Structured Exercise Protects Quality of Life During Prostate Cancer Hormone Therapy
On September 4, 2026, researchers published the results of the STAMINA trial in The Lancet Oncology, demonstrating that a supervised lifestyle and exercise programme significantly reduces fatigue and deterioration in quality of life for men receiving androgen deprivation therapy.
Trial Demographics and Intervention Design
The multicentre, randomised study took place across 15 NHS trusts in England. The researchers enrolled 700 men who were receiving androgen deprivation therapy for prostate cancer. They assigned 389 participants to the lifestyle intervention group and 311 to a control group receiving Optimised Usual Care. The trial lasted for 12 months.
The trial population had a median age of 71.6 years. This demographic places the study directly within the older adult population most affected by treatment-related losses in strength, energy and physical function. The participants were predominantly White, making up 680 of the 700 men enrolled, or 97 percent.
Androgen deprivation therapy suppresses testosterone to slow prostate cancer growth. This necessary treatment can also contribute to fatigue and loss of muscle. Loss of bone strength, weight gain and poorer emotional wellbeing are also common side effects. The STAMINA trial tested whether an integrated lifestyle programme could protect cancer-specific quality of life and reduce fatigue compared with an enhanced form of usual care.
The STAMINA programme combined supervised aerobic exercise and resistance training with dietary advice, behavioral support and complimentary gym membership over the 12 months. According to The Telegraph, participants began with two supervised sessions per week for 13 weeks. They initially received one-to-one coaching before progressing to small group exercise. Supervision was then reduced as the men became more confident exercising independently.
The comparator group did not receive minimal care. Optimised Usual Care included clinician training, educational materials, behavioral prompts and safety checks for exercise. The Telegraph reported that this comparator provided substantially more exercise advice and support than would normally be available through the NHS.
Clinical Outcomes and Relative Reductions
At 12 months, the intervention produced robust and statistically significant clinical results. The researchers recorded an adjusted mean improvement of 4.5 points on the Functional Assessment of Cancer Therapy Prostate measure, with a 97.232 percent confidence interval of 1.7 to 7.2 and a p-value of 0.0004. The adjusted mean improvement on the Functional Assessment of Chronic Illness Therapy Fatigue scale was 1.9 points. This metric carried a confidence interval of 0.4 to 3.4 and a p-value of 0.0068.
The Telegraph reported these clinical findings in relative terms. The deterioration in prostate-cancer-specific quality of life was 26 percent lower than with enhanced usual care. Worsening fatigue was 30 percent lower among the men in the intervention group, and the decline in overall cancer-related quality of life was 37 percent lower. The reported improvement in general quality of life exceeded the threshold the researchers considered clinically meaningful. This means the difference was large enough to be noticeable to the patients in their daily lives.
The economic findings supported the case for broader implementation of the structured programme. The Telegraph reported a programme cost of less than £1,000 per patient per year. The calculated cost was £13,920 per quality-adjusted life year. This figure sits well below the £30,000 threshold commonly regarded as representing value for money in the NHS.
Expert Commentary on the Trial Results
Chief investigator Professor Derek Rosario described the results as a huge step forward for clinical practice. He stated that the findings should have an immediate impact on patients currently undergoing treatment. He argued that improving quality of life and reducing fatigue could potentially have beneficial effects on overall survival. However, he noted that this remains a hypothesis rather than an outcome demonstrated by this specific trial.
Professor Liam Bourke suggested that lifestyle programmes should be integrated comprehensively into routine prostate cancer care. He cautioned that the trial may have underestimated the true difference between structured exercise and ordinary NHS care. Because the control group received enhanced support rather than standard care alone, Bourke characterized the clinically meaningful results as a conservative estimate. He stated that real-world benefits for average patients could be significantly larger.
