse effects over 12-months.Methods Twenty-five patients scheduled to receive at least 12 months of ADT were assigned to either usual care (UC) (n=12) or PRT (n=13) starting after their first ADT injection. Body composition, body cell mass (BCM; a functional component of lean body mass), insulin sensitivity, QOL and muscle function were measured at 6 weeks, 6- and 12 months. Data were analysed by a linear mixed model.Results Across the cohort, ADT had a negative impact on body composition, muscle strength, glucose metabolism and QOL. Compared to PRT patients at 12 months, UC patients had greater reductions in BCM by -1.9 ± 0.8% (p = 0.02) and higher gains in fat mass by 3.1 ± 1.0% (p = 0.002). There was a significant increase in physical activity levels (p = 0.02), and QOL in the mental health (p = 0.01) and vitality (p = 0.02) domains in the PRT compared to the UC group.Conclusion A home-based PRT program instituted at the start of ADT counteracts detrimental changes in body composition, improves physical activity and mental health over 12 months.