STAMINA Trial: Supervised Exercise and Diet Program Cuts Quality-of-Life Decline by a Third in Men on Androgen Deprivation Therapy
核心洞察
The STAMINA lifestyle intervention reduced deterioration in quality of life by as much as one-third in men receiving androgen deprivation therapy (搜索) for prostate cancer (搜索), researchers reported in The Lancet Oncology (搜索).
In the 700-patient UK trial across 15 NHS hospitals, more than 80% of participants attended scheduled supervised exercise sessions over the 12-month study period.
Economic modelling showed the program costs well below standard NHS thresholds for cancer interventions and is expected to remain cost-effective for up to a decade.
A structured lifestyle programme combining supervised exercise, dietary advice and behavioural support reduced the deterioration in quality of life by as much as one-third in men receiving androgen deprivation therapy (搜索) (ADT) for prostate cancer (搜索), according to results of the STAMINA trial published September 4 in The Lancet Oncology (搜索).
The trial, described as the largest of its kind and the first designed for NHS implementation from the outset, was led by Professor Liam Bourke and researchers from Sheffield Hallam University and Sheffield Teaching Hospitals NHS Foundation Trust. It was funded by the National Institute for Health Research (NIHR) and delivered through 18 Nuffield Health (搜索) Fitness and Wellbeing clubs.
Trial Design and Population
Researchers recruited 700 men undergoing ADT for prostate cancer (搜索) from 15 NHS hospitals across England. The median age of participants was 71, and 97% were white. Participants were randomly assigned between January 2022 and January 2023 to either enhanced standard NHS care or the dedicated STAMINA Lifestyle Intervention, with follow-up examinations conducted through June 2024.
The intervention combined supervised aerobic exercise, resistance training programmes, personalised dietary guidance and behavioural support designed to encourage long-term lifestyle change. NHS teams received additional training to identify suitable patients and refer them directly to specially trained Nuffield Health (搜索) personal trainers who were upskilled to operate as clinical exercise specialists.
The five-year research project was designed around pre-existing research recommendations to assess the long-term impact of supervised exercise training on both quality of life and fatigue in men on ADT.
Quality-of-Life and Fatigue Outcomes
More than 80% of participants in the STAMINA group attended their scheduled sessions over the 12-month trial period. Men in the programme reported better physical, emotional and social health outcomes than those receiving standard care, including improved quality of life and reduced fatigue.
"The STAMINA lifestyle intervention meets best practice guidelines, can be implemented in NHS trusts in England, and offers clinicians a clear basis for identification and prescription of a supervised exercise and dietary advice intervention to mitigate negative effects associated with ADT," the study authors wrote.
ADT is a hormone-blocking treatment that lowers levels of androgen hormones such as testosterone to help block androgen-dependent cancers. It is often combined with other cancer treatments such as chemotherapy and radiation. Its potential side effects include low sex drive, erectile dysfunction, loss of bone density, fatigue and mood changes. According to the trial investigators, many patients also experience reduced muscle mass, weight gain, increased cardiovascular risk and significant emotional distress.
Ying Wang, PhD, a senior principal scientist with the Department of Population Science at the American Cancer Society, who was not involved in the study, said the trial fills an important evidence gap. "Much of the research in this area has focused on breast cancer survivors, so strong trial evidence that a structured lifestyle program improves quality of life and reduces fatigue specifically among men receiving ADT is especially valuable," Wang told Healthline.
Cost-Effectiveness and Implementation
Economic modelling showed the programme costs well below standard NHS thresholds for cancer interventions and is expected to remain cost-effective for up to a decade.
Professor Liam Bourke, Academic Programme Director of STAMINA at Sheffield Hallam University, framed the result as a practice-changing milestone. "STAMINA is a huge achievement – it has taken us nearly two decades of incredibly hard work to get here – and it offers a definitive step-change in how lifestyle programmes should be considered and integrated comprehensively into routine prostate cancer (搜索) care," he said.
"As the largest trial of its kind ever to be conducted, and the first to be designed to work in the NHS from day one, this study is really unique and ensures that the positive outcomes of the research will be delivered exactly where they need to be – to NHS patients during routine care," Bourke added.
Following the trial's success, Nuffield Health (搜索) launched its Cancer Activity Programme, which will initially support men living with prostate cancer (搜索) before expanding to patients with breast and bowel cancers. The organisation has committed to funding 50,000 programme places by 2030, potentially creating one of the largest exercise-based cancer rehabilitation initiatives in the UK.
The NIHR-funded trial brought together Queen Mary University of London, the University of Leeds, the University of Sheffield, the University of Bristol, the University of York, the University of Edinburgh, Cardiff University and Nuffield Health (搜索), with additional support from the NIHR Biomedical Research Centre: Barts.
Unresolved Questions on Survival
The trial assessed quality of life and fatigue over 12 months rather than cancer outcomes, leaving the long-term effect on prostate cancer (搜索) survival undetermined. "The study does not establish whether these benefits translate into longer survival because it assessed quality of life and fatigue over 12 months rather than cancer outcomes," Wang said.
Wang also highlighted the role of structured delivery and coaching in the trial's results. "A key lesson from STAMINA is that information alone may not be sufficient," she said. "Both study groups received education, clinician encouragement, and behavioral prompts. The additional benefit observed with supervised exercise, ongoing coaching, and structured program delivery suggests that helping patients translate recommendations into sustained action may be as important as the recommendations themselves."
Wang noted that the American Cancer Society's prostate cancer (搜索) survivorship guidelines recommend at least 150 minutes per week of moderate-intensity aerobic physical activity, such as brisk walking, together with resistance training and a healthy diet rich in fruits and vegetables.
Clinical Context
S. Adam Ramin, MD, a urologist, urologic oncologist and medical director of Urology Cancer Specialists in Los Angeles, who was not involved in the study, said lifestyle modification can yield meaningful benefits for men undergoing prostate cancer (搜索) treatment. A diet that "emphasizes leafy greens, legumes, and healthy fats — not red meat — supports a healthier prostate, and this study supports the consumption of healthy fats for potentially longer survival after a prostate cancer diagnosis," he told Healthline.
"Regular exercise promotes a healthier lifestyle and can reduce mental stress," Ramin added. "Exercise releases endorphins (chemicals produced by the nervous system that help the body cope with pain and stress) into the bloodstream, which positively affect overall health — both physical and mental." He cited running, swimming and elliptical training as potentially beneficial activities, and said that in the post-treatment period, healthy eating and exercise "may improve outcomes by reducing inflammation in the body and supporting a stronger immune system."
According to the American Cancer Society, more than 330,000 new cases of prostate cancer (搜索) are expected in the United States in 2026, with more than 36,000 deaths from the disease. The organisation notes that cases increased about 3% per year between 2014 and 2022, with the steepest rise in advanced-stage diagnoses, largely due to more men being screened. Black males have a higher incidence than white males, and the 5-year survival rate is 99% when the disease is detected in its early stages.
Around 600,000 men in the UK are currently living with prostate cancer (搜索), with up to half receiving ADT, according to the trial investigators.