Associations Between Physical Activity, Quality Of Life And Emotional Well-being During Active Surveillance For Prostate Cancer

Abstract

PURPOSE: The purpose of this retrospective longitudinal study was to examine the association between post-diagnosis physical activity (PA), and the change in quality of life (QoL) and emotional well-being over time in men on active surveillance (AS) for low-risk prostate cancer. METHODS: Our analysis included 630 participants from AS initiation until AS discontinuation or loss to follow up. A modified Godin Leisure-Time Exercise Questionnaire was used to measure post-diagnosis PA in metabolic equivalent-minutes per week (MET-min/wk). Participants were categorized based on their PA levels: inactive (<210 MET-min/wk), insufficiently active (210-499 MET-min/wk), active (500-1000 MET-min/wk), and highly active (>1000 MET-min/wk). QoL and emotional well-being were assessed by the Patient-Oriented Prostate Utility Scale. The association between post-diagnosis PA (independent variable) and QoL (dependent variable) was assessed using generalized estimated equations (GEE). GEEs were also used to determine the association between PA (independent variable) and emotional well-being (dependent variable). All models adjusted for participant’s age. RESULTS: Compared to inactive participants, active (&#946;1.14; 95%CI= 0.11, 2.16, p=0.029) and highly active (&#946;1.62; 95%CI = 0.58, 2.67; p=0.002) participants had higher QOL during AS. Highly active participants were more likely to experience high emotional well-being (OR =1.55 95%CI = 1.11, 2.16; p= 0.010) over time compared to their inactive counterparts. In a subgroup analysis for men with low emotional well-being early on during AS, engaging in > 1000 MET-min/wk (highly active) was associated with greater odds of experiencing high emotional well-being over time (OR = 2.17; 95%CI = 1.06, 4.46, p= 0.034) relative to lowest PA (<210 MET-min/wk). CONCLUSIONS: Our findings emphasize the importance of PA as a supportive care strategy during AS for low-risk prostate cancer.