Zytiga & Exercise - Are they Compatible?

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Hi Folks,Overall I've had a pretty good response to abiraterone: a nice drop in PSA included. My big gripe is loss of weight and muscle mass despite a pretty good appetite. Maybe I am too active and too demanding on myself. I still manage to get out & do a bit of cardio every day. To avoid stress, I stretch my weight routines out over the week so as not to induce too much (stress) at any one time or place. Exercise of course induces stress whether you like it or not.

Galvao has done a fair amount of investigation on exercise in men with advanced PC, BUT I am not sure if that translates directly into men who exercise with abiraterone. The drug information sheet notes that increased levels of stress should may require an increase in prednisolone. Is that enough to compensate? Doesn't prednisolone carryits own weight in terms of SE's ?

Any takers on this?  It is still early days, but I should be very interested to hear how anyone else manages with advanced PC. e.g. 

BMC Cancer. 2011 Dec 13;11(1):517. [Epub ahead of print]

Efficacy and safety of a modular multi-modal exercise program in prostate cancer patients with bone metastases: a randomized controlled trial.

Galvao DA, Taaffe DR, Cormie P, Spry N, Chambers SK, Peddle-McIntyre C, Baker M, Denham J, ph D, Groom G, Newton RU.

Abstract

ABSTRACT:

BACKGROUND:

The presence of bone metastases has excluded participation of prostate cancer patients in exercise intervention studies to date and is also a relative contraindication to supervised exercise in the community setting because of concerns of fragility fracture. However, this group of patients often have developed significant muscle atrophy and functional impairments from prior and continuing androgen deprivation that is exacerbated by subsequent and more intensive interventions such as chemotherapy. The aim of this study is to determine the efficacy and safety of a modular multi-modal exercise program in prostate cancer patients with bone metastases.

METHODS:

Multi-site randomized controlled trial in Western Australia and New South Wales to examine the efficacy and safety of a modular multi-modal physical exercise program in 90 prostate cancer survivors with bone metastases. Participants will be randomized to (1) modular multi-modal exercise intervention group or (2) usual medical care group. The modular multi-modal exercise group will receive a 3-month supervised exercise program based on bone lesion location/extent. Measurements for primary and secondary endpoints will take place at baseline, 3 months (end of the intervention) and 6 months follow-up.

DISCUSSION:

Delaying or preventing skeletal complication and improving physical function for men with bone metastases would provide clinically meaningful benefits to patients. However, exercise programs must be designed and executed with careful consideration of the skeletal complications associated with bone metastatic disease and cumulative toxicities from androgen deprivation such as osteoporosis and increased risk of fractures. 

The results from this study will form the basis for the development of a specific exercise prescription in this patient group in order to alleviate disease burden, counteract the adverse treatment related side-effects and enhance quality of life. 

Trial Registration ACTRN: ACTRN12611001158954.

PMID: 

22166044 

[PubMed - as supplied by publisher] 

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Sam.