Professor Derek Rosario, consultant urological surgeon at Sheffield Teaching Hospitals NHS Foundation Trust, has been named the chief investigator of a brand new £2.5 million National Institute for Health Research study investigating whether a new exercise programme could improve the lives of men suffering with prostate cancer.
The STAMINA (Supported exercise training for men with prostate cancer on androgen deprivation therapy) trial, involving Sheffield Teaching Hospitals, Sheffield Hallam University and not-for-profit healthcare provider by Nuffield Health, is one of the largest studies of its kind anywhere in the world and will look to investigate whether a longer-term supported exercise programme – embedded in NHS cancer care and delivered via expert commercial partners in the community – can counter the problems caused by androgen deprivation therapy (ADT).
ADT is the standard treatment for men with advanced prostate cancer but it is associated with significant side effects including: fatigue, depression, sexual dysfunction, cognitive dysfunction (impairment of memory and concentration), increased fat mass and loss of muscle strength. ADT also increases the risk of developing bone fractures, diabetes and heart and circulatory problems.
Previous research has shown that short-term exercise can help tackle some of these side effects, and current treatment guidelines from the National Institute for Health and Care Excellence (NICE) recommend 12 weeks of supervised exercise for men having ADT to help boost their quality of life. But the benefits of exercise decline without ongoing support, and very few treatment centres are able to offer exercise as a core part of the NHS service for men with prostate cancer.
If found to be clinically effective, STAMINA will be the first evidence-based service of its kind for improving the lives of those living with prostate cancer, with findings applicable across other countries where prostate cancer is prevalent.
Professor Derek Rosario said: “We have been working in this area for over 10 years now. We have shown that specific targeted exercise training significantly reduces many of the adverse effects caused by ADT as well as improving quality of life in these men. Unless the intervention is embedded within the cancer care of the man and ongoing support is provided though, participation dwindles and the benefits are lost.
"So finding cost-effective ways of ensuring men on ADT continue with their training programme is essential if we are to reduce the side effects and provide sustained benefits. The NIHR-funded STAMINA study is a novel approach and if the model is successful, it could be applied to a number of long-term health conditions."
Academic lead, Professor Liam Bourke from Sheffield Hallam University, said: "This is one of the largest studies of its kind anywhere in the world - it is designed to test fundamentally new ideas about reducing the treatment burden in men with prostate cancer. It's very ambitious but if the results are positive it could offer new ways of looking at treatment across several cancers including breast and colorectal."
The STAMINA study will involve around 1000 men being treated with ADT, split randomly into two groups. One group will receive a 12 month individually tailored exercise programme delivered free of charge by Nuffield Health through their national network of Fitness and Wellbeing Clubs. The other group will receive NHS best practice treatment based on the NICE guidance. The study will take place at around 40 NHS sites.
STAMINA will also explore ways to optimise communication between clinical and exercise teams so that men receive the support they need to stick with exercise training for the full prescribed duration.
Dr Davina Deniszczyc, charity director and primary medical director at Nuffield Health said: “STAMINA aims to generate robust ‘real-world’ evidence that is required to define best practice. We can test whether supported exercise delivered in our clubs can provide value for money in comparison to other community-based exercise interventions.”