The survival rate of PCa patients has continuously increased in the last few years. This development has generated interest in behavior and lifestyle interventions that might further improve disease outcomes and quality of life in PCa survivors. Latest investigations show that resistance and aerobic training may improve physical fitness, fatigue, quality of life, and body composition in PCa patients [39
]. These positive effects are now underlined by an observational finding that suggests that post-diagnosis physical activity is even associated with improved survival rates in PCa patients [40
Regardless of these positive observations and the increasing evidence in the field of physical activity in PCa patients, a majority of patients are inactive, physicians hesitate to prescribe physical exercise, insurance coverage is insufficient, lifestyle and behavior interventions lack prioritization in the health care systems and patients are uninformed [16
]. In order to improve the current situation and promote physical activity in PCa patients effective strategies have to be identified, including further research in the field, active involvement and briefing of oncologists, exercise therapists and insurance companies and tailored exercise programs [16
The ProRehab project aims to create a unique and lasting exercise offer for PCa patients and improve the knowledge in the field of physical activity and PCa. To date the first official and certified rehabilitative sports groups particularly for PCa patients have been established in Germany. This preliminary success is based on a close cooperation between oncologists/urologists, sports clubs, university institutions, the Cancer Society NRW, the State Sport Association NRW and the statutory health insurance companies. By combining science, practice, and public relations a great contribution to the care structure for PCa patients could already be made.
We planned the described patient preference randomized controlled trial to assess the efficacy of the offered rehabilitative sports program on physical activity levels, physical fitness, incontinence, erectile dysfunction, blood values, and quality of life. According to Keogh and MacLeod (2012) group-based physical activities offer greater benefits for prostate cancer patients than home-based interventions and aerobic training should best be supplemented by resistance exercises [41
]. While the positive effects of pelvic floor muscle exercises on urinary incontinence have been well proven [42
], Wolin et al. now found that physically active PCa patients in general have lower incontinence rates [43
]. The influence of physical activity on sexual functioning in PCa patients has hardly been studied [30
]. We are therefore, for possibly the first time, examining the effects of a multi-modal exercise program on incontinence and erectile dysfunction in PCa patients.
Depending on the findings of our study and future investigations the exercise program offered in the rehabilitative sports groups needs to be adjusted, since evidence based guidelines for physical activities with PCa patients have not yet been published. Especially randomized controlled studies with longer intervention periods (>1
year) or follow-up measurements that examine the long-term effects of physical activities in PCa patients are still missing. To our knowledge this is the first study in which PCa patients exercise in a supervised setting for 15
months. By offering a physical exercise intervention that is group-based, lasts for 15
months and involves a motivational and multi-modal exercise program we are convinced that a long-term lifestyle change in PCa patients can be promoted.