Feasibility Of High-intensity Interval Training In Men With Prostate Cancer Undergoing Active Surveillance: Erase Trial

Abstract

PURPOSE: To examine the feasibility of high-intensity interval training (HIIT) in prostate cancer patients on active surveillance from the Exercise duRing Active Surveillance for prostatE cancer (ERASE) trial. METHODS: ERASE is a two-armed, single centre, randomized controlled trial in Edmonton, Alberta, Canada. Men diagnosed with very low- to favorable intermediate-risk prostate cancer undergoing active surveillance are approached via clinic visit or telephone call. Participants are randomized to either the HIIT group or usual care group. The HIIT group performs a 12-week, thrice-weekly, supervised, aerobic HIIT protocol on a treadmill for 28-40 min/session. Work and recovery intervals alternated every 2 minutes with workloads corresponding to 85-95% and 40% VO2peak, respectively. The target sample size is 66 to detect a significant between-group difference in VO2peak of 3.5 ml/kg/min with a two-tailed alpha level of less than 0.05, 80% power, and a 10% drop-out rate. RESULTS: To date, we have recruited from July 2019 to October 2020 with a planned additional 2 months of recruitment. Of 283 patients screened so far, 131 (46%) were eligible, and 43 (33%; mean age 67±7 years) were randomized (22 in the HIIT group; 21 in the usual care group). Ineligible patients were mostly living too far away (47%), too active (22%), or having medical issues (19%). Reasons for eligible patients declining were mostly lack of time (35%), not interested (34%), or lost contact (14%). Of 43 patients randomized so far, 33/35 (94%) have completed postintervention assessments. The reasons for dropout were unwilling to continue in the study and lost contact. Total number of attended sessions is 593/612 (96.9%) with 100% compliance to the HIIT protocol. Reasons for missed sessions were dropout (16 sessions), knee pain (2 sessions), and traveling (1 session). 6 participants in the HIIT group reported aggravation of a previous joint issue, 1 chest discomfort, and 1 light-headedness, all explainable by previous medical history. CONCLUSION: Prostate cancer patients undergoing active surveillance are interested in HIIT and are able to achieve high adherence. Future analyses of ERASE will report the preliminary efficacy of HIIT for improving fitness outcomes, patient-report outcomes, and biomarkers related to cancer progression and survival.