Impact of adherence to a remote exercise program on health-related quality of life in prostate cancer patients undergoing treatment: A prospective study in Brazil.

Abstract

130 Background: Patients with metastatic prostate cancer (mPCa) undergoing treatment often experience declines in health-related quality of life (HRQoL) and increased symptom burden. Exercise interventions are known to mitigate these effects, but adherence to such programs remains a challenge. This study aimed to assess the impact of adherence to a remote, home-based exercise program on HRQoL and symptom burden among patients with mPCa in a joint cancer practice in Brazil. Methods: This prospective study recruited patients with mPCa undergoing active treatment for both hormone sensitive and hormone resistant disease. Patients were assessed at baseline (T1) and after 12 weeks (T2) using the Functional Assessment of Cancer Therapy-General (FACT-G; scale: 0-108) and the Edmonton Symptom Assessment System (ESAS; scale: 0-90). Eligible participants received weekly exercise guidance through WhatsApp and performed prescribed exercise regimens (3 to 5 hours per week of combined resistance and aerobic training), with proper techniques demonstrated using the Vedius platform. Adherence was categorized as moderate to high (MH) ≥6 weeks of exercise, or low (L) ≤5 weeks. The primary outcomes included changes in HRQoL and symptom burden. Results: A total of 35 patients were recruited. The median age of participants was 74 years (range 58-91), with a majority being white (65.7%), married (82.9%), highly educated (88.6%), and retired (85.7%). All patients were receiving ADT plus abiraterone (34.3%), or docetaxel (25.7%), or enzalutamide (22.8%), or chemotherapy + abiraterone (14.3%). At 12 weeks, patients with moderate to high adherence demonstrated significant improvements in HRQoL (MH Mean T2 =94.9, L Mean T2 =88.7, P=0.01), particularly in physical (MH Mean T2 =25.1, Mean T2 =23.6, P=0.03), functional (MH Mean T2 =22.8, L Mean T2 =20.7, P=0.03), and emotional (MH Mean T2 =22.2, L Mean T2 =20.28, P=0.03) well-being domains, compared to those with low adherence. Additionally, those with higher adherence reported a lower symptom burden (MH Mean T2 =9.1 vs L Mean T2 =14.7, P=01). Conclusions: This study demonstrates that adherence to a remote exercise program significantly improves HRQoL and reduces symptom burden in patients with prostate cancer undergoing treatment. These findings underscore the importance of promoting exercise adherence through accessible platforms, such as WhatsApp, to enhance patient outcomes in mPCa.