Dr Davina Deniszczyc of Nuffield Health noted that exercise should play a central role in cancer care. Alex Perry, the chief executive of Nuffield Health, called for supervised lifestyle support to become a routine, funded part of care for men starting hormone therapy. Professor Peter Johnson, the NHS national clinical director for cancer, said the study added to growing evidence about physical activity. He described prehabilitation and rehabilitation as critical components of high-quality cancer care.
Sector Context and Current Guidelines
The trial findings arrive as NHS England guidance already recommends specific physical interventions. The guidelines state that men receiving hormone therapy should be offered supervised exercise twice a week for 12 weeks. The researchers and The Telegraph reported that this recommendation is rarely delivered in practice.
The NHS has promised new standards for cancer prehabilitation and rehabilitation by 2028. The exact details had not yet been agreed upon at the time of the report. This timeline creates a potential route for the STAMINA model to influence how exercise support is commissioned and delivered.
In the private sector, Nuffield Health has launched a free Cancer Activity Programme. The initiative is initially aimed at men undergoing prostate cancer treatment at its fitness clubs. The organization plans to extend the programme to breast and bowel cancer patients. They aim to provide more than 50,000 free places by 2030.
Practical Implications for Training and Recovery
The trial supports discussing supervised aerobic and resistance training with your oncology team rather than treating physical activity as optional. Men focused on strength and muscle should prioritize both resistance and aerobic work. Resistance training is particularly relevant to maintaining functional strength while receiving hormone therapy. Aerobic work provides necessary support for stamina and everyday activity.
It is critical to start with professional supervision if treatment has changed your physical capacity. The trial used one-to-one coaching before moving participants into small groups. This staged approach is much safer than assuming a man can immediately resume his previous training routine. Monitoring metrics like walking tolerance, balance and the ability to climb stairs provides a clearer picture of your physical status.
Worsening fatigue was 30 percent lower in the intervention group compared to enhanced usual care. Men managing changes in hormones and vitality should treat persistent fatigue as a clinical signal rather than a failure of willpower. Sudden shifts in energy and metabolism require evaluation by a medical team. Factors like anaemia, sleep problems, depression or disease progression may all contribute to systemic exhaustion.
For men with prostate cancer, testosterone suppression is often an intentional part of the medical treatment. The practical goal is not to reverse the therapy but to preserve function and quality of life safely. The STAMINA programme integrated exercise, dietary guidance and behavioral support rather than treating gym attendance as an isolated variable. A physiotherapist, clinical exercise specialist, oncology team and a dietitian can each contribute to a comprehensive plan.
Structural Limitations and Caveats
The researchers noted several structural limitations within the STAMINA trial. One primary limitation is that this was not a survival trial. The study showed better quality of life and fatigue outcomes, but it did not establish that exercise prolonged life or slowed prostate cancer progression. The participants also knew which treatment they had been assigned, which is an unavoidable potential source of bias.
The study had strong retention for a lifestyle trial. Primary outcome data were available for 345 participants in the intervention group, or 89 percent. Data were available for 251 in the comparator group, or 81 percent. The control group received education, behavioral prompts and safety checks, meaning the relative benefits were measured against enhanced support.
The population was not fully representative, as 97 percent of participants were White. The findings may not generalize equally to younger men, more ethnically diverse populations or men with significant disability.
Physical exercise still requires careful clinical screening. The researchers recorded three intervention-related serious adverse events during the trial. These included transient loss of consciousness, leg pain or weakness and back pain. All affected participants recovered, and there were no treatment-related deaths. Men receiving androgen deprivation therapy should obtain clearance from their medical team before beginning training.
Ultimately, this research confirms that structured, supervised physical training should be viewed as a standard, protective adjunct to hormone therapy rather than merely an optional lifestyle suggestion.
How Everfitguys helps
Deciding how to structure aerobic and resistance work during hormone suppression requires evidence rather than generic fitness advice. Everfitguys analyzes emerging clinical trials to help older men combat declining focus, memory and mental sharpness without resorting to unproven supplements. We deliver factual reporting on physical resilience so you can maintain your independence and activity levels through midlife and beyond.
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