Effectiveness of regular physical activity on exercise tolerance and biochemical parameters in high-risk prostate cancer patients during radiotherapy

Katarzyna Hojan; Owidia Ozga-Majchrzak; Maciej Górecki; Ewa Leporowska; Piotr Milecki

doi:10.20883/medical.e20

Authors

Katarzyna Hojan Department of Rehabilitation, Greater Poland Cancer Centre, Poznan, Poland
Owidia Ozga-Majchrzak Department of Rehabilitation, Greater Poland Cancer Centre, Poznan, Poland
Maciej Górecki Department of Rehabilitation, Greater Poland Cancer Centre, Poznan, Poland
Ewa Leporowska Central Laboratory, Greater Poland Cancer Centre, Poznan, Poland
Piotr Milecki Chair and Department of Electroradiology, Poznan University of Medical Sciences, Poland

DOI:

https://doi.org/10.20883/medical.e20

Keywords:

exercises, radiation therapy, oncology, supportive care, rehabilitation

Abstract

Introduction. Radiotherapy (RT) is an important modality for curative treatment in high-risk prostate cancer (PCa) patients that improves overall survival, however, it may cause unfavorable changes in physical fitness, increased risk factors for cardiovascular and metabolic complications. The effects of physical exercise on aerobic capacity and on serum levels of liver and renal function indices in PCa patients undergoing RT are still unknown.
Aim. The purpose was to assess the impact of supervised physical activity on aerobic capacity, hemorheology and metabolic biomarker levels in high-risk PCa patients during RT.
Material and methods. Seventy-two men were randomly allocated to two groups before RT for high-risk prostate carcinoma. Thirty-six men conducted physical exercise (EG) and the other 36 men were a control group (UC). Outcomes measured were 6-Minute Walk Test (6MWT), blood parameters, serum levels of hepatic and renal function biomarkers (urea, creatinine, alanine and aspartate aminotransferase, PSA) in a modified shuttle test before and after RT.
Results. After RT, decreased diastolic blood pressure (before test p = 0.05) was observed in the EG and in the UG, there was an increase in resting heart rate (p = 0.017), a decrease in walking distance (p = 0.036), and an increase in Borg fatigue score during the 6MWT. There was no statistically significant change in renal biomarkers or PSA in the liver in either group.
Conclusions. Physical activity in prostate carcinoma patients during RT improves capacity tolerance with a decrease in Borg fatigue score, but this activity did not influence on serology outcomes or other blood indicators during RT

Downloads

Download data is not yet available.

References

Thompson I, Thrasher JB, Aus G, Burnett AL, Canby‑Hagino ED, Cookson MS. et al. AUA Prostate Cancer Clinical Guideline Update Panel. Guideline for the management of clinically localized prostate cancer: Guideline for the management of clinically localized prostate cancer: 2007 update. J Urol. 2007;177(6):2106–31.

Segal RJ, Reid RD, Courneya KS, Sigal RJ, Kenny GP, Prud'Homme DG. et al. Randomized controlled trial of resistance or aerobic exercise in men receiving radiation therapy for prostate cancer. J Clin Oncol. 2009;27(3): 344–51.

Truong PT, Gaul CA, McDonald RE, Petersen RB, Jones SO, Alexander AS. et al. Prospective evaluation of a 12-week walking exercise program and its effect on fatigue in prostate cancer patients undergoing radical external beam radiotherapy. Am J Clin Oncol. 2011;34(4):350–5.

Kapur G, Windsor PM, McCowan C. The effect of aerobic exercise on treatment‑related acute toxicity in men receiving radical external beam radiotherapy for localised prostate cancer. Eur J Cancer Care. 2010;19(5):643–7.

Windsor PM, Nicol KF, Potter J. A randomised, controlled trial of aerobic exercise for treatment‑related fatigue in men receiving radical external beam radiotherapy for localised prostate carcinoma. Cancer. 2004;101(3):550–557.

Bourke L, Gilbert S, Hooper R, Steed LA, Joshi M, Catto JW. et al. Lifestyle changes for improving disease specific quality of life in men on androgen deprivation therapy for advanced prostate cancer. Eur Urol. 2014;65(5): 865–72.

