Optimising adherence with a customised flexible multimodal exercise regimen in prostate cancer patients on radiation and androgen deprivation therapy

Rationale:

Androgen deprivation therapy is an important component of prostate cancer treatment. This acts by reducing the testosterone levels in the body and thereby cutting off the primary factor which is driving prostate cancer growth. However, testosterone in addition to being the sexual hormone it is also needed for several other protective functions in the body. These include maintaining bone strength, muscle strength, cardiovascular safety, maintaining sugar and cholesterol levels etc. Hence, any reduction in testosterone levels leads to side effects related to these factors resulting in metabolic syndromes, bothersome fatigue, loss of muscle power etc. Exercises have been shown to help in reducing many of these side effects including fatigue and improving muscle strength. While supervised exercise sessions are recommended it is difficult for our patients to get access to such facilities and availability of expertise in the community is a concern. In view of this, in standard practice patients are referred to the rehabilitation services for advice on exercises and after that the patients continue these at home.

Novelty:

The present study is looking to leverage the patient’s visit to the hospital for radiation therapy procedures to give them more frequent visits to the rehabilitation services for supervised sessions to improve adherence to the exercise protocol and thereby improve the quality of life of patients.

Aim:

The aim of this study is to test the effectiveness of frequent visits to the rehabilitation services in improving adherence and quality of life of patients on androgen deprivation therapy.

Objectives:

To assess whether more frequent visits to the rehabilitation services for monitoring of the exercises lead to better adherence to exercises and result in better quality of life of the patients. We will assess the difference in the functional status and body composition between the two groups.

Methods: This will be a two-arm prospective randomised controlled, open-label, parallel-group, superiority trial.

Expected outcome: Incorporation of frequent visits to rehabilitation services is likely to result in increased adherence in doing regular exercises and lead to better quality of life in terms of reduction in fatigue levels. There may also be improvements in functional status and body composition measures with the intervention.