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  1. IMPACT TRIAL DEAKIN UNIVERSITY Burwood Campus Melbourne (For Men with cRMPC on Androgen Deprivation Therapy) An exercise trial with a daily dose of Vitamin D supplied by Deakin. Another worthwhile trial completed. I‘ve been on this trial for the past 12 months. The facilities at Deakin are extensive, the staff most informative and nice to work with. Dexa scans were carried out through the year to monitor Bone density. My overall health was monitored on three separate days during the course of the year. This included fitness tests, blood tests and cognitive tests to see if there was any perceptible impact of ADT therapy on memory. I was provided with comprehensive reports after each of the three major visits. At the completion of the trial I took the detailed report supplied by Deakin to my Medical Onc for review. It was considered that my deteriorating bone structure required treatment so Xevga was prescribed and administered within a matter of days. For members living in Melbourne, Deakin are still recruiting and I think it's worth investigating. "IMPACT: Prostate cancer and exercise study We know exercise training is beneficial for men with prostate cancer. We know that it can potentially improve various aspects of health affected by both prostate cancer and the associated treatments. However, we don’t know if combining exercise training with optimal nutrition can achieve better results. This study will investigate the health benefits of a new exercise and nutrition program for men with prostate cancer treated with androgen deprivation (hormone) therapy. Everyone will receive vitamin D supplements and half will receive a year-long supervised exercise program and daily nutritional supplement. Recruitment is ongoing until the required number of men are recruited. This project is a collaboration between Deakin University and Alfred Health. What does the study involve? As part of this study you may receive: FREE vitamin D supplements and a daily nutritional supplement FREE (or subsidised) exercise program FREE assessment of bone density and muscle mass. I’m interested, how do I get involved? We'll send you details about the study and contact you by phone to discuss your eligibility for the study. Register now Contact Jack Dalla Email Jack Dalla +61 3 9246 8347"
  2. Here's a recent video published by the Prostate Cancer Foundation of Australia about the benefits of exercise.
  3. "We don't know what causes it and we don't know how to treat it." I found this video summary of some of the abstracts presented at the ASCO 2016 meeting interesting, particularly about chemotherapy-induced peripheral neuropathy. Click on this link to view the video.
  4. Tonight's Catalyst program on ABC TV was about a group of cancer patients who are experiencing extraordinary benefits from prescribed targeted exercise programs during chemotherapy. The program will be repeated on Friday 13 May 2016 at 10.30am. Alternatively you can watch it on iview until 19 December 2016.
  5. Paul Edwards

    Exercise has many benefits

    In today's teleconference the role of exercise in reducing depression was discussed. Researchers are finding that there are many different ways in which exercise affects our bodies. Tony Maxwell, one of our Committee Members is working on a Movember initiative, TrueNTH. TrueNTH has an excellent resource on its website about exercise for men with prostate cancer. Click on this link to read this information. There are a number of pages on the website about exercise. They're well worth a read!
  6. ADT carries with it a heightened risk of depression as well as cognitive effects. The cognitive impact, though, is neither well defined nor consistent. The data collectively suggest that the negative impact of ADT on patients directly (and on their intimate partners indirectly) are greater for younger than older men. Across the array of adverse effects, physical exercise appears to have the greatest potential to address the psychological effects of ADT, both in men who are receiving ADT and in their partners. Donovan KA, Walker LM, Wassersug RJ, Thompson LM, Robinson JW. 2015. Psychological effects of androgen-deprivation therapy on men with prostate cancer and their partners. Cancer [epub ahead of print] 15 September 2015. www.ncbi.nlm.nih.gov/pubmed/26372364 From Richard Wassersug's Life on ADT Blog
  7. There is an extensive list of research articles about the benefits of exercise at the Medafit website, both for cancer generally and, more specifically, for prostate cancer. To read these articles, click on this link.
