Changes In Anxiety, Fear Of Cancer Progression, And Quality Of Life In Prostate Cancer Patients On Active Surveillance After A 12-week Exercise Program: A Randomized Controlled Trial

Abstract

PURPOSE: Prostate cancer (PCa) patients undergoing active surveillance often experience psychological distress such as anxiety or fear or cancer progression. This study was to investigate the impacts of a 12-week exercise program on patient-reported outcomes in PCa patients undergoing active surveillance. METHODS: 52 PCa patients on active surveillance were randomized to high-intensity interval training (HIIT; n = 26) or usual care (UC; n = 26). The HIIT group performed a 12-week, thrice-weekly, supervised, aerobic HIIT intervention. Patient-reported outcomes were assessed at baseline and postintervention (12-weeks), including PCa-specific anxiety (Memorial Anxiety Scale for Prostate Cancer; MAX-PC), fear of cancer progression (Fear of Cancer Recurrence Inventory; FCRI), PCa-related symptoms (Expanded Prostate Cancer Index Composite-26; EPIC-26), cancer-related quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30-item; EORTC QLQ-C30), and generic psychosocial outcomes (e.g., fatigue, stress, and self-esteem). Analysis of covariance was used to compare between-group differences. RESULTS: 50/52 (96%) participants completed patient-reported outcome assessments at 12-weeks and adherence to the HIIT program was 96%. Compared to UC, HIIT significantly reduced total PCa-specific anxiety (adjusted between-group mean difference, -2.7; 95% confidence interval[CI], -5.0 to -0.4; p = 0.024; d = 0.28) and fear of recurrence (adjusted between-group mean difference, -2.0; 95% CI, -3.5 to -0.4; p = 0.013; d = 0.67) in MAX-PC; hormonal dysfunction (p = 0.005) in EPIC-26; and perceived stress (p = 0.037), fatigue (p = 0.029), and self-esteem (p = 0.007). CONCLUSIONS: A 12-week supervised HIIT program reduced PCa-specific anxiety, fear of cancer progression, hormone symptoms, stress, and fatigue, and increased self-esteem in men with PCa on active surveillance. Larger trials are warranted to determine the longer-term effects of exercise on patient-reported outcomes and whether such effects influence willingness to continue on active surveillance.