What is the optimal timing of exercise therapy for men taking androgen deprivation therapy?

This study aimed to examine the timing of exercise therapy in patients with prostate cancer taking androgen deprivation therapy (ADT). This study found that starting exercise at the onset of ADT helps preserve muscle mass and bone density. 

Androgen deprivation therapy (ADT) is a treatment option in prostate cancer. ADT blocks the production of male hormones, such as testosterone, responsible for cancer growth. ADT is associated with important side effects which can influence the quality of life of these patients. These can include loss of muscle mass, increased body fat and reduced bone density. Exercise therapy can help with these side-effects. 

It is unclear whether exercise should start when ADT starts or later on for better outcomes. 

This study included 104 patients with prostate cancer. 54 were randomly assigned to immediate exercise (IMEX) and 50 to delayed exercise (DEL) after starting ADT. IMEX included 6 months of supervised resistance/aerobic/impact exercise. DEL included 6 months of usual care followed by 6 months of the identical exercise programme. Body fat, bone density, and muscle mass were assessed at the beginning of the study and at 6 and 12 months after treatment.

Both groups experienced a decrease in bone density. However, at 6 months, bone density at the lumbar spine was better preserved in the IMEX group compared to DEL. Muscle density and lean body mass declined in the DEL group at six months. This improved after exercise started in the DEL group, at 12 months. Body fat increased similarly in both groups over 12 months. 

This study found that starting exercise at the onset of ADT helps preserve muscle mass and density in patients with prostate cancer. 

Some patients also received other treatments such as radiotherapy during the study. This might have influenced the results. The study population is also quite small. Larger studies are needed for more strong evidence.

If you have concerns about losing bone and muscle mass, discuss exercise therapy with your doctor.