Medicine and Health Sciences Commons^™

Effects And Moderators Of Exercise Medicine On Cardiometabolic Outcomes In Men With Prostate Cancer Previously Or Currently Undergoing Androgen Deprivation Therapy: An Individual Patient Data Meta-Analysis, Pedro Lopez, Robert U. Newton, Dennis R. Taaffe, Kerri Winters-Stone, Laurien M. Buffart, Daniel A. Galvão

Research outputs 2022 to 2026

Purpose: To examine the effects and moderators of exercise effects on cardiometabolic outcomes in men with prostate cancer previously or currently undergoing androgen deprivation therapy (ADT). Results: Seven trials including 560 patients were examined. Exercise resulted in significant effects on whole-body and regional fat mass (P ≤ 0.001). For whole-body fat mass, significant exercise effects were observed in patients who were unmarried (−1.4 kg, P < 0.05) and who presented with higher fat mass levels (−1.0 kg, P < 0.05). For diastolic blood pressure and low-density lipoprotein (LDL), younger (−4.7 mmHg, P < 0.05) and older patients (−0.2 mmol.l-1, P < 0.10) achieved greater effects, respectively. Regarding high-density lipoprotein (HDL), patients undertaking ADT + prostatectomy + radiotherapy derived significant exercise effects (0.3 mmol.l-1, P < 0.05). Conclusions: Exercise effectively reduces fat mass across subgroups of men undergoing or following ADT with different characteristics. For diastolic blood pressure, HDL and LDL, groups based on age and treatment history could be specifically targeted with exercise medicine.

Moderators Of Resistance-Based Exercise Programs' Effect On Sarcopenia-Related Measures In Men With Prostate Cancer Previously Or Currently Undergoing Androgen Deprivation Therapy: An Individual Patient Data Meta-Analysis, Pedro Lopez, Robert U. Newton, Dennis R. Taaffe, Kerri Winters-Stone, Daniel A. Galvão, Laurien M. Buffart

Research outputs 2022 to 2026

Introduction: Older men with prostate cancer are commonly affected by reductions in lean mass and physical function following androgen deprivation therapy (ADT). Resistance-based exercise programs are critical to counteract the musculoskeletal toxicities derived from prostate cancer treatment and aging. However, there is significant variability in the effects of exercise interventions. Examining demographic and clinical moderators of exercise effects in this patient group can assist in identifying which subgroups of patients benefit most. Therefore, we examined the effects and moderators of resistance-based exercise programs on sarcopenia-related outcomes that included lean mass, skeletal muscle index, physical function, and muscle strength in older …

Prehabilitative Versus Rehabilitative Exercise In Prostate Cancer Patients Undergoing Prostatectomy, Favil Singh, Robert U. Newton, Dennis R. Taaffe, Pedro Lopez, Jeff Thavaseelan, Matthew Brown, Elayne Ooi, Kazunori Nosaka, Dickon Hayne, Daniel A. Galvão

Research outputs 2022 to 2026

Purpose: The study compared the efficacy of commencing supervised exercise in men with prostate cancer before and after prostatectomy on objective and patient-reported outcomes, hospital length of stay, and urinary incontinence. Methods: Forty-one men were randomised to a 6-week prehabilitation or rehabilitation exercise programme. Prehabilitation involved resistance and aerobic exercise thrice weekly pre-surgery, while rehabilitation comprised the same commencing 6-weeks post-surgery. Assessments included strength, function (chair rise, stair climb, 400-m, 6-m usual, fast, and backwards walk), body composition, fatigue and quality of life, undertaken at pre-surgery, early post-surgery and late post-surgery phase, with urinary incontinence (24-h pad test) assessed at …

Response To Chen Et. Al, Albert Stuart Reece, Gary Kenneth Hulse

Research outputs 2022 to 2026

Whilst our paper was published in three parts to assist with readability it is essentially a single report. Our analysis moves logically from continuous and categorical bivariate studies to inverse probability weighted multivariate (IPWM) and then geospatiotemporal analysis and finally statistical analysis of geospatiotemporal models. Context is important. As stated by Chen and colleagues IPWM models are very powerful and present compelling conclusions and have the effect of transforming ecological into pseudo-randomized studies from which it is entirely proper to draw causal conclusions. That this report follows similar earlier IPWM and geotemporospatial reports on the commonest cancer in adults and …

Experiences Of Participants In A Clinical Trial Of A Novel Radioactive Treatment For Advanced Prostate Cancer: A Nested, Qualitative Longitudinal Study, Bianca Viljoen, Michael S. Hofman, Suzanne K. Chambers, Jeff Dunn, Haryana M. Dhillon, Ian D. Davis, Nicholas Ralph

Research outputs 2022 to 2026

Objectives: Qualitative studies nested within clinical trials can provide insight into the treatment experience, how this evolves over time and where improved supportive care is required. The purpose of this qualitative study is to describe the lived experiences of men with advanced prostate cancer participating in the TheraP trial; a randomised trial of 177Lu-PSMA-617 compared with cabazitaxel chemotherapy. Methods: Fifteen men with advanced prostate cancer were recruited from the TheraP clinical trial with interviews conducted at three timepoints during the trial. An interpretative phenomenological approach was used, and interviews analysed using thematic analysis. This research paper reports the results from …

