STAMINA: Supervised Exercise and Dietary Advice Cut ADT-Related Decline in Prostate Cancer

A multicentre, randomised trial published in The Lancet Oncology shows that a supervised, behaviourally supported lifestyle programme can measurably blunt the adverse effects of androgen deprivation therapy (ADT) for prostate cancer.
Called STAMINA, the study enrolled 700 men on ADT across 15 NHS trusts in England and randomly assigned them in a 5:4 ratio to either the STAMINA lifestyle intervention (n=389) or to behaviourally Optimised Usual Care (n=311). The median age was 71.6 years, and 680 of 700 participants were White. At 12 months, primary outcome data were available for 345 of 389 men (89%) in the STAMINA group and 251 of 311 (81%) in the usual care group.

The trial’s two primary endpoints were cancer-specific quality of life, measured by the FACT-P score, and fatigue, measured by the FACIT-F subscale. STAMINA was superior on both: the adjusted mean difference in FACT-P was 4.5 points, and in FACIT-F it was 1.9 points. In relative terms, the programme reduced deterioration in prostate cancer–specific quality of life by 26%, cut worsening fatigue by 30%, and lowered the decline in overall cancer-related quality of life by 37% compared with enhanced usual care. Adherence was high, with more than 80% of men attending their scheduled sessions over 12 months. Safety signals were limited: three intervention-related serious adverse events occurred in the STAMINA group (transient loss of consciousness, leg pain or weakness, and back pain), all participants recovered, and there were no treatment-related deaths.

Economic modelling indicates the intervention is cost-effective below NICE’s cancer-funding threshold, with a very high probability of remaining cost-effective for up to 10 years even after accounting for staff training.

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