Exercise training in prostate cancer patients on androgen deprivation therapy

Androgen deprivation therapy is the mainstay in the treatment of (locally) advanced prostate cancer. By suppressing testosterone, ADT inhibits prostate tumour growth. However, ADT also has severe adverse effects, such as an increase in body fat mass and a decrease in muscle mass. In the first part of this thesis, the adverse effects of ADT are further explored. Thereafter, it is examined whether resistance exercise training is effective to counteract these adverse effects and whether protein supplementation can enhance the exercise-induced effects. Resistance exercise training appears very effective to counteract the adverse effects of ADT – despite the suppression of testosterone - and even increases muscle mass and strength. This makes resistance exercise training a promising intervention for implementation in clinical practice. However, ADT is generally prescribed for two or more years. Therefore, it is subsequently examined to what extent these exercise-obtained benefits are preserved in the long term. In the last part of the thesis, the focus is shifted to exercise as a potential strategy to attenuate tumor progression. For that, prostate cancer patients scheduled for operative removal of the prostate pursued a low or high daily step count in the week before surgery, and the effects on the protein synthesis rates of the tumour are assessed.