Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review
  • Published:

Exercise can prevent and even reverse adverse effects of androgen suppression treatment in men with prostate cancer

Prostate Cancer and Prostatic Diseases volume 10, pages 340–346 (2007)Cite this article

Abstract

Side effects accompanying androgen deprivation therapy (ADT), including sarcopenia, loss of bone mass and reduction in muscle strength, can compromise physical function, particularly in older patients. Exercise, specifically resistance training, may be an effective and cost-efficient strategy to limit or even reverse some of these adverse effects during and following therapy. In this review, we discuss common morphological and physiological ADT-related side effects or ‘Androgen Deprivation and Sarcopenia-Related Disorders’ and the existing clinical trials incorporating physical exercise in prostate cancer patients receiving active therapy. Further, training concepts and guidelines are provided for prescribing resistance exercise programs for this population.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Parkin DM, Bray F, Ferlay J, Pisani P . Global cancer statistics, 2002. CA Cancer J Clin 2005; 55: 74–108.

    Article  Google Scholar 

  2. Yancik R . Cancer burden in the aged: an epidemiologic and demographic overview. Cancer 1997; 80: 1273–1283.

    Article  CAS  Google Scholar 

  3. Yancik R, Ganz PA, Varricchio CG, Conley B . Perspectives on comorbidity and cancer in older patients: approaches to expand the knowledge base. J Clin Oncol 2001; 19: 1147–1151.

    Article  CAS  Google Scholar 

  4. McCredie M, Cox B . Prostate-specific antigen testing for prostate cancer: the case for informed consent. Med J Aust 1998; 169: 9–10.

    Article  CAS  Google Scholar 

  5. Moul JW . Prostate specific antigen only progression of prostate cancer. J Urol 2000; 163: 1632–1642.

    Article  CAS  Google Scholar 

  6. Rashid MH, Chaudhary UB . Intermittent androgen deprivation therapy for prostate cancer. Oncologist 2004; 9: 295–301.

    Article  CAS  Google Scholar 

  7. Chodak GW . Comparing treatments for localized prostate cancer – persisting uncertainty. JAMA 1998; 280: 1008–1010.

    Article  CAS  Google Scholar 

  8. Ransohoff DF, McNaughton Collins M, Fowler FJ . Why is prostate cancer screening so common when the evidence is so uncertain? A system without negative feedback. Am J Med 2002; 113: 663–667.

    Article  Google Scholar 

  9. Galvão DA, Newton RU . Review of exercise intervention studies in cancer patients. J Clin Oncol 2005; 23: 899–909.

    Article  Google Scholar 

  10. Taaffe DR . Sarcopenia. Exercise as a treatment strategy. Aust Fam Physician 2006; 35: 130–134.

    PubMed  Google Scholar 

  11. Galvão DA, Taaffe DR . Resistance exercise dosage in older adults: single- versus multiset effects on physical performance and body composition. J Am Geriatr Soc 2005; 53: 2090–2097.

    Article  Google Scholar 

  12. Courneya KS . Exercise in cancer survivors: an overview of research. Med Sci Sports Exerc 2003; 35: 1846–1852.

    Article  Google Scholar 

  13. Segal RJ, Reid RD, Courneya KS, Malone SC, Parliament MB, Scott CG et al. Resistance exercise in men receiving androgen deprivation therapy for prostate cancer. J Clin Oncol 2003; 21: 1653–1659.

    Article  Google Scholar 

  14. Galvão DA, Nosaka K, Taaffe DR, Spry N, Kristjanson LJ, McGuigan MR et al. Resistance training and reduction of treatment side effects in prostate cancer patients. Med Sci Sports Exerc 2006; 38: 2045–2052.

    Article  Google Scholar 

  15. Schmitz KH, Ahmed RL, Hannan PJ, Yee D . Safety and efficacy of weight training in recent breast cancer survivors to alter body composition, insulin, and insulin-like growth factor axis proteins. Cancer Epidemiol Biomarkers Prev 2005; 14: 1672–1680.

