Influence of Aerobic Exercise on QOL During Prostate Cancer Treatment

Alexander Ross, BS, BSN, RN

Today we are speaking with Alexander Ross, BS, BSN, RN, a research nurse at the National Institute of Nursing Research (NINR), which is part of the National Institutes of Health. Ross and colleagues at the NINR presented data on the role of aerobic exercise in mitigating symptoms in patients with prostate cancer at the Oncology Nursing Society 42nd Annual Congress, held May 4–7 in Denver.

Cancer Network: Can you discuss what we know about the role of exercise in boosting quality of life and reducing symptoms specifically among patients with prostate cancer?

Alexander Ross: A recent analysis published in JAMA Oncology showed that exercise and psychological intervention are more effective than pharmaceutical agents at reducing fatigue experienced by cancer patients during and after therapy. In men with prostate cancer, a recent review of the literature showed that exercise reduced their fatigue symptoms and improved their quality of life, especially those who were receiving androgen deprivation therapy.

Cancer Network: You and your colleagues examined the role of an 8-week aerobic exercise program on prostate cancer patients’ symptoms. Can you describe the design of the study and the details on the aerobic exercise?

Alexander Ross: We approached patients who were scheduled to receive external beam radiation therapy for nonmetastatic prostate cancer and offered them participation in our exercise intervention. Once patients are eligible to participate, we randomize them into two arms, one is a continuous exercise arm and the other is a high-interval training (HIT) arm. Both exercise arms are 8-weeks’ long and are administered three times per week, about an hour per session.

The continuous arm targets 70% to 80% of the peak target heart rate-the patients exercise continuously for 30 minutes. HIT targets 85% to 95% of the participants’ peak target heart rate. For the HIT arm, each minute of exercise intervention is followed by 2 minutes of rest. Each exercise session, whether continuous or HIT, starts with a 5-minute warm-up and finishes with a 10-minute cool-down. All exercise sessions are monitored by licensed clinicians, a nurse and a nurse practitioner. Vital signs are obtained before and after each exercise session.

Cancer Network: What were the results of the study?

Alexander Ross: Since this is an initial analysis, we combined the data from all of the patients who exercised, a total of 10 participants, and compared them with patients that did not exercise, a total of 46 patients. We compared the change in symptom scores before radiation therapy and after completion of treatment. We noticed that patients who exercised during radiation therapy had improvement in depressive symptoms compared to those who did not exercise. Patients who exercised also had less severe urinary symptoms at the end of the treatment than those who did not exercise. We also noticed that patients who exercised had stable fatigue, meaning that it did not get worse, compared to those that did not exercise. Patients who exercised also had better sleep than those who did not exercise.

Cancer Network: How does this study help nurses and clinicians have conversations with their patients about the benefits of exercise?

Alexander Ross: These results are consistent with what has already been published on the benefits of exercise while receiving cancer therapy. These results, and the recent review should assist clinicians in motivating our patients to exercise, especially while receiving treatment.

Cancer Network: Just lastly, are there studies you are working on or that are about to start to follow this up?

Alexander Ross: This is an actively enrolling study so we hope to receive more inquires and to enroll more patients to these exercise interventions, not only to continue to build the evidence of the benefits of exercise, but more importantly to understand how exercise works and how it works for everybody. Answering these questions will help up optimize and individualize the care that we provide to our patients.

Cancer Network: Thank you so much for joining us today, Alex.

Alexander Ross: Thank you.