Exercise, body composition and fatigue with androgen deprivation therapy

This study aimed to determine whether body composition (lean and fat mass) and exercise had an effect on fatigue levels in men treated with androgen deprivation therapy. The study concluded that fat mass was associated with fatigue, and an increase in lean mass due to exercise successfully reduced fatigue.

Androgen deprivation therapy (ADT) is a common treatment for men with advanced prostate cancer. It decreases the levels of male hormones, such as testosterone, involved in cancer growth. While ADT improves survival rates, it is also associated with some side effects. ADT can decrease bone mineral density (leading to weaker bones), decrease lean mass (the weight on the body that is not fat), and increase fat mass. ADT is also associated with fatigue. Increased fatigue can have an effect on overall quality of life.

It has been suggested that increasing lean mass and decreasing fat mass may help to improve fatigue in men treated with ADT.

This study included 129 men treated with ADT. 92.6% had been treated with ADT for under 12 months. Participants underwent supervised exercise twice a week for 3 to 6 months. Exercises included both aerobic and strength training.

19.3% reported fatigue at the start of the study. Fat mass was higher by an average of 5 kg in patients with fatigue than in patients without.  Patients with lower vitality (energy level) also had higher fat mass. Patients with the lowest vitality had the highest fat mass. There was no significant difference in lean mass.

Patients who reported fatigue at the start of the study but not after exercise training gained an average of 2.1 kg in lean mass. There was a small but significant association between an increase in lean mass and a decrease in fatigue. Vitality also increased when lean mass increased.

This study concluded that fat mass was associated with fatigue in men treated with ADT, and that an increase in lean mass improved fatigue levels. The authors suggested that improving levels of fat and lean mass may be effective in reducing fatigue in prostate cancer patients.

The patients who were followed before and after exercise were selected based on specific criteria. This study may not be representative of all prostate cancer patients on ADT.

Discuss with your doctor the benefits of starting an exercise program.