Acute versus chronic exposure to androgen suppression for prostate cancer: impact on the exercise response

Exercise has been proposed as an effective countermeasure for androgen suppression therapy induced side effects. Since the magnitude of fat gain and muscle loss is most pronounced during the early phases of androgen suppression therapy, the exercise response may differ by the duration of androgen suppression therapy. We investigated whether the exercise response varied by the prior duration of exposure to androgen suppression therapy, that is acute--less than 6 months vs later--6 months or greater.

A total of 50 men 55 to 84 years old undergoing androgen suppression therapy for nonbone metastatic prostate cancer completed a progressive resistance and cardiovascular exercise program for 12 weeks, including 16 with acute and 34 with chronic androgen suppression therapy exposure. We assessed fat and lean mass by dual energy x-ray absorptiometry as well as muscle strength, functional performance, quality of life and blood biomarkers.

Patients on acute androgen suppression showed an increase in total body fat compared to those on chronic androgen suppression (0.9 kg, p = 0.018). Each group experienced increased appendicular skeletal muscle (about 0.5 kg, p <0.01). Triglycerides decreased in the chronic group and increased in the acute group (p = 0.027). Change in triglycerides were associated with the change in total body fat (r = 0.411, p = 0.004). There were no differences between the groups in prostate specific antigen, testosterone, glucose, insulin, total cholesterol, low and high density lipoprotein, cholesterol, C-reactive protein, homocysteine or quality of life. The 2 groups showed similar improvement in muscle strength and function, and cardiovascular fitness.

Apart from differences in body fat and triglycerides the beneficial effects of exercise are similar in patients on acute or chronic androgen suppression therapy.