MP67-16: Getting advantage from the &[Prime]teachable moment&[Prime] at initial diagnosis of prostate cancer - Results of a randomized controlled physical exercise program

Ryan Flannigan, Jennifer Locke, Gerald Schulz, Kristin Campbell, Cheri Van Patten, Larry Goldenberg, Peter Black

Introduction: Vigorous physical activity seems to correlate with reduced prostate cancer (CaP) mortality and the time of diagnosis might be ideal to introduce a lifestyle intervention. We conducted a randomized controlled trial to investigate effects of a pre - radical prostatectomy (RP) exercise program on long-term physical activity and CaP-specific outcome parameters as primary and secondary endpoints.

Methods: Patients with intermediate-risk CaP were randomized into either the intervention group (arm A, supervised 8-12 week combined aerobic and resistance exercise program) or the control group (arm B, continued with usual physical activity). Physical activity (Godin Physical Activity score) was monitored before and after the exercise program and six months after RP. Additionally, functional parameters (Functional Assessment of Cancer Therapy-Prostate, FACT-P), erectile dysfunction (international index of erectile function, IIEF-15), voiding symptoms (International Prostate Symptom Score, IPPS), psychological comorbidity (Center for Epidemiological Studies-Depression, CES-D) were tested between time points. Parameters/groups were compared employing independent and paired-samples t tests. IBM SPSS 25.

Results: Twenty patients (arm A: 10, arm B: 10) undergoing RP between 02/2016 and 02/2018 were enrolled. One patient (arm A) was lost to follow up. There were no significant differences between arm A vs. arm B at the baseline: age (67.8 vs. 65.1 years), PSA (8.6 vs. 13.5 ng/ml), Gleason score in the prostate biopsy specimen (7 vs. 7), BMI (26.0 vs. 27.9 kg/m²), FACT-P scores (127.8 vs. 120.91), CES-D scores (14.1 vs. 15.9), IPSS (6.0 vs. 9.10), IIEF-15 (45.6 vs. 44.3) and Godin activity score (23.7 vs. 22.7). Comparing parameters at the start and 6 months after RP in the interventional group, the Godin activity score significantly improved (24.7 vs. 42.8, p=0.009). In both arms, erectile dysfunction increased (arm A: IIEF-15 45.9 vs. 30.3, p=0.03, arm B: IIEF-15 44.3 vs. 25.8, p=0.005). There were no significant differences between the start and 6 months after RP regarding FACT-P, IPSS and CES-D scores.

Conclusions: Vigorous exercise before RP leads to significantly greater long-term physical activity at 6 months.  Importantly, CaP-specific quality of life and depressive symptoms were similar six months after RP compared to the preoperative status. Source of

Funding: Department of Urological Sciences, UBC