Purpose: Androgen deprivation therapy (ADT) is effective in controlling prostate cancer (PC) but also causes muscle wasting (cachexia), fatness, bone loss, reduced physical fitness and fatigue. The aim of this pilot study was to assess the feasibility and efficacy of progressive resistance training (PRT) as adjunct therapy to minimize these negative effects of ADT. Methods: Ten PC patients on ADTwere recruited and randomly allocated to either 12 weeks of PRT (training group TG, n=5) or standard treatment alone (control group CG, n=5). Body composition was assessed by DEXA and bio-electrical impedance spectroscopy, physical fitness by the senior fitness test battery, physical activity by pedometers, fatigue by bi-dimensional fatigue scale. The difference in change scores between groups was assessed by Mann-Whitney U tests.
Results: One subject in the TG was dropped from the study for safety reasons (diagnosis of bone metastases). All the other subjects in the TG completed 90% of the training sessions. There was a significant increase in total lean mass in the TG (2.2 +/- 1.1 kg) compared to the CG (-0.1 +/- 0.7 kg, p=0.02). This was particularly evident in the arms and legs lean mass, a proxy measure of total body skeletal muscle mass (TG 1.1 +/0.3 vs CG 0.1 |/ 0.3 kg, p=0.02). These changes were not solely due to an increase in extracellular water but also intracellular water and protein mass. There were also significant (PB/0.05) improvements in upper body strength and lower body flexibility and trends (pB/0.2) for physical activity, lower body strength, six minute walk distance, physical fatigue and agility in the TG compared to the CG. Conclusions: PRT is an effective and well tolerated adjunct treatment of cachexia in PC patients receiving ADT. Pending confirmation of these positive results in a larger randomised controlled trial, PRT should become an important component of PC patients' palliative care.