Inflammation, cardiometabolic markers, and functional changes in men with prostate cancer. A randomized controlled trial of a 12‑month exercise program

Abstract

INTRODUCTION Previous studies have shown that physical exercise in cancer patients during radiation therapy (RT) and androgen deprivation therapy (ADT) improves cardiac fitness and quality of life (QoL), as well as reduces fatigue, but it is still not entirely known how it affects inflammation or metabolic factors and what its consequences are in patients with prostate cancer (PCa). OBJECTIVES The aim of the study was to assess the effect of a 12‑month physical exercise program on inflammatory and cardiometabolic parameters, as well as on functional status in patients with PCa undergoing RT and ADT. PATIENTS AND METHODS This was a randomized controlled clinical trial including 72 men with high‑risk and intermediate‑risk PCa, allocated to 2 groups before RT. The physical exercise group trained 5 days/ wk during RT and then 3 days/wk. The control group received usual care according to recommendations. Measurements were performed at baseline, after RT (8 weeks), and after 10 months. The parameters assessed were proinflammatory cytokine levels, lipid profile, aerobic capacity, body mass index (BMI), waist‑to‑hip ratio (WHR), and functional status (FACT‑F and EORTC questionnaires). RESULTS We observed an significant improvement in functional capacity, BMI, and WHR, and a decrease in the levels of proinflammatory cytokines and fatigue in the exercise group compared with controls after 12 months. The level of fatigue was significantly higher in controls than in the exercise group, especially after RT. CONCLUSIONS Long‑term supervised exercise training is more effective than educational materials on physical activity in terms of a decrease in cardiovascular risk and improvement in functional status in patients with PCa during RT and ADT.