Introduction: Men with prostate cancer (PCa) experience increased rates of mental health concerns and current oncology services are needing to adjust to better meet the complex needs of men and their families. The primary aim of this randomized controlled trial (RCT) was to examine the efficacy of structured exercise to aid in the management of psychological distress in men with PCa.
Methods: Men with PCa reporting clinically significant distress (Distress thermometer score of ≥4) were randomized to either a 3-month, group-based, supervised exercise program undertaken 3x/week (IG) or usual care (UC). The primary outcome, psychological distress, was comprehensively assessed at baseline and 3 months using the Brief Symptom Inventory-18 (BSI), Hospital Anxiety and Depression Scale, Male Depression Risk Scale, Distress Thermometer and Kessler Psychological Distress Scale. Secondary outcomes included psychological supportive care needs, quality of life (QoL), fatigue, sleep quality, masculine self-esteem and objective measures of physical fitness and body composition.
Results: From October 2017 to January 2020, 53 men with PCa (age: 65.81 ± 5.86 years, body mass index: 28.69 ± 5.08 kg/m2) enrolled in the study (IG, n=26 and UC, n=27, planned recruitment target, n=100). 84.6 ± 8.7% of exercise sessions were attended. Mixed-model repeated measure analysis showed significant between-group differences from baseline to post-intervention in all psychological distress measures in favour of the IG (e.g. BSI- Depression: mean difference -3.41, 95% CI -5.77; -1.05, p=.006; BSI- Anxiety: mean difference -3.29, 95% CI -4.85; -1.72, p<.001). Psychological supportive care needs, QoL, fatigue, physical function and body composition also improved significantly in favour of the IG (all p<.05).
Conclusions: To our knowledge, this is the first RCT to investigate the effects of a supervised exercise program specifically in men with PCa experiencing clinically significant distress. Our results suggest that structured exercise interventions may represent a well-tolerated and effective mental health care strategy for men with PCa experiencing distress.