Body composition, fatigue and exercise in patients with prostate cancer undergoing androgen‐deprivation therapy

Objectives To investigate the association between lean mass (LM) and fat mass (FM) with fatigue and vitality before and after exercise in patients with prostate cancer already undergoing androgen‐deprivation therapy (ADT). Subjects and Methods Cross‐sectional associations between LM and FM with fati...

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Veröffentlicht in:BJU international 2018-12, Vol.122 (6), p.986-993
Hauptverfasser: Newton, Robert U., Jeffery, Emily, Galvão, Daniel A., Peddle‐McIntyre, Carolyn J., Spry, Nigel, Joseph, David, Denham, James W., Taaffe, Dennis R.
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container_end_page 993
container_issue 6
container_start_page 986
container_title BJU international
container_volume 122
creator Newton, Robert U.
Jeffery, Emily
Galvão, Daniel A.
Peddle‐McIntyre, Carolyn J.
Spry, Nigel
Joseph, David
Denham, James W.
Taaffe, Dennis R.
description Objectives To investigate the association between lean mass (LM) and fat mass (FM) with fatigue and vitality before and after exercise in patients with prostate cancer already undergoing androgen‐deprivation therapy (ADT). Subjects and Methods Cross‐sectional associations between LM and FM with fatigue and/or vitality measures were examined in 229 patients (aged 43–90 years). Prospective analysis was undertaken in 129 patients who underwent a supervised 3–6 months exercise programme (predominantly resistance + aerobic). Whole body and appendicular LM, and total and trunk FM were assessed by dual X‐ray absorptiometry. Fatigue was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire‐Core 30 (EORTC QLQ‐30) and vitality using the Short Form‐36. Results Based on the EORTC QLQ‐30, 19% of patients had clinically relevant fatigue. There was no association between LM and fatigue; however, total (P = 0.013), trunk (P = 0.015) and percentage (P = 0.008) FM were higher in fatigued than not fatigued patients, with total and trunk FM 5.0 and 2.6 kg higher, respectively. For quartiles of vitality, a similar pattern emerged for FM with those in the lowest quartile of vitality having the highest FM values (P = 0.014–0.034). In contrast, following supervised exercise, change in fatigue and vitality were associated with change in total LM (r = −0.182, P = 0.042 and r = 0.309, P = 0.001, respectively) but not FM. Patients fatigued at baseline but not fatigued following the exercise programme gained a median (interquartile range) of 2.1 (0.7–3.2) kg LM. Conclusion In patients with prostate cancer treated with ADT, body composition is associated with fatigue, with higher total and trunk FM in those with clinically relevant fatigue. However, following exercise those no longer fatigued had an accompanying substantial increase in LM. Modifying body composition, both LM and FM, in patients with prostate cancer may favourably alter cancer‐related fatigue levels and should be a target of exercise medicine in this population.
doi_str_mv 10.1111/bju.14384
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Subjects and Methods Cross‐sectional associations between LM and FM with fatigue and/or vitality measures were examined in 229 patients (aged 43–90 years). Prospective analysis was undertaken in 129 patients who underwent a supervised 3–6 months exercise programme (predominantly resistance + aerobic). Whole body and appendicular LM, and total and trunk FM were assessed by dual X‐ray absorptiometry. Fatigue was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire‐Core 30 (EORTC QLQ‐30) and vitality using the Short Form‐36. Results Based on the EORTC QLQ‐30, 19% of patients had clinically relevant fatigue. There was no association between LM and fatigue; however, total (P = 0.013), trunk (P = 0.015) and percentage (P = 0.008) FM were higher in fatigued than not fatigued patients, with total and trunk FM 5.0 and 2.6 kg higher, respectively. For quartiles of vitality, a similar pattern emerged for FM with those in the lowest quartile of vitality having the highest FM values (P = 0.014–0.034). In contrast, following supervised exercise, change in fatigue and vitality were associated with change in total LM (r = −0.182, P = 0.042 and r = 0.309, P = 0.001, respectively) but not FM. Patients fatigued at baseline but not fatigued following the exercise programme gained a median (interquartile range) of 2.1 (0.7–3.2) kg LM. Conclusion In patients with prostate cancer treated with ADT, body composition is associated with fatigue, with higher total and trunk FM in those with clinically relevant fatigue. However, following exercise those no longer fatigued had an accompanying substantial increase in LM. Modifying body composition, both LM and FM, in patients with prostate cancer may favourably alter cancer‐related fatigue levels and should be a target of exercise medicine in this population.