Differential impact of aerobic fitness and muscular strength on bone health, body composition, physical function and patient reported outcomes in men with prostate cancer (#103)
Aim. To compare outcomes commonly affected by prostate cancer treatments between prostate cancer patients according to objectively measured levels of aerobic fitness and muscular strength. Methods. 386 men with localised prostate cancer (age: 69±8 years, BMI: 29±4, Gleason score: 7.6±1.3, time since diagnosis: 3.5±5 years) participated in this cross-sectional study. Participants had undergone or were currently undergoing androgen deprivation therapy (98%), radiation therapy (44%) and/or surgery (24%). Participants were assessed for aerobic fitness (400m walk), muscular strength (1 repetition maximum of leg press and chest press), bone mineral density (whole body and lumbar spine), body composition (dual-energy x-ray absorptiometry), physical function (repeated chair rise, stair climb, 6m usual pace, fast pace and backwards walk, sensory organisation test for balance), quality of life (SF-36, QLQ-PR25) and psychological distress (BSI-18). Comparisons were made between participants with higher and lower aerobic fitness and muscular strength based on the respective median scores. The difference between higher and lower groups was determined by ANCOVA controlling for age, education, smoking status, number of comorbidities and treatment history. Results. Superior aerobic fitness and muscular strength were both associated with significantly (p≤0.05) better physical function (p<0.001-0.041 across all assessments), quality of life (general health, physical function, role-physical, bodily pain, vitality and mental health domains = 2.8-4.6 NBS, 95%CI:0.1–4.1) and predicted monthly medical expenditure (-$77 to -$103, 95%CI:-$50 to -$156). Men with higher muscular strength had significantly superior BMD (0.035-0.039g/cm2, 95%CI:0.007–0.070) and lean muscle mass (2.4-4.6kg, 95%CI:1.7–6.3) but not fat mass. Men with higher aerobic fitness had significantly lower fat mass (-2.6 to -4.2kg, 95%CI:-1.5 to -5.9), but not BMD or lean mass. Conclusions. Higher aerobic fitness and muscular strength confers considerable benefits to physical function, quality of life and medical costs but have specific effects on bone health and body composition in prostate cancer survivors.