A Randomized Trial of the Effects of Exercise on Anxiety, Fear of Cancer Progression and Quality of Life in Prostate Cancer Patients on Active Surveillance.
Level 2 - randomized trial
Individual randomized controlled trial
PubMed 35179044 · doi:10.1097/JU.0000000000002334
What was done
The ERASE trial randomized 52 patients with prostate cancer on active surveillance to either a 12-week, thrice-weekly, supervised aerobic high-intensity interval training (HIIT) program (n = 26) or usual care without exercise (n = 26). Patient-reported outcomes were measured at baseline and post-intervention (12 weeks) using validated instruments: the Memorial Anxiety Scale for Prostate Cancer, Fear of Cancer Recurrence Inventory, Expanded Prostate Cancer Index Composite, EORTC QLQ-C30, and measures of fatigue, stress, and self-esteem. Between-group differences were analyzed using analysis of covariance.
What was found
Fifty of 52 participants (96%) completed the 12-week assessments, with 96% adherence to the HIIT protocol. Compared to usual care, the HIIT group had a statistically significant reduction in total prostate cancer-specific anxiety (adjusted between-group mean difference -2.7, 95% CI -5.0 to -0.4, p = 0.024). Significant improvements were also reported for fear of cancer progression (p = 0.013), hormonal symptoms (p = 0.005), perceived stress (p = 0.037), fatigue (p = 0.029), and self-esteem (p = 0.007).
Why it matters
Anxiety and fear of progression often drive men on active surveillance to seek invasive treatments with potential morbidity. This study provides randomized evidence that a structured exercise intervention can alleviate psychological distress and improve quality of life in this setting.
Limits
The sample size was small (52 participants across two arms). The control group received usual care without an attention-control condition, making it difficult to separate the physiological effects of HIIT from social or instructor contact. Long-term durability of psychological benefits beyond the 12-week supervised period was not assessed.
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