</description><identifier>ISSN: 1464-4096</identifier><identifier>EISSN: 1464-410X</identifier><identifier>DOI: 10.1111/bju.14384</identifier><identifier>PMID: 29750398</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Absorptiometry ; Adult ; Aged ; Aged, 80 and over ; Androgen Antagonists - adverse effects ; Androgen Antagonists - therapeutic use ; Androgens ; androgen‐deprivation therapy ; Antineoplastic Agents, Hormonal - adverse effects ; Antineoplastic Agents, Hormonal - therapeutic use ; Body composition ; Body Composition - drug effects ; Body fat ; Cross-Sectional Studies ; Exercise ; Exercise Therapy ; Exercise Tolerance - physiology ; Fatigue ; Fatigue - chemically induced ; Fatigue - physiopathology ; Fatigue - rehabilitation ; Humans ; Male ; Middle Aged ; Muscle Strength - drug effects ; Muscle, Skeletal - drug effects ; Patients ; PCSM ; Prospective Studies ; Prostate cancer ; ProstateCancer ; Prostatic Neoplasms - drug therapy ; Prostatic Neoplasms - physiopathology ; Prostatic Neoplasms - rehabilitation ; Quality of life ; Resistance Training ; Treatment Outcome</subject><ispartof>BJU international, 2018-12, Vol.122 (6), p.986-993</ispartof><rights>2018 The Authors BJU International © 2018 BJU International Published by John Wiley &amp; Sons Ltd</rights><rights>2018 The Authors BJU International © 2018 BJU International Published by John Wiley &amp; Sons Ltd.</rights><rights>BJUI © 2018 BJU International</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3884-7d790eaf25667c941614bf1a9e373bb8e5f0e142e8982a8e4376c5eb0bbab1163</citedby><cites>FETCH-LOGICAL-c3884-7d790eaf25667c941614bf1a9e373bb8e5f0e142e8982a8e4376c5eb0bbab1163</cites><orcidid>0000-0002-9463-3196 ; 0000-0001-6381-1597 ; 0000-0003-0302-6129 ; 0000-0001-9913-4022 ; 0000-0001-8659-5065</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fbju.14384$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fbju.14384$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,782,786,1419,27933,27934,45583,45584</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29750398$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Newton, Robert U.</creatorcontrib><creatorcontrib>Jeffery, Emily</creatorcontrib><creatorcontrib>Galvão, Daniel A.</creatorcontrib><creatorcontrib>Peddle‐McIntyre, Carolyn J.</creatorcontrib><creatorcontrib>Spry, Nigel</creatorcontrib><creatorcontrib>Joseph, David</creatorcontrib><creatorcontrib>Denham, James W.</creatorcontrib><creatorcontrib>Taaffe, Dennis R.</creatorcontrib><title>Body composition, fatigue and exercise in patients with prostate cancer undergoing androgen‐deprivation therapy</title><title>BJU international</title><addtitle>BJU Int</addtitle><description>Objectives To investigate the association between lean mass (LM) and fat mass (FM) with fatigue and vitality before and after exercise in patients with prostate cancer already undergoing androgen‐deprivation therapy (ADT). Subjects and Methods Cross‐sectional associations between LM and FM with fatigue and/or vitality measures were examined in 229 patients (aged 43–90 years). Prospective analysis was undertaken in 129 patients who underwent a supervised 3–6 months exercise programme (predominantly resistance + aerobic). Whole body and appendicular LM, and total and trunk FM were assessed by dual X‐ray absorptiometry. Fatigue was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire‐Core 30 (EORTC QLQ‐30) and vitality using the Short Form‐36. Results Based on the EORTC QLQ‐30, 19% of patients had clinically relevant fatigue. There was no association between LM and fatigue; however, total (P = 0.013), trunk (P = 0.015) and percentage (P = 0.008) FM were higher in fatigued than not fatigued patients, with total and trunk FM 5.0 and 2.6 kg higher, respectively. For quartiles of vitality, a similar pattern emerged for FM with those in the lowest quartile of vitality having the highest FM values (P = 0.014–0.034). In contrast, following supervised exercise, change in fatigue and vitality were associated with change in total LM (r = −0.182, P = 0.042 and r = 0.309, P = 0.001, respectively) but not FM. Patients fatigued at baseline but not fatigued following the exercise programme gained a median (interquartile range) of 2.1 (0.7–3.2) kg LM. Conclusion In patients with prostate cancer treated with ADT, body composition is associated with fatigue, with higher total and trunk FM in those with clinically relevant fatigue. However, following exercise those no longer fatigued had an accompanying substantial increase in LM. Modifying body composition, both LM and FM, in patients with prostate cancer may favourably alter cancer‐related fatigue levels and should be a target of exercise medicine in this population.