A multidisciplinary team-based approach with lifestyle modification and symptom management to address the impact of androgen deprivation therapy in prostate cancer: A randomized phase II study

Yao Yao Pollock, Li Zhang, Stacey A. Kenfield, Erin L. Van Blarigan, Tammy Rodvelt, Michael Rabow, Greta Macaire, Rami Weinberg, Kimberly Topp, Terence Friedlander, Amy Lin, Lawrence Fong, Won Kim, Brian Ma, Jeffrey Hough, Mina Lee, Alan Paciorek, Charles J. Ryan, June M. Chan, Eric SmallRahul Aggarwal

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Androgen deprivation therapy (ADT) is associated with numerous toxicities that are potentially modifiable. We sought to evaluate the impact of participation in a multidisciplinary clinic, STAND (Supportive Therapy in Androgen Deprivation) Clinic, designed to provide individualized lifestyle modification and management of ADT-related side effects.

METHODS: This phase II study recruited men with prostate cancer who had started ADT <6 months prior to enrollment, and in whom ADT was planned for at least 12 months following enrollment. Patients were randomized in a 1:1 ratio to either the STAND Clinic or usual care. Patients randomized to the STAND Clinic were provided monthly multidisciplinary assessment and counseling on exercise, nutrition, and symptom management for 12 months on a rotating schedule. Primary outcome was change from baseline to 12 months in percent body fat. Feasibility outcomes were also assessed by measuring percentage of completed visits. Secondary outcomes included change from baseline to 12 months in 3 domains: (1) metabolic impact and bone health, (2) quality of life (QOL), and (3) physical activity.

RESULTS: A total of 25 men were randomized to STAND clinic, and 23 were randomized to usual care. The study did not meet its accrual target of 32 men in each arm and was closed early due to lack of financial support. Overall, 91% (295 of 325) of STAND clinic visits were completed. Eighteen out of the 25 patients in STAND clinic arm (72%) completed all 12 months of STAND clinic visits, and 80% (20 of 25) completed the first 6 months. For all primary and secondary outcomes, there were no statistically significant differences between treatment arms.

CONCLUSION: Individualized and comprehensive management of ADT toxicities in a multidisciplinary clinic was well attended by patients. However, we did not find any differences in the outcomes assessed between the intervention arm and control.

Original languageEnglish (US)
Pages (from-to)730.e9-730.e15
JournalUrologic Oncology: Seminars and Original Investigations
Volume39
Issue number10
DOIs
StatePublished - Oct 2021
Externally publishedYes

Bibliographical note

Funding Information:
This work was supported by the UCSF Mount Zion Health Fund.

Publisher Copyright:
© 2021 Elsevier Inc.

Keywords

  • Androgen deprivation therapy
  • Diet
  • Exercise
  • Lifestyle modification
  • Nutrition
  • Physical activity
  • Prostate cancer
  • Quality of life

PubMed: MeSH publication types

  • Journal Article
  • Research Support, Non-U.S. Gov't

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