Lifestyle Management

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Comprehensive care for lifestyle management

Why is lifestyle management important in ADT management?

More than two-thirds of men on ADT experience weight gain, and body composition changes can occur. These changes typically include increased body mass index (BMI), increased fat mass, and decreased lean mass.1,2
There is a 2.5-fold increase in risk for prostate cancer–specific mortality with Western diet3
There is a 31% decrease in risk for prostate cancer–specific mortality with physical activity4

Recommendations for healthcare providers managing lifestyle during ADT

  1. Counsel patients on potential changes in body composition5
  • Explain the risk for weight gain during treatment due to increased fat mass, particularly in the stomach and hips, and loss of muscle mass and quality
  • Discuss prevention or mitigation of these changes with regular exercise and healthy nutrition
  1. Assess baseline activity level to determine interventions needed5
  • Identify any barriers patients have to physical activity and provide recommendations
  • Prescribe physical activity for all patients and discuss the benefits
  • Explain doses of activity needed and the benefits of dyad- and/or group-based programs
  • Consider referral to exercise physiology program if needed
  1. Evaluate eating habits and help develop healthier nutrition if needed
  • Educate patients about healthy foods they should incorporate into their diets, including whole foods such as fruits, vegetables, and lean meats5
  • Recommend avoiding processed foods, foods high in trans fats and simple sugars, and alcohol5
  • Discuss benefits of healthy eating, which include a reduced risk for prostate cancer–specific and all-cause mortality6,7
  1. Educate patients about common side effects2,8,9
  • Explain side effects like hot flashes, fatigue, and sleep disturbances are common and can be managed through lifestyle changes
Building healthy exercise and nutritional habits can help patients feel their best during ADT
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ADT, androgen deprivation therapy.

View resources that can provide support to healthcare providers and patients throughout ADT

Tools & Resources

References: 1. Kim HS, Moreira DM, Smith MR, et al. A natural history of weight change in men with prostate cancer on androgen-deprivation therapy (ADT): results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database. BJU Int. 2011;107(6):924-928. 2. Kokorovic A, So AI, Serag H, et al. Canadian Urological Association guideline on androgen deprivation therapy: adverse events and management strategies. Can Urol Assoc J. 2021;15(6):E307-E322. 3. Jochems SHJ, Van Osch FHM, Bryan RT, et al. Impact of dietary patterns and the main food groups on mortality and recurrence in cancer survivors: a systematic review of current epidemiological literature. BMJ Open. 2018;8(2):e014530. 4. Benke IN, Leitzmann MF, Behrens G, Schmid D. Physical activity in relation to risk of prostate cancer: a systematic review and meta-analysis. Ann Oncol. 2018;29(5):1154-1179. 5. Crawford ED, Garnick MB, Eckel RH, et al. A proposal for the comprehensive care of men on androgen deprivation therapy: recommendations from the Multidisciplinary Prostate Cancer 360 Working Group. Urol Pract. 2024;11(1):18-29. 6. Freedland SJ, Mavropoulos J, Wang A, et al. Carbohydrate restriction, prostate cancer growth, and the insulin-like growth factor axis. Prostate. 2008;68(1):11-19. 7. Yang M, Kenfield SA, Van Blarigan EL, et al. Dietary patterns after prostate cancer diagnosis in relation to disease-specific and total mortality. Cancer Prev Res (Phila). 2015;8(6):545-551. 8. Rhee H, Gunter JH, Heathcote P, et al. Adverse effects of androgen-deprivation therapy in prostate cancer and their management. BJU Int. 2015;13(Suppl 5):3-13. 9. Gonzalez BD, Small BJ, Cases MG, et al. Sleep disturbance in men receiving androgen deprivation therapy for prostate cancer: the role of hot flashes and nocturia. Cancer. 2018;124(3):499-506.

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