</description><subject>Absorptiometry</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Androgen Antagonists - adverse effects</subject><subject>Androgen Antagonists - therapeutic use</subject><subject>Androgens</subject><subject>androgen‐deprivation therapy</subject><subject>Antineoplastic Agents, Hormonal - adverse effects</subject><subject>Antineoplastic Agents, Hormonal - therapeutic use</subject><subject>Body composition</subject><subject>Body Composition - drug effects</subject><subject>Body fat</subject><subject>Cross-Sectional Studies</subject><subject>Exercise</subject><subject>Exercise Therapy</subject><subject>Exercise Tolerance - physiology</subject><subject>Fatigue</subject><subject>Fatigue - chemically induced</subject><subject>Fatigue - physiopathology</subject><subject>Fatigue - rehabilitation</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Muscle Strength - drug effects</subject><subject>Muscle, Skeletal - drug effects</subject><subject>Patients</subject><subject>PCSM</subject><subject>Prospective Studies</subject><subject>Prostate cancer</subject><subject>ProstateCancer</subject><subject>Prostatic Neoplasms - drug therapy</subject><subject>Prostatic Neoplasms - physiopathology</subject><subject>Prostatic Neoplasms - rehabilitation</subject><subject>Quality of life</subject><subject>Resistance Training</subject><subject>Treatment Outcome</subject><issn>1464-4096</issn><issn>1464-410X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kUtOHDEQhi2UKLyyyAUiS9mAlAG_2u1eAiJAhMQGJHaW7a4ePJqxG7sbMrscgTPmJHgywAIJb2yVPn-qqh-hb5Qc0HIO7Ww8oIIrsYG2qJBiIii5_fT6Jo3cRNs5zwgpBVl9QZusqSvCG7WF7o9ju8QuLvqY_eBj-Ik7M_jpCNiEFsMfSM5nwD7gvtQhDBk_-uEO9ynmwQyAnQkOEh5DC2kafZiuPqY4hfDv71MLffIPZiXGwx0k0y930efOzDN8fbl30M2v0-uT88nl1dnFydHlxHGlxKRu64aA6VglZe0aQSUVtqOmAV5zaxVUHQEqGKhGMaNA8Fq6Ciyx1lhKJd9Be2tv6fR-hDzohc8O5nMTII5ZM8IVq4mkpKA_3qGzOKZQutOM8kqxhjBVqP015croOUGny2wLk5aaEr3KQZcc9P8cCvv9xTjaBbRv5OviC3C4Bh79HJYfm_Tx75u18hnvaZQ-</recordid><startdate>201812</startdate><enddate>201812</enddate><creator>Newton, Robert U.</creator><creator>Jeffery, Emily</creator><creator>Galvão, Daniel A.</creator><creator>Peddle‐McIntyre, Carolyn J.</creator><creator>Spry, Nigel</creator><creator>Joseph, David</creator><creator>Denham, James W.</creator><creator>Taaffe, Dennis R.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9463-3196</orcidid><orcidid>https://orcid.org/0000-0001-6381-1597</orcidid><orcidid>https://orcid.org/0000-0003-0302-6129</orcidid><orcidid>https://orcid.org/0000-0001-9913-4022</orcidid><orcidid>https://orcid.org/0000-0001-8659-5065</orcidid></search><sort><creationdate>201812</creationdate><title>Body composition, fatigue and exercise in patients with prostate cancer undergoing androgen‐deprivation therapy</title><author>Newton, Robert U. ; Jeffery, Emily ; Galvão, Daniel A. ; Peddle‐McIntyre, Carolyn J. ; Spry, Nigel ; Joseph, David ; Denham, James W. ; Taaffe, Dennis R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3884-7d790eaf25667c941614bf1a9e373bb8e5f0e142e8982a8e4376c5eb0bbab1163</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Absorptiometry</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Androgen Antagonists - adverse effects</topic><topic>Androgen Antagonists - therapeutic use</topic><topic>Androgens</topic><topic>androgen‐deprivation therapy</topic><topic>Antineoplastic Agents, Hormonal - adverse effects</topic><topic>Antineoplastic Agents, Hormonal - therapeutic use</topic><topic>Body composition</topic><topic>Body Composition - drug effects</topic><topic>Body fat</topic><topic>Cross-Sectional Studies</topic><topic>Exercise</topic><topic>Exercise Therapy</topic><topic>Exercise Tolerance - physiology</topic><topic>Fatigue</topic><topic>Fatigue - chemically induced</topic><topic>Fatigue - physiopathology</topic><topic>Fatigue - rehabilitation</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Muscle Strength - drug effects</topic><topic>Muscle, Skeletal - drug effects</topic><topic>Patients</topic><topic>PCSM</topic><topic>Prospective Studies</topic><topic>Prostate cancer</topic><topic>ProstateCancer</topic><topic>Prostatic Neoplasms - drug therapy</topic><topic>Prostatic Neoplasms - physiopathology</topic><topic>Prostatic Neoplasms - rehabilitation</topic><topic>Quality of life</topic><topic>Resistance Training</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Newton, Robert U.