High-intensity interval training resulted in decreased prostate-specific antigen levels and speed, as well as a decrease in prostate cell growth in men with localized prostate cancer.
Men with localized prostate cancer who used high-intensity interval training (HIIT) as a form of exercise were able to increase their cardiorespiratory fitness, as well as other prostate-specific antigen (PSA) and speed benefits, as shown in the results of. according to the Phase 2 ERASE study (NCT03203460) published in JAMA Oncology.
Patients adhering to the HIIT regimen had an increase in peak oxygen consumption (VO2) of 0.9 ml / kg / min, and the group in the usual care group saw a decrease of 0.5 ml / kg / min (adjusted mean difference between the groups 1.6 ml / kg / min.). (95% CI, 0.3-2.9; P = 0.01) Patients in the HIIT group showed reduced PSA values (-1.1 µg / l; 95% CI, -2.1 to 0 , 0; P = 0.04), PSA rate (- 1.3 µg / L / y; 95% CI, -2.5 to -0.1; P = .04) and LNCaP cell growth (-0 , 13 optical density unit; 95% CI, -0.25 to -0.02; P = .02). In addition, the researchers found no statistically significant differences in PSA doubling time or testosterone. In addition to a significant increase in peak VO2 in liters per minute, patients in the HIIT cohort experienced upper body strength and lower body flexibility.
“To the best of our knowledge, the ERASE study was the first randomized clinical trial to evaluate the effectiveness of HIIT in men with localized prostate cancer who were actively monitored. As we suspected, a monitored 12-week HIIT program significantly improved cardiorespiratory fitness and indicators of prostate cancer biochemical progression, ”the study researchers write.
52 eligible male patients took part in the study, of whom 26 were randomized to the HIIT group and 26 to the normal care group. The mean age was 63.4 years and 89% (n = 46) of the patients identified themselves as white. Overall, 88% (n = 46) of the patients completed the post-interventional peak VO2 determination and 94% (n = 49) of the patients completed the post-interventional blood draw.
The mean resistance training behavior at the start of the study was unbalanced between the groups, with the HIIT group using an 18 (42) min / week and the normal care group using a 44 (62) min / week, which was adjusted for analyzes based on the prognostic association with PSA and fitness -Results.
This study was completed 2 weeks earlier than expected at 10 weeks due to the impending facility closure during the COVID-19 outbreak for the last 6 participants – 3 per group.
Investigators reported 100 percent compliance with intensity and duration, and patients participated in 96% (n = 880) of the planned training sessions. Overall, 15% (n = 8) of patients reported worsening previous medical problems, including joint pain (n = 6), chest discomfort (n = 1), and drowsiness (n = 1); the medical problems related to HIIT. In addition, 1 patient reported gastric bleeding from a Dieulafoy lesion that was not related to HITT.
PSA doubling time was better in the HIIT group, although it did not reach statistical significance (adjusted mean intergroup difference, 17.9 months; 95% CI, -3.8 to 39.6; P = 0.10 ). The researchers did not identify an adjusted mean difference between the groups in testosterone (1.0 nmol / L; 95% CI, -0.7 to 2.6; P = 0.24). LNCap cell growth was significantly inhibited in the HIIT group versus the normal care group, with the adjusted mean difference between groups -0.13 units of optical density (95% CI, -0.25 to -0.02; P = 0.02; or -5.1.) Was%).
“These improvements seem to make sense and may lead to better outcomes for prostate cancer patients treated with active surveillance,” the researchers concluded.
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