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Exercise Medicine for the Management of Prostate Cancer

Every day more than 45 men are diagnosed with prostate cancer in Australia, making it the most commonly diagnosed cancer in Australian men (one in six men). Due to advanced diagnosis and treatment options, however, many men are living with and dying with prostate cancer rather than from it. Despite survival rates for prostate cancer improving, the disease itself and the treatments involved, have a significant impact on patients’ quality of life and require appropriate supportive care.

Continuing research evaluating the role of exercise in men with prostate cancer establishes exercise to be a safe and effective intervention, which results in improved physical, psychological and social well-being in prostate cancer patients. In addition, data from observational studies suggests that men with prostate cancer who participate in regular physical activity can lower their all-cause mortality by up to 42 percent and their prostate cancer mortality by up to 39 percent. Research also supports exercise in positively counteracting the adverse effects of prostate cancer treatments, such as fatigue, and potentially even improving treatment tolerance.

These findings have set the scene for multiple research studies currently underway in Melbourne, further examining the impact of exercise medicine for the management of prostate cancer.

PEX Trial – Preoperative Exercise Medicine for Prostate Cancer
Radical prostatectomy is often followed by short- and long-term side effects such as urinary incontinence and sexual dysfunction. Recent research suggests that pre-surgical exercise offers strong potential to optimise physical function and minimise the side effects of surgery. The purpose of the PEX trial is to examine whether exercise before and after prostatectomy can decrease treatment-related side effects such as urinary incontinence and sexual dysfunction. One hundred prostate cancer patients that are scheduled to undergo prostatectomy with one of five selected surgeons at the Royal Melbourne Hospital will be recruited for this randomised controlled trial.

Exercise Therapy – Counteracting Mental Health Issues in Men with Prostate Cancer through Exercise
Men with prostate cancer experience increased rates of mental health issues. Current healthcare strategies are failing to adequately address these issues as approximately 50 percent of these men report unmet needs for psychological support. These data indicate a gap in knowledge surrounding optimal strategies to promote mental health following prostate cancer. The Exercise Therapy study examines whether exercise aids in the management of mental health issues in men with prostate cancer. A unique approach to delivering mental healthcare services is proposed, which aims to facilitate engagement by men through an intervention that is tailored to prostate cancer patients. This randomised controlled trial is recruiting men with prostate cancer who may be experiencing some level of concern with their mental well-being.

EX-HEART Trial – Exercise for Heart Health in Prostate Cancer
Androgen deprivation therapy (ADT) is an efficacious anti-cancer therapy that reduces prostate cancer mortality. However, ADT may increase the risk of cardiovascular morbidity and mortality. Improvements in prostate cancer treatment mean that patients are living long enough to experience the late effects associated with ADT. Thus, cardiovascular disease is a significant issue faced by many men with prostate cancer. Evidence from cardiovascular medicine highlights the potential efficacy of exercise medicine to modify cardiovascular risk. The purpose of the EX-HEART Trial is to identify the impact of ADT on cardiovascular structure and function, as well as evaluate the influence of exercise training during ADT on cardiac remodelling. This randomised controlled trial is recruiting men with prostate cancer that are scheduled or within one month of initiating ADT.

The outcomes of these studies are expected to support the role of exercise physiologists in the oncological setting and the call for exercise to be embedded as part of standard practice in cancer care. If you would like to find out more about these research studies, please contact the Exercise Oncology Team at the Australian Catholic University (ExerciseOncology@acu.edu.au) or the Australian Prostate Centre (info@apcr.org.au).

Responses from participants in Exercise Therapy…
• “I’ve never felt better in my life. I have no doubt that anyone undertaking this study will benefit.”
• “I’ve found that it really has made me mentally strong.”
• “The training was fantastic because it was tailor-made for me.”
• “The program has provided everyone in our group, including myself, with a more positive outlook.”
• “I’ll continue this [exercise program] for the rest of my life.”
• “Things seem to be easier to handle and I feel that my relationship with those close to me has improved since commencing the ACU program.”
• “It’s doing a world of good for everyone who has prostate cancer.”

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