Exercise and cardiorespiratory fitness in black men with prostate cancer receiving androgen deprivation therapy
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Abstract
BACKGROUND: Black men are more frequently diagnosed with prostate cancer (PCa), and often more aggressive forms, than their White counterparts. Androgen deprivation therapy (ADT) has become a first-line treatment despite some detriments including a higher risk of all-cause mortality and increased risk for cardiovascular disease (CVD). Cardiorespiratory fitness is strongly associated with the risk of CVD and all-cause mortality and is a strong predictor of longevity.
RESEARCH QUESTION: What is the impact of a 16-week virtually supervised combined resistance and aerobic exercise intervention on cardiorespiratory fitness among Black men with PCa on ADT?
METHODS: This single-center randomized controlled trial included 25 Black men with PCa who were receiving ADT. Participants were randomized 1:1 to the exercise group (n=12) or the control group (n=13). The exercise intervention involved tri-weekly sessions virtually supervised by a certified exercise trainer. Each session lasted approximately one hour and consisted of high-intensity interval training (HIIT) and resistance exercises. The HIIT intervention consisted of (1) warm-up (five minutes at 50% VO2peak), (2) alternating a high-intensity exercise phase (one minute at 75-95% of VO2peak) and a recovery phase (one minute at 40% of VO2peak) repeating 10 times (20 minutes in total), and (3) cool-down (five minutes at 30% VO2peak). Resistance exercises consisted of two groups completed on alternating days (i.e., odd sessions = group one exercises, even sessions = group two exercises). Each group of resistance exercises was comprised of five exercises targeting upper and lower body muscle groups. Each exercise was performed for 2-3 sets of 15-20 repetitions at 60-75% of 1-repetition max (1-RM) measured at a pre-intervention visit. Participants randomized to the control group were asked to maintain their normal exercise habits. Cardiorespiratory fitness was assessed by four different measures (i.e., relative VO2peak, absolute VO2peak, RER, and VE/VCO2 slope) through a graded maximal exercise stress test utilizing a ramp cycling protocol before and after the intervention. Normality was assessed with Q-Q plots and Shapiro-Wilks tests. Paired samples t-tests were used to compare pre-intervention and post-intervention measures within groups, while independent samples t-tests and Wilcoxon signed-rank tests were used to compare the effect between groups. ANCOVA analyses were used to compare the effect of different covariates (i.e., the pre-intervention value of variable, age, and cancer stage) on each measure of fitness.
RESULTS: The mean age for participants was 67.5 ± 9.3 years. The average Gleason score for participants was 8.0 ± 1.4. The mean body fat percentage was 35.2% ± 5.3%. Primary within-group analysis revealed no significant change in any of the variables for the exercise or control group. Secondary between-group analysis revealed no significant difference between groups for any of the fitness measurements. ANCOVA analysis revealed that each pre-intervention variable was a strong predictor of its post-intervention measurement. Age and cancer stage were both strong predictors of post-intervention RER.
CONCLUSION: A 16-week virtually supervised exercise intervention did not have a significant effect on measures of cardiorespiratory fitness in Black men with PCa who received ADT.
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2025