ANZUP 2017 – Prof Dennis TaaffeProf Dennis Taaffe discusses the RADAR trial investigating the important benefits of exercise in men with prostate cancer
Talking Urology podcast transcript
ANZUP 2017 Interviews – Joseph Ischia and Dennis Taaffe
This Talking Urology ANZUP conference highlight features Joseph Ischia talking with exercise physiologist Dennis Taaffe from Western Australia regarding his best of the best oral presentation on his research.
Joseph Ischia: I’m Joseph biscuit and I’m talking with Dennis Taaffe. He’s an exercise physiologist from the Edith Cowan University in Western Australia. He was one of the best of the best oral presentations here at ANZUP 2017, so I’ve got the opportunity to catch up with him, so he can tell us a little bit about their research.
Dennis Taaffe: Good.
Dennis: Thanks. Well look, what this was this is a secondary analysis from an exercise trial that we undertook. These are men from the RADAR Study. we’ve actually randomized 100 men from the Radar Study to a year-long exercise trial Where they received six months supervised exercise and then six months of the homebased program.
Joseph: What were the men in the radar study? What have they had?
Dennis: These are men that had been previously treated with either 6 months or 18 months of androgen deprivation therapy with radiotherapy and then with or without bisphosphonate as well, so essentially four groups. But what we’ll get is really just a two-factor group, six months versus 18 months. Essentially what we found was that were improvements at the end of the trial compared to the comparison group for muscle strength and physical function, but when we looked at changes in lean mass and fat mass, they weren’t actually much more substantial difference between the two. We actually went in and looked to see if there was a moderating effect of ADT time and actually, we found that there was, in that the men who are long term users of ADT actually had a better beneficial effect to exercise than with the short-term users actually were.
Joseph: That was the complete opposite of what you would have expected when you were creating your hypothesis, I guess.
Dennis: Well look, this is a bit of an exploratory study. The thing to take into account here, these were members with three years post ADT cessation, so it’s quite a long time since. Actually, what we found there was no baseline differences between the two groups when we started the trial, yet the response was quite substantial between the two. For instance, in lean mass, those who were formerly the longer-term users of ADT gained up to only 1 kg full lean mass and there was a bit of an effect for fat mass as well but no change within the short-term group. And also, when we looked at muscle performance and physical function, the improvements were better in the long term than shorter term group, not readily apparent why we found that difference. What we actually put it down to is that there actually may be some residual effects of treatment. They’re just not really recognized by the methods that we’re testing men for now. The deficits that they have, they may be actually greater, they’re just what people appreciate at the moment.
Joseph: Okay. And you were saying in your talk that in an era of targeted medicine, exercise physiologists have come to town.
Dennis: Yes. This is this is actually what it was all about. It was because when you do an exercise trial, that doesn’t matter whether they’re currently on treatment or before treatment or after treatment, you always get some who respond in a much better fashion than other people. Essentially, have responders and often non-responders. The question always is when you have described exercise is you want to prescribe the right exercise for the right group that responds under the right circumstances. Here we actually found that the longer-term previous users responded better than the short-term previous users and they’ll be the ones that you’d be especially trying to encourage to undertake an exercise to sort of offset any residual effects they had from their treatment.
Joseph: And you had a term for that, didn’t you, in your talk? Which I don’t want to steal from you.
Dennis: Term that I had…
Joseph: Targeted exercise medicine.
Dennis: Oh, targeted exercise— it’s like precision medicine, yet it’s precision exercise medicine.
Joseph: It’s very good. Thank you very much Dennis. It has been a pleasure chatting to you.