Wednesday 17 October • Viewing time: 1 minute

Our research about how exercise and lifestyle changes can help cancer survivors has changed international guidelines on treating cancer — and improved countless lives.

Around 50,000 men are diagnosed with prostate cancer every year in the UK. Although survival rates are good, the treatment can be traumatic.

The cornerstone of advanced prostate cancer treatment is androgen deprivation therapy (ADT), a type of hormone treatment which effectively castrates patients, and can include removal of the testicles.

While effective at treating the cancer, this can have a debilitating effect on the patient’s quality of life. Previous research has shown that cancer survivors can suffer from fatigue, depression, anxiety, sexual dysfunction and an increased risk of cardiovascular disease.

Here at Sheffield Hallam University, I lead a research team dedicated to making life better for people who have had cancer. Over the last few years, we’ve shown how targeted and appropriate lifestyle changes can make meaningful improvements to prostate cancer survivors’ quality of life.

Our research has been used to update international guidelines for treating prostate cancer — changing how doctors around the world manage the adverse effects of cancer treatment, and improving the lives of thousands of patients.

Trials that make a difference

So how did we get to that point? First, we designed clinical trials that were truly relevant. I’m a firm believer that scientific research has to make a difference to the world. I want to make things better.

This starts with choosing the right people to study. You have to work with people who are representative of the population at large, so you can extrapolate the results to improve treatment for everyone. Recruiting the right representation of patients for trials is very hard work, but it’s absolutely vital if you want your results to be usable in the real world.

Once we had found our patients, we were able to test how to improve their quality of life. We put men who had received ADT on a 12-week exercise programme, with dietary advice too. They attended one-to-one training and group sessions with an exercise physiologist.

After prostate cancer treatment, the lower levels of testosterone in the body can lead to a greater risk of heart disease. We used a new ultrasound technique to measure our patients’ cardiovascular health before and after the exercise programme.

We found that the patients who underwent the lifestyle intervention experienced clinically meaningful improvements in their cancer-specific quality of life, and reduced cancer-specific fatigue.

The improvements could also translate to 29% fewer cardiovascular-adverse events (including heart attacks) — a real and clinically meaningful impact. In focus groups at the end of the trial, these patients also told us they had less anxiety and fear of the disease recurring.

Making sure people get the right treatment

Once we had the evidence of just how much exercise can alleviate the negative effects of cancer treatment, the next stage was to make sure patients had access to the care pathways we suggested.

So we are working with the NHS and the charity provider Nuffield Health to help embed these recommendations for best practice into the care that NHS prostate cancer patients receive.

We’re providing training to doctors and nurses in the NHS, and we’re also training exercise professionals at Nuffield Health to be able to design and deliver safe exercise programmes for people who have been through ADT cancer treatment.

It means doctors can be confident they are referring their patients to dedicated exercise professionals who are fully trained in helping prostate cancer survivors.

Changing treatment around the world

The European Association of Urology is a very large professional organisation that provides guidelines to doctors on how to treat prostate cancer. They set the standards for prostate cancer care across Europe, and in many non-European countries too.

After seeing my research on the benefits of exercise on prostate cancer survivors, they asked me to contribute to a new chapter in their guidelines.

Before my intervention, their guidance didn't include advice about how to use lifestyle changes to mitigate the adverse impacts of ADT on patients’ quality of life. Now the guidelines are clear: it says, "Offer men on androgen deprivation therapy 12 weeks of supervised exercise".

This advice is accessed 200,000 times a year by health professionals, benefiting thousands of men diagnosed with prostate cancer around the world.

On behalf of the whole team, I'm enormously proud of this. Our work is having a hugely positive impact on countless people’s lives. To me, that’s what research is all about.