Androgen deprivation brings fatigue, muscle loss, weight gain, bone loss and worse metabolic health within months. Most men are told to 'stay active' and little else.
Treat exercise like a drug: name the type, frequency and duration, and refer to a supervised programme where one exists. A typical target is aerobic activity most days plus resistance training two or three times a week. Check cardiovascular fitness and bone metastases before recommending heavy resistance work.
At the same visit, check baseline weight, blood pressure, glucose and lipids, and consider bone density, so the metabolic effects of ADT are tracked from the start.
- Give a written exercise plan with aerobic and resistance components
- Refer to a supervised programme where available
- Screen for cardiac limitations and bone metastases before heavy resistance training
- Record baseline weight, blood pressure, glucose, lipids and bone health
Why it matters
The harms of ADT start early, and so should the countermeasure.
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