</creatorcontrib><creatorcontrib>Jeffery, Emily</creatorcontrib><creatorcontrib>Galvão, Daniel A.</creatorcontrib><creatorcontrib>Peddle‐McIntyre, Carolyn J.</creatorcontrib><creatorcontrib>Spry, Nigel</creatorcontrib><creatorcontrib>Joseph, David</creatorcontrib><creatorcontrib>Denham, James W.</creatorcontrib><creatorcontrib>Taaffe, Dennis R.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium &amp; Calcified Tissue Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>BJU international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Newton, Robert U.</au><au>Jeffery, Emily</au><au>Galvão, Daniel A.</au><au>Peddle‐McIntyre, Carolyn J.</au><au>Spry, Nigel</au><au>Joseph, David</au><au>Denham, James W.</au><au>Taaffe, Dennis R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Body composition, fatigue and exercise in patients with prostate cancer undergoing androgen‐deprivation therapy</atitle><jtitle>BJU international</jtitle><addtitle>BJU Int</addtitle><date>2018-12</date><risdate>2018</risdate><volume>122</volume><issue>6</issue><spage>986</spage><epage>993</epage><pages>986-993</pages><issn>1464-4096</issn><eissn>1464-410X</eissn><abstract>Objectives To investigate the association between lean mass (LM) and fat mass (FM) with fatigue and vitality before and after exercise in patients with prostate cancer already undergoing androgen‐deprivation therapy (ADT). Subjects and Methods Cross‐sectional associations between LM and FM with fatigue and/or vitality measures were examined in 229 patients (aged 43–90 years). Prospective analysis was undertaken in 129 patients who underwent a supervised 3–6 months exercise programme (predominantly resistance + aerobic). Whole body and appendicular LM, and total and trunk FM were assessed by dual X‐ray absorptiometry. Fatigue was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire‐Core 30 (EORTC QLQ‐30) and vitality using the Short Form‐36. Results Based on the EORTC QLQ‐30, 19% of patients had clinically relevant fatigue. There was no association between LM and fatigue; however, total (P = 0.013), trunk (P = 0.015) and percentage (P = 0.008) FM were higher in fatigued than not fatigued patients, with total and trunk FM 5.0 and 2.6 kg higher, respectively. For quartiles of vitality, a similar pattern emerged for FM with those in the lowest quartile of vitality having the highest FM values (P = 0.014–0.034). In contrast, following supervised exercise, change in fatigue and vitality were associated with change in total LM (r = −0.182, P = 0.042 and r = 0.309, P = 0.001, respectively) but not FM. Patients fatigued at baseline but not fatigued following the exercise programme gained a median (interquartile range) of 2.1 (0.7–3.2) kg LM. Conclusion In patients with prostate cancer treated with ADT, body composition is associated with fatigue, with higher total and trunk FM in those with clinically relevant fatigue. However, following exercise those no longer fatigued had an accompanying substantial increase in LM. Modifying body composition, both LM and FM, in patients with prostate cancer may favourably alter cancer‐related fatigue levels and should be a target of exercise medicine in this population.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>29750398</pmid><doi>10.1111/bju.14384</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-9463-3196</orcidid><orcidid>https://orcid.org/0000-0001-6381-1597</orcidid><orcidid>https://orcid.org/0000-0003-0302-6129</orcidid><orcidid>https://orcid.org/0000-0001-9913-4022</orcidid><orcidid>https://orcid.org/0000-0001-8659-5065</orcidid><oa>free_for_read</oa></addata></record>
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subjects Absorptiometry
Adult
Aged
Aged, 80 and over
Androgen Antagonists - adverse effects
Androgen Antagonists - therapeutic use
Androgens
androgen‐deprivation therapy
Antineoplastic Agents, Hormonal - adverse effects
Antineoplastic Agents, Hormonal - therapeutic use
Body composition
Body Composition - drug effects
Body fat
Cross-Sectional Studies
Exercise
Exercise Therapy
Exercise Tolerance - physiology
Fatigue
Fatigue - chemically induced
Fatigue - physiopathology
Fatigue - rehabilitation
Humans
Male
Middle Aged
Muscle Strength - drug effects
Muscle, Skeletal - drug effects
Patients
PCSM
Prospective Studies
Prostate cancer
ProstateCancer
Prostatic Neoplasms - drug therapy
Prostatic Neoplasms - physiopathology
Prostatic Neoplasms - rehabilitation
Quality of life
Resistance Training
Treatment Outcome
title Body composition, fatigue and exercise in patients with prostate cancer undergoing androgen‐deprivation therapy
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