Effect of a Home-based Walking Intervention on Cardiopulmonary Fitness and Quality of Life Among Men with Prostate Cancer on Active Surveillance: The Active Surveillance Exercise Randomized Controlled Trial

Erin L Van Blarigan; Stacey A Kenfield; Adam Olshen; Neil Panchal; Katriel Encabo; Imelda Tenggara; Rebecca E Graff; Alexander S Bang; Katsuto Shinohara; Matthew R Cooperberg; Peter R Carroll; Lee W Jones; Kerri Winters-Stone; Anthony Luke; June M Chan

doi:10.1016/j.euo.2023.10.012

Effect of a Home-based Walking Intervention on Cardiopulmonary Fitness and Quality of Life Among Men with Prostate Cancer on Active Surveillance: The Active Surveillance Exercise Randomized Controlled Trial

Eur Urol Oncol. 2024 Jun;7(3):519-526. doi: 10.1016/j.euo.2023.10.012. Epub 2023 Oct 29.

Authors

Affiliations

¹ Department of Urology, University of California, San Francisco, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA; Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA.
² Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA; Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA.
³ Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA, USA.
⁴ Department of Urology, University of California, San Francisco, San Francisco, CA, USA.
⁵ Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
⁶ Department of Urology, University of California, San Francisco, San Francisco, CA, USA; Department of Dermatology, Weill Cornell Medicine, New York, NY, USA.
⁷ Department of Urology, University of California, San Francisco, San Francisco, CA, USA; Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA.
⁸ Memorial Sloan Kettering Cancer Center, New York, NY, USA.
⁹ Oregon Health & Sciences University Knight Cancer Institute, Portland, OR, USA.
¹⁰ Department of Urology, University of California, San Francisco, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA; Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA. Electronic address: june.chan@ucsf.edu.

PMID: 37907387
DOI: 10.1016/j.euo.2023.10.012

Abstract

Background: Active surveillance (AS) is standard care for most men with low-risk prostate cancer (PC); yet, many men on AS eventually undergo curative therapy. Interventions to lower the risk of cancer progression and fear of recurrence among men on AS for PC are needed.

Objective: To determine the effect of aerobic exercise on cardiorespiratory fitness, body size, and quality of life (QOL) among men on AS for PC.

Design, setting, and participants: We conducted a 1:1 randomized controlled trial among 51 men with low-risk PC who elected AS. Participants were enrolled at the University of California, San Francisco.

Intervention: The 16-wk intervention included a home-based walking program with a nonlinear exercise prescription tailored to baseline fitness level, heart rate monitor, and weekly phone call with an exercise physiologist. Controls received printed materials.

Outcome measurements and statistical analysis: Cardiorespiratory fitness was measured using VO₂peak; secondary outcomes included change in body size, anxiety, and QOL. Analyses were based on intention to treat.

Results and limitations: Between 2016 and 2021, we randomized 51 men to intervention (n = 26) or control (n = 25). Follow-up was 88% (45/51), 85% (22/26) in the intervention and 92% (23/25) in the control group. At 16 wk, the intervention group had a higher mean VO₂peak than the control group (31.9 ± 4.7 vs 27.2 ± 4.8 ml/kg/min; group × time effect p value: <0.001). Additionally, the intervention group reported less fear of PC recurrence and urinary obstruction/irritation, while controls reported more of these two QOL measures, from 0 to 16 wk (p = 0.04 and 0.03, respectively). Two participants discontinued the intervention, including one due to knee pain related to the study.

Conclusions: A home-based walking program improved VO₂peak and reduced urinary obstruction/irritation and fear of recurrence among men on AS for PC.

Patient summary: Moderate to vigorous aerobic exercise improves fitness and quality of life among men on active surveillance for prostate cancer.

Keywords: Active surveillance; Cardiorespiratory fitness; Exercise; Fear of cancer recurrence; Prostate cancer.

Publication types

Randomized Controlled Trial

MeSH terms

Aged
Cardiorespiratory Fitness* / physiology
Exercise Therapy / methods
Home Care Services
Humans
Male
Middle Aged
Prostatic Neoplasms* / psychology
Quality of Life*
Walking*
Watchful Waiting

Grants and funding

R01 CA181802/CA/NCI NIH HHS/United States