Supported progressive resistance training for countering the adverse side effects of prostate cancer treatment

Ashton, Ruth (2019) Supported progressive resistance training for countering the adverse side effects of prostate cancer treatment. Doctoral thesis, Northumbria University.

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Abstract

Exercise is recommended for cancer patients due to its positive effects on treatment side effects and quality of life. Currently no structured exercise guidelines for prostate cancer patients exist and most advice is aimed at those receiving androgen deprivation therapy (ADT). The over-arching aim of this thesis is to develop an exercise programme to improve cardiometabolic health in patients treated for prostate cancer, particularly via robot-assisted radical prostatectomy, and assess its effectiveness through a randomised controlled trial.

Resistance exercise training has shown via a systematic review and meta-analysis, to be effective for inducing improvements in resting blood pressure, endothelial function, blood biomarkers and aerobic capacity and is a safe mode of exercise in both healthy and clinical populations (Chapter 3). This thesis also demonstrates that some men after robot-assisted radical prostatectomy are at increased risk of cardiovascular disease within ten years of surgery and suffer with clinically significant levels of fatigue (Chapter 4). Furthermore men after robot-assisted radical prostatectomy appear to meet the Government recommended guidelines for aerobic physical activity but not for resistance-based exercise.

Patient and public involvement was integral to this thesis with the patients leading on the design and implementation of the exercise programme (Chapter 5). The results of the randomised controlled trial (Chapter 6), demonstrated that resistance exercise training had a clear effect on body composition, aerobic capacity, strength, functional wellbeing and prostate cancer specific quality of life and showed evidence of a favourable reductions in resting blood pressure and some blood biomarkers.

Collectively, this thesis provides evidence that resistance exercise training is effective in improving multiple cardiometabolic health benefits in men who have undergone robot-assisted radical prostatectomy whilst being a safe and well-received mode of exercise. Therefore, resistance exercise training can generally be considered a useful adjunct therapy for this patient population.

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