Exercise to Enhance Cardiovascular Health Among Black Prostate Cancer Patients with Androgen Deprivation Therapy: The POWER Trial
Abstract
One in eight men in the United States will develop prostate cancer in their lifetime, which makes this cancer the most common cancer among American men. At the same time, more than 30,000 men die of prostate cancer each year, which is the second highest number following lung cancer. However, when comparing by race, Black men have the highest chances of developing and dying of prostate cancer, which is approximately two times higher compared with White men. Hormone therapy is one of the standard treatments for prostate cancer. The sex hormone of men, called androgen, can cause prostate cancer cells to grow; therefore, lowering androgen levels often makes prostate cancers shrink or grow slowly or even prevents them from spreading to the body. This hormonal therapy is called androgen deprivation therapy (ADT), and many men with prostate cancer will receive this treatment to improve survival. However, ADT can cause side effects such as loss of skeletal muscle, fat gain, increased cholesterol levels, and reduced sexual desire and impotence, which can lead to a reduced quality of life. Furthermore, one of the important long-term side effects of ADT is that it can increase the risk of having cardiovascular disease. Notably, Black prostate cancer patients who received ADT are about 1.8 times more likely to develop cardiovascular disease compared with White men. One reason is that Black men are already at higher risks of having poor health conditions or other diseases during ADT which further increases the risk of cardiovascular disease. Recent research has reported that exercise is not only safe in prostate cancer patients while receiving ADT, but also effective in reducing side effects of ADT. Especially, a combination of aerobic and resistance exercise can improve a number of physical and psychological health, such as improved cardiovascular fitness, muscle mass and strength, and quality of life. Nevertheless, previous exercise studies for prostate cancer patients receiving ADT have been mostly in White patients; almost no studies have been done in Blacks. There also are considerable differences in cultural, social, and economic factors across racial groups that need to be considered when designing and programming exercise for Black prostate cancer patients. Given that Black men are more likely to develop prostate cancer in addition to other existing diseases and experience short- and long-term side effects of ADT such as cardiovascular disease, an exercise intervention that is specifically designed for and provided to Black prostate cancer patients who are receiving ADT will significantly improve physical and psychological outcomes in this underserved population. Therefore, we have developed a virtual, home-based, aerobic and exercise program and will test its effects on cardiovascular risks, as well as physical and psychological health in Black men with prostate cancer who are receiving ADT. The exercise program is more accessible (supervised virtually and provided with free home-bike and weight training equipment), individualized (one-on-one supervision orientation sessions), and engaging (through monthly group interactions and biweekly newsletters). Participants will be randomly assigned to either the exercise group or the non-exercise group for 16 weeks and then followed up at 1 year after joining the study. The non-exercise group will receive the same exercise program after the completion of the study. Our study is designed to tackle the disparities in health outcomes among Black prostate cancer patients on ADT. We anticipate that exercise will exert benefits on cardiovascular health as well as physical fitness, body composition, and quality of life after the 16-week of intervention. Our study findings will be a critical foundation of future studies that will be conducted in a large number of patients to investigate the impacts of exercise on long-term health outcomes, such as development of cardio
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Dec 28, 2022
- Source ID
- W81XWH2210705
Entities
People
- Christina M Dieli-Conwright
Organizations
- Dana–Farber Cancer Institute
- United States Army