Purpose Androgen deprivation therapy
(ADT) in men with prostate cancer (PCa) is associated with an array of adverse effects, including reduced bone
mineral density (BMD) predisposing patients to increased fracture risk. Our purpose was to examine the effects of targeted exercise
modes on BMD in men with PCa undergoing ADT.
Between 2009 and 2012, 154 PCa patients 43–90 yr old on ADT were randomized to exercise
targeting the musculoskeletal system (impact
loading + resistance
training [ImpRes], n
= 57) supervised for 12 months, cardiovascular and muscular systems (aerobic + resistance
= 50) supervised for 6 months followed by a 6-month home-based program, or delayed aerobic exercise
= 47) received exercise
information for 6 months followed by 6 months of supervised aerobic exercise
(stationary cycling). End points were lumbar spine, hip and whole-body BMD measured by dual-energy x-ray absorptiometry with secondary end points of lean and fat mass, appendicular skeletal muscle mass, and neuromuscular strength. ANOVA was used to compare the exercise
groups with DelAer at 6 and 12 months.
There was a between-group difference in BMD for ImpRes and DelAer at the spine (6 months, P
= 0.039; 12 months, P
= 0.035) and femoral neck (6 months, P
= 0.050), with decline attenuated in ImpRes (~−1.0% vs ~−2.0%). Compared with DelAer, ImpRes increased appendicular skeletal muscle at 6 months (0.3 kg, P
= 0.045) and improved muscle strength at 6 and 12 months (P
≤ 0.012) by 9%–34%. A limitation was inclusion of well-functioning patients.
loading and resistance exercise
loss at the spine and enhances overall musculoskeletal function in PCa patients undergoing ADT.