Effect of an Aerobic Exercise Programme on Bone Density in Middle-Aged and Elderly Patients with Prostate Cancer Undergoing Androgen Deprivation Therapy: A Retrospective Study.

Abstract

Background: Prostate cancer is a remarkable health concern in men, particularly in middle-aged and elderly men, with androgen deprivation therapy (ADT) being a common treatment approach for this malignancy. However, ADT is associated with adverse effects on bone health, including accelerated bone loss and decreased bone mineral density, leading to increased fracture risk. As a result, exploring interventions to mitigate ADT-induced bone loss is needed.

Methods: This retrospective study analysed clinical data from middle-aged and elderly patients with prostate cancer undergoing ADT. Patients were divided into the routine treatment and aerobic exercise therapy groups on the basis of whether they participated in an aerobic exercise programme. Laboratory measurements included baseline and 4-month follow-up assessments of calcium, vitamin D, osteocalcin, cyclophosphamide (CTX) and bone density parameters analysed by using dual-energy X-ray absorptiometry.

Results: This study involved 126 patients, including 62 patients receiving routine treatment and 64 patients participating in an aerobic exercise programme. At the 4-month follow-up, the aerobic exercise therapy group demonstrated significant improvements in calcium levels (8.94 ± 0.45 mg/dL vs. 8.68 ± 0.51 mg/dL, p = 0.003) and vitamin D levels (32.89 ± 6.17 ng/mL vs. 29.58 ± 5.68 ng/mL, p = 0.002) compared with the routine treatment group. No significant differences were observed in bone turnover markers at 4 months. At 4 months, the aerobic exercise therapy group showed significant increases in bone density in the lumbar spine, femoral neck, total hip, radius and whole body compared with the routine treatment group (p < 0.05). Correlation analysis revealed that the aerobic exercise programme had positive correlations with calcium level, vitamin D level, osteocalcin and bone density at various anatomical sites in the study population.

Conclusions: This study provided compelling evidence of the beneficial effects of aerobic exercise programmes on bone density and related serum biomarkers in middle-aged and elderly patients with prostate cancer undergoing ADT.