  8. During here talk to our members in September 2015, nutrition expert Dr Olivia Wright referred to the following: Her slides for the talk, including some recipes for the Mediterranean diet: Olivia Wright slides Sep 2015.pdf The test of how Mediterranean your diet is: A 14-Item Mediterranean Diet Assessment Tool and Obesity Indexes among High-Risk Subjects: The PREDIMED Trial A paper showing that 'good' fats can extend life: Fat intake after diagnosis and risk of lethal prostate cancer and all-cause mortality Current research project that our members may wish to take part in: Can nutrition therapy with additional high intensity interval training improve cancer-related fatigue and quality of life in men with prostate cancer on androgen deprivation therapy? Olivia Wright study Sep 2015.pdf
  9. Exercise is good. But what exercises are suitable? The table contained in this post may help you when discussing exercise with your doctor. In recent clinical trials by Edith Cowan University exercise therapy has been shown to be beneficial for men with advanced prostate cancer and bone metastases. In particular, aerobic and resistance exercise is safe and effective for men with bone metastases when supervised and individually tailored to avoid direct loading of bones with secondary tumours. It is essential that you consult with an accredited exercise physiologist who specialises in cancer management so that a special program can be developed for your unique condition and personal circumstances. The researchers at Edith Cowan University have prepared a table to show the way in which exercises need to be modified depending on the location and severity of bone lesions. This table may be useful when discussing exercise with your doctor. To view the table, click on this link. To help you understand the table, as an example, if you have a lesion in your Pelvis (which is very common in men with advanced prostate cancer which has metastasised); you are able to perform any resistance exercises involving the upper-body and trunk, with modified resistance exercises involving the lower-body to only allow knee movements while avoiding hip movements. Similarly, you would not perform weight-bearing aerobic exercise, but could perform any non-weight-bearing aerobic exercise and any flexibility exercises. To read the table, you find the location of the lesion (in this case Pelvis), and trace along the row to determine what is permissible and what is to be avoided. Before beginning an exercise program, you should discuss it first with your doctor and your accredited exercise physiologist to determine whether it is suitable for you based on the location and severity of your bone lesions. Your exercise program may need to be modified if there are changes in your condition. You should review your exercises on an ongoing basis with your doctor and your accredited exercise physiologist. This Community does not give medical advice. You should not rely on anything in this post without first getting advice from your doctor.
  10. I got asked by someone about handling the side effects from chemo. Here are some suggestions. Click on this link for some suggestions from the Cancer Council. Click on this link for a research study which looked at the evidence for what works and what doesn’t. Do any members have other suggestions of what worked for them?
  11. Paul Edwards

    ADT affects the brain

    Cognitive impairment can occur in cancer patients who are treated with a variety of therapies, including radiation therapy, hormone therapy, and chemotherapy. After chemotherapy treatment it is commonly called "chemo brain." Signs of cognitive impairment include forgetfulness, inability to concentrate, problems recalling information, trouble multi-tasking and becoming slower at processing information. The number of people who experience cognitive problems following cancer therapy is broad, with an estimated range of 15 to 70 percent. There have been several studies analyzing this side effect in breast cancer patients, but few have investigated cognitive impairment following androgen deprivation therapy (ADT) for men being treated prostate cancer. A new Moffitt Cancer Center study indicated that men who are on ADT have greater odds of experiencing impaired cognitive function. In this study, researchers used formal tests to compare the cognitive ability of 58 prostate cancer patients on ADT to 84 prostate cancer patients not on ADT, and to 88 men without cancer. The researchers also reported for the first time a possible genetic link among those individuals who experience cognitive impairment whilst on ADT. They found that patients who have a particular version of a gene called GNB3 were 14 times more likely to suffer from cognitive problems on ADT. The researchers suggested that doctors: before starting ADT, should discuss the risk of changes in cognitive functioning with their patients; and after starting ADT, should also ask their patients if they suffered cognitive impairment with a view to referring them for assessment and treatment as needed. I wrote to one of the researchers and asked what treatment was available for prostate cancer patients on ADT who suffered cognitive impairment as a side effect. This was his reply: “Unfortunately little research has been done on ways to improve cancer treatment-related cognitive impairment. But some recent studies have suggested that "brain training" may improve cognitive function...and [there is] some preliminary evidence suggesting benefits to cancer survivors who had cognitive impairment. There are also medications that could be helpful, such as stimulants (e.g., methylphenidate, modafinil). It is also recommended that other issues that could contribute to cognitive decline be adequately addressed. For example, depression or sleep problems could easily worsen cognitive functioning and are usually treatable. Exercise has also been shown to be very important for cognitive function. I would recommend first addressing the issue with your oncologist or perhaps requesting a referral to a neuropsychologist or another provider who may be able to make recommendations tailored to your situation.” Brian D. Gonzalez et al Course and Predictors of Cognitive Function in Patients with Prostate Cancer Receiving Androgen-Deprivation Therapy: A Controlled Comparison http://jco.ascopubs.org/cgi/doi/10.1200/JCO.2014.60.1963
