E-poster Presentation 2014 World Cancer Congress

Effects of a clinician referral and exercise program for men who have completed active treatment for prostate cancer: a multicentre cluster randomized controlled trial [ENGAGE]. (#892)

Patricia M Livingston 1 , Melinda Craike 1 , Jo Salmon 1 , Kerry Courneya 2 , Cadeyrn J Gaskin 1 , Steve F Fraser 1 , Mohammadreza Mohebbi 1 , Suzanne Broadbent 3 , Mari Botti 1 , Bridie Kent 4 , ENGAGE Uro-Oncology Clinicians' Group** [Damien Bolton, Sarat Chander, Michael Chao, Andrew Coleman, Thea Connor, James Jackson, Darryl Lim Joon, Michael Lim Joon, Nathan Lawrentschuk, Shomik Sengupta, Mark Shaw, Joseph Sia, Matthew Threadgate, David Webb, Angela Wilkinson]
  1. Faculty of Health, Deakin University, Melbourne, VIC, Australia
  2. Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada
  3. School of Health and Human Sciences, Southern Cross University, Lismore, NSW, Australia
  4. Plymouth University, Plymouth, England, United Kingdom

Background:

Exercise programs have a positive impact on quality of life outcomes in men with prostate cancer and have been shown to be safe, feasible and effective. Despite the potential benefits, many men living with prostate cancer do not participate in regular exercise.

Aim:

To test the efficacy of a clinician referral and exercise program to improve physical activity levels, psychological wellbeing and quality of life among men with prostate cancer.

Methods:

A multicentre, cluster randomized controlled trial in Melbourne, Australia, randomized 15 clinicians to either refer eligible participants (n=54) to a supervised exercise program (two gym sessions and one home-based session per week for 12 weeks) or follow usual care (n=93). The primary outcome was self-reported physical activity. Secondary outcomes: an objective measure of physical activity, quality of life, levels of anxiety and symptoms of depression.

Results:

At 12 weeks, no significant intervention effects were observed for combined moderate and vigorous physical activity levels (effect size: 0.08; 95% CI: -0.28, 0.45; p=0.48); significant intervention effects were observed for vigorous-intensity exercise (effect size: 0.46; 95% CI: 0.09, 0.82; p=0.010). Significant intervention effects were observed for the percentage of participants meeting exercise guidelines (≥150 minutes per week) based on combined moderate-vigorous (Odds Ratio (OR): 3.9; 95% CI: 1.9, 7.8; p=0.002) exercise; a significant inverse effect was observed on anxiety levels (effect size: 0.42, 95% CI: 0.06, 0.79; p=0.02) and borderline intervention effects for depression symptoms (effect size: -0.35, 95% CI: -0.71, 0.02; p=0.06); 80% of participants reported the clinician’s recommendation influenced them to participate in the 12-week exercise program. 

Conclusions:

Clinicians are ideally suited to refer men to tailored exercise programs as part of their clinical care for men who have completed active treatment for prostate cancer, to improve physical activity levels and quality of life outcomes.