Are exercise programs more beneficial if they are initiated at the onset of ADT?

Key sentence from this abstract: “Exercise either at the onset or after 6 months ADT preserves/enhances muscle strength and physical function. However, to avoid any initial treatment-related adverse effects on strength and function, exercise should be prescribed and commenced at the onset of ADT”

Researchers and clinicians continue to endorse the many benefits of physical activity for men who are completing androgen-deprivation therapy (ADT).  Nuances in the timing of different exercise interventions are now being investigated in order to clarify the optimal delivery of physical activity protocols. 

In a recent (2018) study by Taaffe and colleagues, researchers examined the relative benefits of a initiating a supervised exercise intervention either at the onset of ADT or after men had already completed 6 months of ADT.  In this study, 104 men with prostate cancer were randomized to two groups:  1) an immediate-exercise group; 2) a delayed exercise group.  Members of the immediate exercise group completed 6 months of supervised resistance, aerobic, and impact exercises, starting at the beginning of ADT treatment.  Members of the delayed exercise group waited 6 months after initiating ADT before starting the 6-month supervised resistance, aerobic, and impact exercise intervention. 

Although men in the immediate-exercise group demonstrated greater improvements by the six-month follow-up assessment, the researchers found no significant differences between the immediate-exercise group and the delayed-exercise group by a 12-month follow-up assessment.  Importantly, men in both groups had significant improvements in muscle strength and physical performance by the 12-month assessment.  Results therefore suggest that exercise programs are associated with improvements in strength and physical function, whether they are initiated at the onset of ADT or after a short delay.  However, the study authors note the importance of starting a physical activity program as soon as possible, in order to minimize any treatment-related impacts on strength and function.

Taaffe, D. R., Newton, R. U., Spry, N., Joseph, D., Chambers, S. K., Gardiner, R. A., Cormie, P., Shum, D., Galvao, D. A. (2018). Benefits of immediate versus delayed exercise in men initiating ADT for prostate cancer. Medicine & Science in Sports & Exercise, 50(5S), 384. doi: 10.1249/01.mss.0000536351.44823.34