Standardized, progressive exercise program (EXCAP) to reduce psychological distress and improve inflammatory cytokines of distress among prostate cancer survivors.

Patient and Survivor Care
Session Type and Session Title: 
Clinical Science Symposium, Outcomes and Interventions in Older Cancer Patients and Survivors
Abstract Number: 
J Clin Oncol 32:5s, 2014 (suppl; abstr 9510)
Charles Stewart Kamen, Michelle Christine Janelsins, Kathi Heffner, Anita Roselyn Peoples, Mohamedtaki Abdulaziz Tejani, Marie Anne Flannery, Luke Joseph Peppone, Gary R. Morrow, Karen Michelle Mustian; University of Rochester Medical Center, Rochester, NY; Department of Surgery, University of Rochester Medical Center, Rochester, NY

Abstracts that were granted an exception in accordance with ASCO's Conflict of Interest Policy are designated with a caret symbol (^).

Abstract Disclosures


Background: Psychological distress (a negative emotional, social, or spiritual response to cancer) is among the most common side effects of cancer diagnosis and treatment. Brief and palatable interventions are needed to ameliorate distress in diverse cancer populations, including men with prostate cancer, who may be unwilling to engage in traditional and time-intensive forms of psychotherapy. EXCAP(Exercise for Cancer Patients), a standardized, 6-week, home-based, progressive aerobic and resistance training program, has proven efficacious in improving fatigue among cancer survivors, but its effect on distress and on inflammatory cytokines associated with the pathophysiology of distress are unknown. Methods: In this Phase II RCT, 58 older prostate cancer survivors (age M=67) were randomized either to Arm 1) standard care (control) or Arm 2) EXCAP(intervention). Psychological distress (from the Profile of Mood States) and inflammatory cytokines (IFN-γ, IL-6, IL-8, IL-10, sTNFR-1) were measured at baseline and post-intervention (6 wks later). We used ANCOVA to assess the effect of EXCAPon distress and inflammatory cytokines at post-intervention, controlling for baseline values. We used Pearson correlations to evaluate mechanistic associations between change in distress and change in inflammatory cytokines from pre to post. Results: Among men with prostate cancer, the EXCAPintervention significantly improved psychological distress relative to standard care, as measured by the POMS Total score (EXCAP M=-5.17, SD=14.02; control M=2.43, SD=8.06; F(4,51)=3.34, p=.02). Decreases in distress among EXCAPparticipants were associated with decreases in IFN-γ (r = .40, p = .03) and IL-10 (r = .39, p = .04). This pattern was not seen in the control arm. Conclusions: This study supports the use of EXCAPfor reducing psychological distress and suggests a potential biological mechanism by which this improvement occurs, namely by reducing systemic inflammation. Future, confirmatory research is needed to replicate these findings in larger and diverse samples of cancer survivors. Clinical trial information: NCT00815672.