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Physical Function in Men With Prostate Cancer on Androgen Deprivation Therapy

CA Clay, MD, is Co-Investigator, Akron Children's Hospital, Akron, Ohio.
S Perera, PhD, is Statistician, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa.
JM Wagner, PA-C, is Study Coordinator, Department of Medicine, University of Pittsburgh.
ME Miller, BS, is Study Coordinator, Department of Medicine, University of Pittsburgh.
JB Nelson, MD, is Co-Investigator, Department of Urology, University of Pittsburgh.
SL Greenspan, MD, is Principal Investigator, is Professor, Department of Medicine, University of Pittsburgh, 3471 Fifth Ave, Suite 1110, Pittsburgh, PA 15213-3221 (USA).

greenspans{at}dom.pitt.edu

Background and Purpose: Androgen deprivation therapy (ADT) has become an increasingly standard intervention for both early and advanced stages of prostate cancer; however, decreased physical function and hypogonadism have been reported in men receiving ADT. The objectives of this study were: (1) to determine whether ADT (and hypogonadism) resulted in decreased strength and mobility and (2) to examine the effect of ADT on an associated test of cognitive and motor function by assessing visuomotor performance.

Subjects and Methods: Physical function, walking speed, visuomotor performance, gonadal status, body composition, and Comorbidity Disease Index (CMDI) scores were assessed in a cohort of 100 participants that included: (1) men with prostate cancer who were not on ADT, (2) men with prostate cancer who were on short-term ADT (<6 months), (3) men with prostate cancer who were on long-term ADT (6 months), and (4) control subjects who did not have prostate cancer.

Results: Walking speed varied significantly across the 4 groups, even after adjusting for age, CMDI, and percentage of body fat. Age and CMDI were significantly associated with measurements of physical performance. Adjusted for covariates, men on long-term ADT walked 0.18 m/s slower than the control subjects. Physical function also varied significantly across the 4 groups. Androgen deprivation therapy did not have a significant effect on visuomotor performance.

Discussion and Conclusion: The results suggest that ADT has a significant effect on walking speed and physical performance in men with prostate cancer.