ORIGINAL ARTICLE Endocrine and immune responses to resistance training in prostate cancer patients DA Galva ˜o 1,2 , K Nosaka 2 , DR Taaffe 3 , J Peake 3 , N Spry 4,5 , K Suzuki 6 , K Yamaya 7 , MR McGuigan 1,2 , LJ Kristjanson 8 and RU Newton 1,2 1 Vario Health Institute, Edith Cowan University, Joondalup, Western Australia, Australia; 2 School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia; 3 School of Human Movement Studies, The University of Queensland, Brisbane, Queensland, Australia; 4 Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia; 5 Faculty of Medicine, University of Western Australia, Crawley, Western Australia, Australia; 6 Consolidated Research Institute for Advanced Science and Medical Care, Faculty of Human Sciences, Waseda University, Tokorozawa, Saitama, Japan; 7 Oyokyo Kidney Research Institute, Hirosaki, Aomori, Japan and 8 WA Centre for Cancer & Palliative Care, Curtin University of Technology, Bentley, Western Australia, Australia This study examined the effect of 20 weeks resistance training on a range of serum hormones and inflammatory markers at rest, and following acute bouts of exercise in prostate cancer patients undergoing androgen deprivation. Ten patients exercised twice weekly at high intensity for several upper and lower-body muscle groups. Neither testosterone nor prostate-specific antigen changed at rest or following an acute bout of exercise. However, serum growth hormone (GH), dehydroepiandrosterone (DHEA), interleukin-6, tumor necrosis factor-a and differential blood leukocyte counts increased (Po0.05) following acute exercise. Resistance exercise does not appear to compromise testosterone suppression, and acute elevations in serum GH and DHEA may partly underlie improvements observed in physical function. Prostate Cancer and Prostatic Diseases (2008) 11, 160–165; doi:10.1038/sj.pcan.4500991; published online 17 July 2007 Keywords: androgen antagonists; testosterone; inflammation; exercise Introduction Androgen deprivation therapy (ADT) is widely em- ployed in the management of prostate cancer to improve survival during the early stage of the disease and to gain control of the disease in the more advanced situations. 1,2 ADT is achieved by either surgical castration, or more commonly by administering luteinizing hormone-releas- ing hormone agonist (LHRHa) or antiandrogen medica- tions that block the androgen receptors, or both. 2 However, ADT is accompanied by a range of adverse effects including reduced muscle strength, lean and bone mass, increased fat mass and fracture risk. 3,4 These side effects are clinically important, because they are likely to compromise physical function, reduce independence and quality of life. 5 Regular resistance training is a reliable, safe and effective countermeasure to the age-related loss of skeletal muscle 6 and bone 7 in healthy older adults, and may counter or even reverse some of the negative side effects that often accompany ADT. 8 We and others have recently reported beneficial effects of resistance training on physical function and quality of life in patients on ADT following 12 weeks of moderately intense training 9 and 20 weeks of heavy training. 10 We noted that muscle strength improved and lean mass was preserved without any harmful effect on prostate cancer disease control, as assessed by the resting level of prostate-specific antigen (PSA), 10 or on the therapeutic castrate resting level of testosterone. The latter finding contrasts with the situation in the non-androgen-sup- pressed individual, where resistance training can lead to acute testosterone release (changes occurring immedi- ately after an exercise session), which could adversely affect ADT disease control. However, the acute effect of resistance training on testosterone release in prostate cancer patients undergoing ADT is unknown and remains to be determined. Moreover, resistance training may lead to other hormonal changes, such as in circulating levels of growth hormone (GH) and intra- muscular insulin-like growth factor-1 (IGF-1), which are well described among healthy older adults. 11,12 In prostate cancer patients, no data are currently available on the acute effects of resistance training on these growth factors and increased circulating levels of GH and IGF-1 in prostate cancer patients may help to improve physical function and quality of life, and to preserve body composition. Received 1 May 2007; accepted 18 May 2007; published online 17 July 2007 Correspondence: Dr DA Galva ˜o, Vario Health Institute, School of Exercise, Biomedical and Health Sciences, Edith Cowan University, 100 Joondalup Drive, Joondalup, Western Australia 6027, Australia. E-mail: d.galvao@ecu.edu.au Prostate Cancer and Prostatic Diseases (2008) 11, 160–165 & 2008 Nature Publishing Group All rights reserved 1365-7852/08 $30.00 www.nature.com/pcan