Spry NA, Taaffe DR, England PJ, Judge JS, Stephens DA, Peddle‑McIntyre C, et al. Long‑term effects of intermittent androgen suppression therapy on lean and fat mass: a 33-month prospective study. Prostate Cancer Prostatic Dis. 2013;16(1):67–72.

Van Doornen LJ, Snieder H, Boomsma DI. Serum lipids and cardiovascular reactivity to stress. Biol Psychol. 1998;47(3):279–97.

Islami F, Mańczuk M, Vedanthan R, Vatten L, Polewczyk A, Fuster V. et al. A cross‑sectional study of cardiovascular disease and associated factors. Ann Agric Environ Med. 2011;18(2):255–259.

Mazza A, Pessina AC, Tikhonoff V, Montemurro D, Casiglia E. Serum creatinine and coronary mortality in the elderly with normal renal function: the CArdiovascular STudy in the Elderly (CASTEL). J Nephrol. 2005;18(5): 606–12.

Banfi G, Colombini A, Lombardi G, Lubkowska A. Metabolic markers in sports medicine. Adv Clin Chem. 2012; 56:1–54.

Vera FM, Manzaneque JM, Maldonado EF, Carranque GA, Cubero VM, Blanca MJ, Morell M. Biochemical changes after a qigong program: lipids, serum enzymes, urea, and creatinine in healthy subjects. Med Sci Monit. 2007; 13(12):560–6.

El‑Sayed MS, Ali N, El‑Sayed Ali Z. Haemorheology in exercise and training. Sports Med. 2005;35(8):649–70.

Huang SH, Catton C, Jezioranski J, Bayley A, Rose S, Rosewall T. The effect of changing technique, dose, and PTV margin on therapeutic ratio during prostate radiotherapy. Int J Radiat Oncol Biol Phys. 2008;71:1057–64.

Schmidt K, Vogt L, Thiel C, Jäger E, Banzer W. Validity of the six‑minute walk test in cancer patients. Int J Sports Med. 2013;34(7):63–6.

Mao J, Zhang J, Zhou S, Das S, Hollis DR, Folz RJ. et al. Updated assessment of the six‑minute walk test as predictor of acute radiation‑induced pneumonitis. Int J Radiat Oncol Biol Phys. 2007;67(3):759–67.

Solway S, Brooks D, Lacasse Y, Thomas S. A qualitative systematic overview of the measurement properties of functional walk tests used in the cardiorespiratory domain. Chest. 2001;119(1):256–70.

ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six‑minute walk test. Am J Respir Crit Care Med. 2002;166(1):111–117.

Spence RR, Heesch KC, Brown WJ. Exercise and cancer rehabilitation: A systematic review. Cancer Treat Rev. 2010;36(2):185–94.

Rock CL, Doyle C, Demark‑Wahnefried W, Meyerhardt J, Courneya KS, Schwartz AL. et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012;62(4):242–74.

Vellas B, Guigoz Y, Garry PJ, Nourhashemi F, Bennahum D, Lauque S, Albarede JL. The Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition. 1999;15(2):116–122.

Lissoni P, Meregalli S, Bonetto E, Mancuso M, Brivio F, Colciago M, Gardani G. Radiotherapy‑induced lymphocytopenia: changes in total lymphocyte count and in lymphocyte subpopulations under pelvic irradiation in gynecologic neoplasms. J Biol Regul Homeost Agents. 2005;19(3–4):153–8.

Drouin JS, Young TJ, Beeler J, Byrne K, Birk TJ, Hryniuk WM, Hryniuk LE. Random control clinical trial on the effects of aerobic exercise training on erythrocyte levels during radiation treatment for breast cancer. Cancer. 2006;107(10):2490–5.

Galvão DA, Spry N, Taaffe DR, Denham J, Joseph D, Lamb DS. et al. A randomized controlled trial of an exercise intervention targeting cardiovascular and metabolic risk factors for prostate cancer patients from the RADAR trial. BMC Cancer. 2009;9:419.

Brancaccio P, Maffulli N, Limongelli FM. Creatine kinase monitoring in sport medicine. Br Med Bull. 2007;81–82:209–30.