Impact of a dietary and exercise intervention on health-related quality of life of prostate cancer patients on active surveillance with overweight/obesity: a secondary analysis of a randomized controlled trial.

PURPOSE: Quality of life (QOL) is important for men on active surveillance (AS) for prostate cancer (PCa). To improve QOL, interventions such as those focused on diet and exercise have been proposed. However, their effectiveness remains unclear, especially in individuals with overweight/obesity.

METHODS

We previously conducted and published a randomized controlled trial of a lifestyle intervention for PCa patients on AS with overweight/obesity. Men were randomized to as follows: (1) 6-month diet and exercise intervention with a 7% weight loss goal vs (2) provided US Dietary and Physical Activity Guidelines. Herein, we report the secondary QOL findings from the trial. QOL was assessed at baseline and conclusion of the intervention via four validated questionnaires. Linear regression and two-sided t-tests evaluated mean differences. Subset analyses of the questionnaires were performed using cut-points correlating with clinical assessments.

RESULTS

Between 2016 and 2020, 100 men completed the trial. The intervention group had a mean weight loss of 7.1% vs 1.8% in controls. Despite this, no significant difference was observed between groups in general QOL (EQ-5D-5L), urinary QOL (IPSS), PCa-related QOL (EPIC-26), or PCa specific anxiety (MAX-PC). However, exploratory subgroup analyses demonstrated that participants with poor "bowel function," low "sexual bother," and good "sexual function" had clinically significant improvements of 12 (95% CI 0.1-24.0), 22 (95% CI 4.2-39.0), and 19 points (95% CI 4.4-34.0) on the EPIC-26.

CONCLUSION

In this secondary analysis of a previously published randomized trial, a 6-month diet and exercise intervention did not improve overall QOL among men with overweight/obesity on AS for PCa. While diet and exercise interventions may not universally improve QOL in this population, they remain important for broader health benefits and may offer targeted value for certain patients.