    Article  CAS  Google Scholar 

  16. Kaisary AV . Evaluating the use of early hormonal therapy in patients with localised or locally advanced prostate cancer. Prostate Cancer Prostatic Dis 2005; 8: 140–151.

    Article  CAS  Google Scholar 

  17. Moyad MA . Promoting general health during androgen deprivation therapy (ADT): a rapid 10-step review for your patients. Urol Oncol 2005; 23: 56–64.

    Article  Google Scholar 

  18. Shahinian VB, Kuo YF, Freeman JL, Goodwin JS . Risk of the ‘androgen deprivation syndrome’ in men receiving androgen deprivation for prostate cancer. Arch Intern Med 2006; 166: 465–471.

    PubMed  PubMed Central  Google Scholar 

  19. Smith MR, Finkelstein JS, McGovern FJ, Zietman AL, Fallon MA, Schoenfeld DA et al. Changes in body composition during androgen deprivation therapy for prostate cancer. J Clin Endocrinol Metab 2002; 87: 599–603.

    Article  CAS  Google Scholar 

  20. Greenspan SL, Coates P, Sereika SM, Nelson JB, Trump DL, Resnick NM . Bone loss after initiation of androgen deprivation therapy in patients with prostate cancer. J Clin Endocrinol Metab 2005; 90: 6410–6417.

    Article  CAS  Google Scholar 

  21. Chen Z, Maricic M, Nguyen P, Ahmann FR, Bruhn R, Dalkin BL . Low bone density and high percentage of body fat among men who were treated with androgen deprivation therapy for prostate carcinoma. Cancer 2002; 95: 2136–2144.

    Article  Google Scholar 

  22. Basaria S, Lieb II J, Tang AM, DeWeese T, Carducci M, Eisenberger M et al. Long-term effects of androgen deprivation therapy in prostate cancer patients. Clin Endocrinol (Oxford) 2002; 56: 779–786.

    Article  CAS  Google Scholar 

  23. Braga-Basaria M, Muller DC, Carducci MA, Dobs AS, Basaria S . Lipoprotein profile in men with prostate cancer undergoing androgen deprivation therapy. Int J Impot Res 2006; 18: 494–498.

    Article  CAS  Google Scholar 

  24. Sharifi N, Gulley JL, Dahut WL . Androgen deprivation therapy for prostate cancer. JAMA 2005; 294: 238–244.

    Article  CAS  Google Scholar 

  25. Shahinian VB, Kuo YF, Freeman JL, Goodwin JS . Risk of fracture after androgen deprivation for prostate cancer. N Engl J Med 2005; 352: 154–164.

    Article  CAS  Google Scholar 

  26. Smith MR, Lee WC, Brandman J, Wang Q, Botteman M, Pashos CL . Gonadotropin-releasing hormone agonists and fracture risk: a claims-based cohort study of men with nonmetastatic prostate cancer. J Clin Oncol 2005; 23: 7897–7903.

    Article  CAS  Google Scholar 

  27. Higano CS . Bone loss and the evolving role of bisphosphonate therapy in prostate cancer. Urol Oncol 2003; 21: 392–398.

    Article  CAS  Google Scholar 

  28. Petrella JK, Kim JS, Tuggle SC, Hall SR, Bamman MM . Age differences in knee extension power, contractile velocity, and fatigability. J Appl Physiol 2005; 98: 211–220.

    Article  Google Scholar 

  29. Basaria S, Muller DC, Carducci MA, Egan J, Dobs AS . Hyperglycemia and insulin resistance in men with prostate carcinoma who receive androgen-deprivation therapy. Cancer 2006; 106: 581–588.

    Article  CAS  Google Scholar 

  30. Fowler Jr FJ, McNaughton Collins M, Walker Corkery E, Elliott DB, Barry MJ . The impact of androgen deprivation on quality of life after radical prostatectomy for prostate carcinoma. Cancer 2002; 95: 287–295.

    Article  Google Scholar 

  31. Spry NA, Kristjanson L, Hooton B, Hayden L, Neerhut G, Gurney H et al. Adverse effects to quality of life arising from treatment can recover with intermittent androgen suppression in men with prostate cancer. Eur J Cancer 2006; 42: 1083–1092.

