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Talk Outline
• Background
• Methods
• Results
• Conclusion
Background
• Prostate cancer is the most common type of cancer in men (~3000 new cases/year in NZ—about 10% are Māori). Close to 180 new patients are in Dunedin.
• Treatment for localized prostate cancer includes prostatectomy or radiation therapy.
• A common treatment for systemic prostate cancer is androgen deprivation therapy (ADT).
• Over 40% of prostate cancer patients would be on ADT at some point in their life (Meng et al., 2002).
ADT side effects
Due to the loss of androgens, patients on ADT experience many side effects including:
• Sarcopenic obesity (weight gain as fat and loss of muscle mass).
• Fatigue
(Saylor & Smith, 2009)
Healthy man ADT patient
Exercise
Exercise can alleviate some ADT side effects, including fatigue and risks of cardiovascular events
Current recommendation for cancer patients:
• 150 minutes of moderate-intensity aerobic exercise
• Resistance training at least 2 days per week
*The recommendation is outlined by the Canadian Society for Exercise Physiology and the American College of Sports Medicine. (Segal et al. 2017. Curr Oncol 24(1):40-46.)
Research Question
How does exercise level affect sleep and sexual parameters of prostate cancer patients?
• 45 minute online survey completed by prostate cancer patients
• Survey was posted by prostate cancer or cancer organizations internationally.
• Exercise levels were measured by the Godin-Shepard leisure-time physical activity questionnaire- (Score≥24 = physically active)
• Sleep quality is assessed by Insomnia Severity Index (ISI)
• Sexual parameters are assessed by the Arizona Sexual Experiences Scale (ASEX).
*There are other data collected, but they won’t be discussed here.
Methods
Demographic
• Sample size = 142
• Age= 67.1 ± 8.9 years
• 85% were in a relationship for 35.2 ± 14.6 years
• 58.45% had at least one university degree.
• 83.1% Caucasian
Prostate cancer treatment
• 59.2% had received prostatectomy
• 39.4% had received external beam radiation
• 33% had been on ADT
ADT Side Effects
The proportion of patients having
insomnia between the two groups are
similar.
Patients on ADT are more likely to have
no sexual activity than patients who
are not on ADT (P < 0.001).
0
10
20
30
40
50
60
70
80
Non-ADT ADT
Per
cen
tage
of
pat
ien
ts
Insomnia Prevalence
No insomnia Insomnia
0
10
20
30
40
50
60
70
80
90
Non- ADT ADT
Per
cen
tage
of
pat
ien
ts
Sexual Frequency
Sexually active Not sexually active
Insomnia symptom- early waking
* ] Physically active patients on ADT have less problems with waking up too early than those who are
less physically active.
1
Sco
re
0.0
5.0
10.0
15.0
20.0
25.0
30.0
Sexual Function Scores
1
Sco
re
0.0
5.0
10.0
15.0
20.0
25.0
30.0
Sexual Function Scores
Sexual Function Score
Non-ADT ADT
*P = 0.024
Active
Non-active
Physically active patients on ADT have better sexual function than patients on ADT who are non-physically
active. [Further analyses found beneficial exercise effects on sex drive, orgasm satisfaction and sexual frequency.]
*
Limitation
• Small sample size
• Most are Caucasian
• Well-educated
• Partnered
• Data are based on self-report
• Types of exercises are not standardized
Conclusion• Physical activity may have beneficial effects on sleep and sexual function for patients
who are on ADT.
Sheila Garland, PhD, R Psych
Department of Psychology,
Memorial University, Canada
Erik Wibowo, PhD
Department of Anatomy,
University of Otago
Acknowledgement
Thanks to the cancer organizations and support groups who helped with posting the survey.
• Prostate Cancer Foundation NZ
• Cancer Society NZ
• Prostate Cancer Canada
• Prostate Cancer Foundation BC
• Prostate Cancer Centre Calgary
• Prostate Cancer International
• Canadian Cancer Society
• Cancer Survivors Network
• PPML (Prostate Problem Mailing List)
• Support groups
• Prostate Cancer Foundation Australia
• SurvivorNet
• Cancer Society Ireland
• Prostate Cancer Foundation
Acknowledgement
Exercise Tracking
• Spatial navigation study
• Validated exercise-tracking app/device
• For measuring walking distance and duration
https://www.passauer-land.de/en/bad-griesbach-nordic-walking-center/
Godin Questionnaire
