Exercise and Diet Reduce Fatigue During Prostate Cancer ADT

A 12-month lifestyle intervention combining supervised exercise, dietary advice, and behavioral support improved cancer-specific quality of life and fatigue compared with behaviorally optimized usual care among men receiving androgen deprivation therapy (ADT) for prostate cancer in England. The findings come from the multicenter, randomized STAMINA trial published in The Lancet Oncology.

The trial was conducted across 15 National Health Service (NHS) trusts. Participants were randomly assigned in a 5:4 ratio through computer-generated minimization, and they were aware of their treatment allocation. The STAMINA intervention included supervised aerobic and resistance exercise for 12 months, dietary advice, behavioral support, and complimentary gym membership. Optimized usual care included clinician training, educational materials, behavioral prompts, and safety-to-exercise checks.

The primary outcomes were scores on the Functional Assessment of Cancer Therapy–Prostate and the Functional Assessment of Chronic Illness Therapy–Fatigue subscale at 12 months, analyzed by intention to treat. From January 20, 2022, through June 12, 2023, investigators assigned 700 men to the STAMINA intervention (n=389) or optimized usual care (n=311). The median age was 71.6 years, and 680 participants (97%) were White.

Primary-outcome data were available for 345 participants (89%) in the intervention group and 251 (81%) in the usual-care group. STAMINA was superior for the quality-of-life score, with an adjusted mean difference of 4.5 (97.232% CI, 1.7-7.2; P=0.0004), and for the fatigue score, with an adjusted mean difference of 1.9 (97.232% CI, 0.4-3.4; P=0.0068).

Three intervention-related serious adverse events occurred: transient loss of consciousness, leg pain or weakness, and back pain. All affected participants recovered, and no treatment-related deaths occurred. The investigators concluded that the program could be implemented in NHS trusts in England to help mitigate adverse effects associated with ADT. The study population was predominantly White, and primary-outcome availability differed between groups.

Source: Bourke L, Rosario DJ, Reale S, et al. An integrated lifestyle intervention for mitigation of adverse effects associated with androgen deprivation therapy for prostate cancer (STAMINA): a multicentre, randomised trial. Lancet Oncol. Published online September 4, 2026. doi:10.1016/S1470-2045(26)00304-9