Does exercise help men on prostate cancer hormone therapy?
Yes. In 700 men on hormone therapy for prostate cancer, a 12-month supervised exercise and diet program improved both quality of life and fatigue more than usual care did. The quality-of-life gap was 4.5 points on the standard prostate cancer questionnaire, and the fatigue gap was 1.9 points.
Androgen deprivation therapy, usually shortened to ADT, works by shutting down testosterone so prostate cancer has less fuel to grow. It also causes real side effects. The researchers describe them as substantial, and the list familiar to anyone on the drug includes muscle loss, weight gain, hot flushes, and heavy fatigue. National and international guidelines already tell clinicians to offer supervised exercise for this. The problem, as the authors put it, is that supervised exercise is rarely integrated into care. Men get told to stay active and are left to sort out the rest on their own.
The STAMINA trial tested whether a real program, delivered inside the health system rather than in a research lab, could close that gap.
What the data show
Between January 2022 and June 2023, researchers randomly assigned 700 men across 15 NHS trusts in England. Of those, 389 went to the STAMINA lifestyle program and 311 to what the trial called Optimised Usual Care. Median age was 71.6 years. Both groups were measured at 12 months on two questionnaires: FACT-P, which scores prostate cancer quality of life, and FACIT-F, which scores fatigue.
The exercise group did better on both. On FACT-P, the adjusted difference was 4.5 points in favor of the program, and the true effect is very likely somewhere between 1.7 and 7.2 points (97.232% confidence interval). The chance that a difference this size came from luck alone is about 4 in 10,000 (p=0.0004). On fatigue, the difference was 1.9 points, very likely between 0.4 and 3.4 points, with about a 7 in 1,000 chance of being coincidence (p=0.0068). Both are modest numbers, and both point the same direction.
Dr. Kumar’s Take
The interesting part of this trial is not the effect size, it is the comparison group. Usual care here was not neglect. The control men got clinician training, educational materials, behavioural prompts, and safety-to-exercise checks. That is a much better version of usual care than most men actually receive. Supervised exercise still beat it. When you improve the control arm and your intervention still wins, the finding is harder to explain away.
The size of the benefit deserves an honest read. A few points on a questionnaire is not a transformation, and the trial did not measure whether men lived longer or whether their cancer behaved differently. What it measured is how men felt and functioned across a full year on a drug that makes many of them feel terrible. For a treatment with essentially no downside risk, that is a reasonable trade.
How the program was delivered
The STAMINA program ran for 12 months and combined supervised aerobic and resistance exercise with dietary advice, behavioural support, and a complimentary gym membership. That last piece matters more than it sounds. Removing cost and access barriers is often the difference between a program that exists on paper and one men actually attend.
Follow-through was good. Primary outcome data came back for 345 of 389 men in the exercise group, about 89%, and 251 of 311 in the usual care group, about 81%. For a year-long program in men with a median age over 71, holding onto that many participants is a strong signal that the format was workable.
Safety and limits
Three intervention-related serious adverse events occurred in the exercise group: a transient loss of consciousness, leg pain or weakness, and back pain. All three men recovered, and no treatment-related deaths occurred in the trial.
Two limits are worth naming. First, 680 of the 700 participants, or 97%, were White, so how well this transfers to other populations is untested here. Second, men knew which group they were in, which is unavoidable in an exercise trial but does affect questionnaires that ask people how they feel. Some of the gain on a self-reported score may reflect knowing you are in the active arm.
Practical Takeaways
- If you or someone you care about is starting androgen deprivation therapy, ask the oncology team directly what supervised exercise program they can refer you to, because guidelines already recommend one.
- Look for a program that includes both aerobic work and resistance training, since STAMINA combined the two rather than relying on walking alone.
- Expect the benefit to build over months, not weeks, as this trial measured its main outcomes at the 12-month mark.
- Treat cost and gym access as part of the plan, not an afterthought, since the trial included free membership as a core piece of the program.
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FAQs
How much exercise did the men in this prostate cancer trial actually do?
The published summary describes the program as supervised aerobic and resistance exercise delivered over 12 months, alongside dietary advice and behavioural support. It does not spell out a weekly session count or a target intensity in the abstract. What it does establish is the shape of the thing: supervised, mixed aerobic and strength work, sustained for a full year rather than an eight-week block. If you are building your own version, that structure is the part worth copying.
Is exercise safe while on androgen deprivation therapy?
This trial recorded three serious adverse events linked to the program among the 389 men assigned to it, and all three recovered fully. No deaths were related to treatment. Hormone therapy does thin bone and reduce muscle mass over time, which is exactly why supervision matters and why the usual care arm included safety-to-exercise checks. Anyone starting resistance training on ADT should have a clinician confirm there are no bone lesions or fracture risks that would change the plan.
Why did this trial compare exercise to “optimised” usual care instead of nothing?
Because leaving the control group with nothing would have overstated the benefit. The control arm here received clinician training, educational materials, behavioural prompts, and safety checks, which is a serious attempt at good standard care. Comparing a supervised program to that harder benchmark gives a more honest estimate of what supervision adds beyond good advice, so the 4.5-point gap reflects what supervision added on top of care that already encouraged exercise.
Bottom Line
A 12-month supervised exercise and diet program improved quality of life and fatigue in men on hormone therapy for prostate cancer, and it did so against a control group that was already getting better-than-typical advice. The gains were modest in size but consistent across both primary outcomes, the safety record was clean, and the program ran inside 15 ordinary NHS hospital trusts rather than a research center. That last detail is the point of the trial. Supervised exercise for men on ADT is already recommended, and this shows it can actually be delivered.
