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Innovations in Oncology 2019

Could exercise beat advanced prostate cancer?

Dr Mark Buzza (pictured)

Global Director of Biomedical Research, Movember

Regular workouts can help men with early prostate cancer live better, for longer but could it also help patients with advanced disease?

Staying physically active might be the last thing on your mind when you’re exhausted from dealing with cancer – but exercise make a huge difference before, during and after treatment.
Continuing to be physically active throughout treatment has been proven to help prevent a decline in cardiorespiratory and muscle fitness. It also helps patients cope with cancer-related fatigue, improves their overall wellbeing and reduces the likelihood of dying from the disease that claims the lives of 11,000 men in the UK every year.

New exercise guidelines for cancer patients

Last month (October 2019), a thorough review of the available evidence, conducted by an international group of 40 experts led by the University of British Columbia, resulted in the development of new guidelines for preventing, managing and recovering from cancer.
The updated international recommendations now advise that taking part in exercise helps improve survival after a diagnosis of breast, colon and/or prostate cancer.
This is good news for patients as it gives us a real opportunity to continue integrating exercise medicine within cancer care.

We need better understanding of how exercise affects those with advanced cancer

However, we still don’t yet know enough about the benefits of exercise for men with advanced disease. This is a gap in our knowledge and an important question that needs to be studied.

That’s why Movember has initiated the INTERVAL GAP4 trial, the first randomised, controlled trial in the world, which is aiming to prove whether high-intensity aerobic exercise combined with resistance training could extend the lives of men with metastatic prostate cancer.

Over 20 research teams from eight countries, including the UK, US, Canada, Australia and Germany, are working together to recruit 866 men to test whether exercise could be prescribed as a medicine alongside standard treatments such as chemotherapy, radiotherapy or hormone therapy.

Half of the men who sign up are assigned to the active (or supervised exercise) arm, while the other half are put on a control arm. Every man participating in the study is given regular check-ups (alongside their normal treatment).

Trialing a two-year, tailored exercise plan aimed to delay prostate cancer progression

Men on the supervised exercise arm are given a detailed training plan – designed to increase their strength, fitness and flexibility. The plan is specifically tailored to them and their disease and they will follow it for two years. The programme includes two 75-minute sessions of mixed resistance and aerobic exercise and one 30-minute session of aerobic exercise each week for the duration of the trial.

A 2016 pilot study led by Professor Rob Newton from Edith Cowan University in Western Australia, published in the medical journal the British Medical Journal Open, demonstrated that this type of exercise has the potential to be a powerful tool to delay the progression of advanced prostate cancer. It’s an ambitious project and there is a long way to go, but we hope it could lead to a revolution in the way we tackle advanced prostate cancer.

The men who join GAP4 are not only benefitting from the exercise programmes but by tracking their progress, they are also helping us get a better understanding of how best to treat the disease and improve the lives of all men living with prostate cancer.

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