    Article  CAS  Google Scholar 

  32. Yaffe K, Lui LY, Zmuda J, Cauley J . Sex hormones and cognitive function in older men. J Am Geriatr Soc 2002; 50: 707–712.

    Article  Google Scholar 

  33. Shores MM, Sloan KL, Matsumoto AM, Moceri VM, Felker B, Kivlahan DR . Increased incidence of diagnosed depressive illness in hypogonadal older men. Arch Gen Psychiatry 2004; 61: 162–167.

    Article  Google Scholar 

  34. Herr HW . Quality of life in prostate cancer patients. CA Cancer J Clin 1997; 47: 207–217.

    Article  CAS  Google Scholar 

  35. Galvão DA, Newton RU, Taaffe DR . Anabolic responses to resistance training in older men and women: a brief review. J Aging Phys Act 2005; 13: 343–358.

    Article  Google Scholar 

  36. Windsor PM, Nicol KF, Potter J . A randomized, controlled trial of aerobic exercise for treatment-related fatigue in men receiving radical external beam radiotherapy for localized prostate carcinoma. Cancer 2004; 101: 550–557.

    Article  Google Scholar 

  37. Thompson IM, Pauler DK, Goodman PJ, Tangen CM, Lucia MS, Parnes HL et al. Prevalence of prostate cancer among men with a prostate-specific antigen level ⩽4.0 ng per milliliter. N Engl J Med 2004; 350: 2239–2246.

    Article  CAS  Google Scholar 

  38. Hakkinen K, Pakarinen A, Kraemer WJ, Newton RU, Alen M . Basal concentrations and acute responses of serum hormones and strength development during heavy resistance training in middle-aged and elderly men and women. J Gerontol A Biol Sci Med Sci 2000; 55: B95–B105.

    Article  CAS  Google Scholar 

  39. Kraemer WJ, Hakkinen K, Newton RU, Nindl BC, Volek JS, McCormick M et al. Effects of heavy-resistance training on hormonal response patterns in younger vs older men. J Appl Physiol 1999; 87: 982–992.

    Article  CAS  Google Scholar 

  40. Loblaw DA, Mendelson DS, Talcott JA, Virgo KS, Somerfield MR, Ben-Josef E et al. American society of clinical oncology recommendations for the initial hormonal management of androgen-sensitive metastatic, recurrent, or progressive prostate cancer. J Clin Oncol 2004; 22: 2927–2941.

    Article  Google Scholar 

  41. Sato N, Akakura K, Isaka S, Nakatsu H, Tanaka M, Ito H et al. Intermittent androgen suppression for locally advanced and metastatic prostate cancer: preliminary report of a prospective multicenter study. Urology 2004; 64: 341–345.

    Article  Google Scholar 

  42. Taaffe DR, Pruitt L, Pyka G, Guido D, Marcus R . Comparative effects of high- and low-intensity resistance training on thigh muscle strength, fiber area, and tissue composition in elderly women. Clin Physiol 1996; 16: 381–392.

    Article  CAS  Google Scholar 

  43. Taaffe DR, Duret C, Wheeler S, Marcus R . Once-weekly resistance exercise improves muscle strength and neuromuscular performance in older adults. J Am Geriatr Soc 1999; 47: 1208–1214.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Vario Health Institute, School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia

    D A Galvão & R U Newton

  2. School of Human Movement Studies, University of Queensland, Brisbane, Queensland, Australia

    D R Taaffe

  3. Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia

    N Spry

  4. Faculty of Medicine, University of Western Australia, Nedlands, Western Australia, Australia

    N Spry

Authors
  1. D A Galvão
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D R Taaffe
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. N Spry
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R U Newton
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to D A Galvão.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Galvão, D., Taaffe, D., Spry, N. et al. Exercise can prevent and even reverse adverse effects of androgen suppression treatment in men with prostate cancer. Prostate Cancer Prostatic Dis 10, 340–346 (2007). https://doi.org/10.1038/sj.pcan.4500975

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.pcan.4500975

Keywords

This article is cited by

Search

Advanced search

Quick links