Social Ecological Influences On Treatment Decision-Making In Men Diagnosed With Low Risk, Localised Prostate Cancer, Megan Mcintosh, Melissa J. Opozda, Camille E. Short, Daniel A. Galvão, Rebecca Tutino, Michael Diefenbach, Behfar Ehdaie, Christian Nelson

Research outputs 2022 to 2026

Objective: Individuals diagnosed with low risk, localised prostate cancer (PCa) face a difficult decision between active surveillance (AS) and definitive treatment. We aimed to explore perceived influences on treatment decision-making from the patient and partner's perspectives. Methods: Patients (and partners) who met AS criteria and had chosen their treatment were recruited. Semi-structured individual interviews were conducted via telephone to explore experiences of diagnosis, impact on patient lifestyle, experiences with physicians, treatment preferences/choice, treatment information understanding and needs, and overall decision-making process. Interviews were audio recorded, transcribed verbatim, and analysed using Reflexive Thematic Analysis. Results: Twenty-four male patients (18 chose AS) …

Impact Of Different Unconditional Monetary Incentives On Survey Response Rates In Men With Prostate Cancer: A 2-Arm Randomised Trial, Megan Mcintosh, Melissa J. Opozda, Michael O’Callaghan, Andrew D. Vincent, Daniel A. Galvão, Camille E. Short

Research outputs 2022 to 2026

Background:

Men are often viewed as a difficult group to recruit for psychological research, including in psycho-oncology. Whilst research has demonstrated the effectiveness of small monetary incentives for encouraging research participation, little research has examined different large unconditional incentive amounts. Larger unconditional incentives may result in increased participation of men in psychological research. This randomised study within a case–control trial of men diagnosed with early-stage prostate cancer aimed to investigate whether (a) response rates to a 30-min questionnaire completed via mail, online, or phone would vary with different unconditional incentive amounts, and (b) demographics would vary in those who responded …

Modulating Tumour Hypoxia In Prostate Cancer Through Exercise: The Impact Of Redox Signalling On Radiosensitivity, Malcolm Brown, Amélie Rébillard, Nicolas H. Hart, Dominic O’Connor, Gillian Prue, Joe M. O’Sullivan, Suneil Jain

Research outputs 2022 to 2026

Prostate cancer is a complex disease affecting millions of men globally. Radiotherapy (RT) is a common treatment modality although treatment efficacy is dependent upon several features within the tumour microenvironment (TME), especially hypoxia. A hypoxic TME heightens radioresistance and thus disease recurrence and treatment failure continues to pose important challenges. However, the TME evolves under the influence of factors in systemic circulation and cellular crosstalk, underscoring its potential to be acutely and therapeutically modified. Early preclinical evidence suggests exercise may affect tumour growth and some of the benefits drawn, could act to radiosensitise tumours to treatment. Intracellular perturbations in skeletal …

Exercise In Advanced Prostate Cancer Elevates Myokine Levels And Suppresses In-Vitro Cell Growth, Jin Soo Kim, Dennis R. Taaffe, Daniel A. Galvão, Nicolas H. Hart, Elin Gray, Charles J. Ryan, Stacey A. Kenfield, Fred Saad, Robert U. Newton

Research outputs 2022 to 2026

Background:

Altering the systemic milieu through exercise has been proposed as a potential mechanism underlying exercise-driven tumour suppression. It is not yet known whether men with advanced prostate cancer can elicit such adaptations following a program of exercise. The purpose is to examine myokine levels of serum acquired from metastatic castrate-resistant prostate cancer (mCRPC) patients recruited to the INTERVAL-GAP4 trial before and after 6 months of exercise and its tumour-suppressive effect.

Methods:

Twenty-five men with mCRPC (age = 74.7 ± 7.1 yrs) were randomised to supervised multimodal (aerobic and resistance) exercise (EX) or self-directed exercise control group (CON). Body composition …

Exercise In Preventing Falls For Men With Prostate Cancer: A Modelled Cost-Utility Analysis, Kim Edmunds, Paul Scuffham, Robert U. Newton, Daniel A. Galvão, Haitham Tuffaha

Research outputs 2022 to 2026

Introduction:

Men who receive androgen deprivation therapy (ADT) for prostate cancer (PCa) are a vulnerable falls population due to the side effects of treatment. The purpose of this paper is to determine the cost-effectiveness of exercise in preventing falls and fractures for this high-risk population in Australia.

Methods:

A decision analytic model was constructed to evaluate the cost utility of an exercise intervention compared to usual care from a health system perspective. The intervention comprised two 1-h sessions of supervised exercise per week over 1 year for men with non-metastatic PCa receiving curative radiation therapy and ADT. A Markov model …

Why Do Men With Prostate Cancer Discontinue Active Surveillance For Definitive Treatment? A Mixed Methods Investigation, Megan Mcintosh, Melissa J. Opozda, Michael O’Callaghan, Andrew D. Vincent, Daniel A. Galvão, Camille E. Short

Research outputs 2022 to 2026

Objectives: To explore the personal and/or medical reasons patients on active surveillance (AS) have, or consider having, further definitive treatment for their prostate cancer. Research suggests up to 50% of patients on AS will discontinue within 5 years, though reasons for discontinuation from the patient's perspective is under-explored. Methods: Prostate cancer patients who were or had been on AS for at least 6 months were recruited. A questionnaire assessed reasons for receiving/considering definitive treatment and the extent to which reasons were personal or medical. Clinical information was extracted from a state-level population registry. A subset of participants were interviewed to …