Physiotherapist-guided pelvic floor muscle therapy: Referral behaviours of urologists for radical prostatectomy patients

Objective: Active Surveillance (AS) is a strategy for low risk localised prostate cancer where active treatment is delayed to reduce overtreatment and spare patients from treatment-related side effects. Clinical trials have demonstrated consistently the beneficial effects of exercise in prostate cancer survivors both during and after medical treatment. However, so far no study has looked at the effects of an exercise intervention alone in men undergoing AS. Methods: We initiated a randomised controlled pilot study to determine the feasibility and effects of a combined aerobic and resistance training in prostate cancer patients on AS. In an exploratory analysis of 8 participants, we examined patients’ physical and mental health outcomes after exercising three times per week for 3 months. Results: Patients in the intervention group (n= 5) improved their body size/composition, physical fitness and psychological distress, in particular with regard to waist circumference, leg strength and depression. Patients in the control group (n= 3) increased their waist circumference and showed less or no improvements with regard to physical fitness and mental health outcomes.
Conclusions: Only recently the idea has emerged to initiate exercise interventions prior to medical treatment. Lifestyle interventions and our first observations suggest promising effects of exercise during AS. Interventions that decrease psychological distress and possibly inhibit tumour progression can play a key role in AS adherence and delay of active treatment. This preliminary data is limited; however a subsequent randomised controlled trial with a larger sample size is in preparation.