  12. The Annual General Meeting of the American Society of Clinical Oncologists (ASCO) is an important event where lots of new developments in oncology are announced and discussed. This year’s meeting will be held from 29 May 2015 to 2 June 2015. Ahead of the meeting, a number of abstracts (summaries of scientific articles) have been released. One of these abstracts was a study by researchers led by Professor Daniel Galvao of Edith Cowan University in Perth. The benefits of exercise for prostate cancer survivors is well established. Professor Galvao and his colleagues studied 463 Australian prostate cancer survivors to see how many of the men were getting sufficient exercise. The participants in the study were also tested for psychological distress, unmet supportive care needs, and quality of life. Current exercise guidelines for cancer survivors recommend 150 minutes of moderate intensity or 75 minutes of strenuous exercise per week and twice weekly resistance exercise. Only 12.3% of the men got sufficient exercise in accordance with the guidelines. 40.2% of the men did some exercise. 47.5% of the men were inactive. The study found that lack of physical activity contributed to poorer quality of life and greater psychological distress. However, doing some exercise was better than doing none at all. The men who did some exercise had less psychological distress and anxiety than the men who didn’t exercise. 2015 ASCO Annual Meeting Abstract No: e16089 Australian prostate cancer survivors’ compliance to contemporary aerobic and resistance exercise oncology guidelines and associations with psychological distress, unmet supportive care needs and quality of life.
  13. Paul Edwards

    Another reason to exercise

    There is lots of evidence that exercise is good for men with advanced prostate cancer. Psychological distress (a negative emotional, social, or spiritual response to cancer) is one of the most common side effects of cancer diagnosis and treatment. Recent research has shown that exercise by cancer survivors reduced psychological distress. A study enrolled 35 men into an arm with a regular structured physical exercise program and 23 men into a control arm which did not have an exercise program. Both arms received the usual medical treatment regimens for prostate cancer. The lead researcher, Dr Charles Kamen, said that the improvement in the men who did the exercise program was possibly due to a reduction in inflammatory processes. Men who did the exercise program experienced a decrease in pro-inflammatory cytokines, interleukin-6 and interleukin-8. A larger study is required to confirm the results of this small exploratory study and to investigate whether this exercise-induced cut in cytokines might impact on prostate cancer progression. Source reference: Kamen C, et al "Standardized, progressive exercise program to reduce psychological distress and improve inflammatory cytokines of distress among prostate cancer survivors" ASCO 2014; Abstract 9510.
  14. The following item by Dr Prue Cormie, a Senior Research Fellow at Edith Cowan University Perth, was first broadcast on the ABC on the Science Show on Saturday 31 May 2014. We are grateful to the ABC and Dr Cormie for permission to publish a transcript. Men think about sex a lot. On average every 45 minutes, which is more often than they think about food or sleep. So it's not surprising that sexual dysfunction is the most frequently identified issue of importance among prostate cancer survivors. Significant reductions in sexual well-being occur in up to 90% of men with prostate cancer. And only a third regain pre-treatment levels. Current management options include drugs such as Viagra, penile implant surgery, or the injection of drugs directly into the penis. Now, not only do these strategies have low levels of uptake and compliance, but they exclusively target erectile function, with no consideration of the many factors that drive sexual dysfunction. There is a critical need for better management options, ones which comprehensively counteract the unique variety of factors contributing to sexual dysfunction following prostate cancer. Now, the good news is we've discovered such a treatment. Exercise. Now, in a world-first we took a set of men with prostate cancer and we divided them into two groups, one which maintained their normal lifestyle or usual care, while the other participated in a supervised exercise program, involving twice-weekly group based sessions. These sessions involved resistance exercise which required men to lift weights, as well as a aerobic exercises such as walking and cycling. After just three months the men involved with the exercise program had a 50% greater level of sexual activity. Fifty percent! This difference was driven primarily through changes in sexual desire, with a larger proportion of men in the exercise program maintaining a high level of libido. In a subsequent study we again observed a targeted exercise program to minimise declines in sexual function, this time during the initial phase of prostate cancer treatment where that impairment is most pronounced. So what is it about exercise that works? Well, exercise prompts improvements in many of the side effects of prostate cancer treatment that contribute to sexual dysfunction. We observed enhanced sexual well-being to be accompanied by significant improvements in a range of factors, such as body composition, especially gains in muscle mass to counteract body feminisation, as well as improvements in fatigue, depression, anxiety, strength, fitness and quality of life. By conducting interviews with these men we discovered that enhanced masculine self-esteem was an additional driver of improved virility. So with this research we've established that exercise is an effective medicine that can be prescribed to counteract the devastating sexual dysfunction caused by prostate cancer treatments. [Edit: Yet again, exercise, the wonder medicine!!]
