High-intensity interval training helped men with localized prostate cancer improve cardiorespiratory fitness

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High-intensity interval training resulted in decreased levels and rate of prostate specific antigen, as well as decreased growth of prostate cells in men with prostate cancer localized.

Based on the results of the Phase 2 ERASE trial (NCT03203460) which was published in JAMA Oncology.

Patients who adhered to the HIIT regimen had an increase in peak oxygen uptake (VO2) of 0.9 ml / kg / min and the usual care group experienced a decrease of 0.5 ml / kg / min (adjusted mean difference between groups, 1.6 ml / kg / min (95% CI: 0.3-2.9; P = .01). Patients in the HIIT group experienced decreased PSA levels (-1.1 g / L; 95% CI, -2.1 to 0.0; P = 0.04), PSA rate (-1.3 g / L / year; 95% CI, -2.5 to -0.1; P = 0.04) and growth of LNCaP cells (-0.13 optical density unit; 95% CI, -0.25 to -0.02; P = .02). In addition, the researchers did not identify any statistically significant differences in the doubling time of PSA or testosterone. In addition to experiencing a significant increase in peak VO2 in liters per minute, patients in the HIIT cohort experienced upper body strength and lower body flexibility.

“To our knowledge, the ERASE trial was the first randomized clinical trial to examine the effectiveness of HIIT in men with localized prostate cancer under active surveillance. As we speculated, a 12-week supervised HIIT program significantly improved cardiorespiratory fitness and indicators of prostate cancer biochemical progression, ”the study investigators wrote.

The trial enrolled 52 eligible male patients, of whom 26 were randomized to the HIIT group and 26 to the usual care group. The mean age was 63.4 years and 89% (n = 46) of the patients identified as white. A total of 88% (n = 46) of patients completed the post-intervention peak VO2 assessment and 94% (n = 49) of patients completed the post-intervention blood test.

Baseline mean resistance exercise behavior was out of balance between groups, with the HIIT group using 18 (42) min / week and the usual care group using 44 (62) min / week, which was adjusted for the analyzes in because of the prognostic association with PSA and fitness outcomes.

This study was completed 2 weeks ahead of schedule at 10 weeks for the last 6 participants, 3 for each group, due to the impending closure of facilities during the COVID-19 outbreak.

Investigators reported a 100% adherence rate to intensity and duration, and patients attended 96% (n = 880) of the planned exercise sessions. A total of 15% (n = 8) of patients reported worsening of previous medical problems, including joint pain (n = 6), chest discomfort (n = 1), and dizziness (n = 1); the medical problems were related to HIIT. In addition, 1 patient reported gastric hemorrhage from a Dieulafoy lesion that was unrelated to HITT.

PSA doubling time was better in the HIIT group, although it did not reach statistical significance (adjusted mean difference between groups, 17.9 months; 95% CI, -3.8 to 39, 6; P = .10). The researchers did not identify an adjusted mean difference between the testosterone groups (1.0 nmol / L; 95% CI, -0.7 to 2.6; P = .24). Growth of LNCap cells was significantly inhibited in the HIIT group compared to the usual care group, the adjusted mean difference between groups being -0.13 optical density units (95% CI, -0.25 to – 0.02; P = .02; or -5.1%.

“These improvements appear to be significant and may translate into better outcomes for patients with prostate cancer who are managed by active surveillance,” the researchers concluded.

Reference

Kang DW, Fairey AS, Boulé NG, Field CJ, Wharton SA, Courneya KS. Effects of exercise on cardiorespiratory fitness and biochemical progression in men with localized prostate cancer under active surveillance: the ERASE randomized clinical trial. JAMA Oncol. Published online August 19, 2021. doi: 10.1001 / jamaoncol.2021.3067


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