Home-based Exercise Influence On Circulating Cytokines, Functional Capacity And Quality Of Life In Men With Prostate Cancer Under Active Surveillance

Abstract

PURPOSE: To investigate the impact of a home-based exercise program in men with PCa. METHODS: Fifteen men with PCa under active surveillance completed 24 weeks of home-based exercise (HBE), combining aerobic and body-weight based exercises. Aerobic exercise included 5 days of walking for 30 minutes at 40-60% of the participant’s heart rate reserve. Body-weight based exercises were performed 3 times per week consisting of 3 sets of 15 reps of bodyweight squats, inclined push-ups, and hip thrusts. Baseline and end of study assessments were done. Blood was collected to measure circulating eotaxin, IFNγ, IL-12, IL-1a, IL-5, IL-6, TNF-α, and VEGF (pg/mL; Millipore Sigma, Billerica, MA). A 6-minute walk test (6MWT) was done to measure physical function. The Short form 36 (SF-36) and Functional Assessment of Chronic Illness Therapy Fatigue (FACIT-F) were used to quantify changes in quality of life (QoL). T-tests were performed with significance set to p < 0.05. RESULTS: Of the 15 men consented, 9 men completed the intervention (40% attrition due to COVID). Participants were 72.0 ± 8.52 yrs old, 85.31 ± 6.41 kg with BMI of 27.77 ± 2.93 kg/m2. A tendency was observed for improved 6MWT distance (Pre: 382.7 ± 108.1 m; Post: 466.7 ± 73.78; p = 0.08). Non-significant reductions were seen in circulating of IFNγ (Pre: 152.9 ± 312.7; Post: 118.9 ± 258.8; p = 0.08) and VEGF (Pre: 125.2 ± 198.7; Post: 80.29 ± 124.3; p = 0.06). Several other biomarkers showed relevant, though not significant, decreases as well, including IL-12 (Pre: 28.69 ± 32.06; Post: 23.92 ± 19.38; -16.6%), IL-1a (Pre: 78.76 ± 183.3; Post: 65.55 ± 147.6; -16.8%), IL-6 (Pre: 23.71 ± 45.64; Post: 21.24 ± 45.18; -10.4%), and TNF-α (Pre: 24.58 ± 35.4; Post: 19.71 ± 20.76; -19.8%). Significant differences were identified in the SF-36 for role limitation due to emotional problems (Pre: 85 ± 15.1; Post: 96.7 ± 7.0; p = 0.003) and the FACIT subscales for physical wellbeing (Pre: 3.7 ± 0.2; Post: 1.3 ± 1.5; p < 0.001) and emotional wellbeing (Pre: 3.7 ± 0.3; Post: 1.5 ± 0.9; p < 0.001). CONCLUSIONS: : Despite the loss of participants due to COVID-19 protocols limiting in person research visits, the results show promising indications that HBE can be effective in reducing cytokines, increasing functional capacity and promoting QoL in men with PCa. Further investigation is needed with a powered sample.