  15. Exercise has been found in clinical trials to counter many of the side effects of androgen deprivation therapy. Edith Cowan University in Perth has been prominent in undertaking clinical trials about exercise and cancer. The results of one of their latest trials are being presented last Saturday at the American Society of Clinical Oncology (ASCO) 2014 Annual General Meeting. The purpose of the study was to assess the effects of two varying exercise regimens, one targeting the musculoskeletal system (impact loading + resistance training; ILRT) and the other the cardiovascular and muscular systems (aerobic + resistance training; ART) against a control group. 195 men undergoing treatment for prostate cancer involving ADT with no regular exercise (undertaking structured aerobic or resistance training two or more times per week) within the previous 3 months were recruited for the study. They were then randomly allocated to one of 3 groups 12 month program of resistance/impact loading exercise, 12 month program of resistance/cardiovascular exercise and 6 months usual care (no planned exercise) followed by 6 months of exercise (delayed) Groups 1 and 2 did the same resistance training exercises that targeted the major upper and lower body muscle groups. Group 1 then did impact loading exercises such as skipping, hopping, leaping and drop jumping. Group 2 then did aerobic exercise using various modes such as walking or jogging on a treadmill, cycling or rowing stationary ergometer, or exercising on a cross training machine. The study found that: compared to pre-intervention, the impact loading and resistance training group and the aerobic plus resistance exercise training group generally improved in most physical function tasks. The impact loading and resistance training regime produced superior gains in lean mass and muscle strength compared to the aerobic plus resistance training regime. An abstract of the study “A multicenter yearlong randomized controlled trial of different exercise modalities in prostate cancer survivors on androgen deprivation therapy” is available at http://abstracts.asco.org/144/AbstView_144_132825.html Warning. This report of the study should not be seen as a substitute for your doctor’s or other health professional’s advice. The exercise regimes mentioned here may not be suitable for you. You should not commence or vary an exercise regime without first obtaining appropriate advice.
  16. The Prostate Cancer Foundation has advised us that the following clinical trial being conducted at Deakin University, 221 Burwood Highway, Burwood, Melbourne is now recruiting. The efficacy of exercise training and nutritional supplementation in prostate cancer survivorsTrial Summary: The aim of this study is to evaluate the efficacy of resistance exercise training and nutritional supplementation in prostate cancer survivors treated with androgen deprivation therapy. Who is it for? You may be eligible to join this study if you are a male aged 50-85 years and are currently undergoing treatment for prostate cancer with androgen deprivation therapy which is expected to continue for at least 52 weeks. Study details Participants in this study will be randomly (by chance) allocated to one of two groups. Participants in one group will participate in an individually tailored progressive resistance exercise training program three times a week and receive daily supplementation of calcium, vitamin D and protein over a period of 52 weeks. Participants in the other group will receive the usual care administered to men undergoing androgen deprivation therapy. Participants will be assessed at baseline, 26 weeks and 52 weeks in order to determine any changes in musculoskeletal health, cardiometabolic risk factors, and health-related quality of life. Assessment is by bone scans, blood tests, and questionnaires. The results of this study may contribute to the development of exercise and nutritional guidelines for optimising overall health in men treated with androgen deprivation therapy. If you are interested in participating or would like further information, please contact Patrick Owen email pow@deakin.edu.au or phone: 03 9244 5013 or mobile:0414 221 902.
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