Exercise makes ADT more manageable – but does it matter when you start exercising?

It is well known that exercise makes managing many ADT side effects easier. Exercise limits loss of muscle strength, bone density, and physical function (e.g., walking quickly, climbing stairs, and lifting oneself out of a chair). What remains less clear is whether it matters when you start an exercise program if you are going on ADT.

In a recent study out of Australia, researchers looked at potential differences in strength and physical function for two groups of men with prostate cancer. One group (of 54 men) started a structured, supervised exercise program when they started ADT. The other group (of 50 men) waited 6 months post-ADT-initiation before starting the same exercise program. All participants completed assessments of upper and lower body muscle strength and physical function at baseline, 6-month, and 12-month follow-ups.

The supervised, group-based exercise program consisted of resistance training (e.g., leg press, bicep curl), impact-loading activities (e.g., hopping, skipping, drop-jumping) and aerobic activities (e.g., walking/jogging, cycling, to a targeted heart-rate level). Participants attended 3 exercise sessions per week (each ~60 minutes) and were encouraged to complete an additional 2 sessions at home.

The researchers reported 3 important findings:

1.) A targeted exercise program commenced at the start of ADT both preserved and improved muscle strength and physical function.

2.) For men who delayed the start of the exercise program, losses in muscle strength and physical function during the initial 6-month delayed start “recouped” and showed further gains once they completed the exercise program.

3.) By the 12-month mark, men in both groups had comparable muscle strength and physical function.

The authors concluded:

These results indicate that initiating exercise either at the onset of ADT or after 6 months of treatment is effective, both for not only preserving but also enhancing muscle strength and physical function. However, to avoid any treatment-related declines in muscle strength and function following the initiation of ADT, exercise should be commenced at the onset of treatment.

This study provides encouraging evidence of the benefit exercise can have, whether men have just started ADT or have been on it for some time.

It should be noted that it’s important to get clearance from your physician when beginning any new exercise programs.

To read the full article, see:  https://www.nature.com/articles/s41391-019-0200-z

Newton, R.U., Galvao, D.A., Spry, N., Joseph, D., Chambers, S.K., Gardiner, R.A., Hayne, D., & Taaffe, D.R. (2020). Timing of exercise for muscle strength and physical function in men initiating ADT for prostate cancer. Prostate Cancer and Prostatic Diseases. Advance Online Publication. doi: 10.1038/s41391-019-0200-z