Diet and exercise led to weight loss in men on prostate active surveillance without overall quality-of-life gain

Design

Secondary analysis of a randomised controlled trial

Population

100 men with prostate cancer on active surveillance with overweight or obesity, who completed the trial

Primary outcome

Quality of life (EQ-5D-5L, IPSS, EPIC-26, MAX-PC) at the end of 6 months

Effect

Weight loss 7.1% vs 1.8%; no significant between-group difference in the four questionnaires

This is a secondary analysis of a previously published randomised trial of 100 men on active surveillance for prostate cancer with overweight or obesity. One group had a six-month diet and exercise programme with a 7% weight-loss goal; the other was given national dietary and physical activity guidelines. Quality of life was assessed at baseline and at the end of the programme with four validated questionnaires.

The intervention group lost a mean 7.1% of body weight against 1.8% in controls. There was no significant difference in general quality of life (EQ-5D-5L), urinary symptoms (IPSS), prostate cancer-specific quality of life (EPIC-26) or cancer-specific anxiety (MAX-PC). In exploratory subgroups, men with poor bowel function, low sexual bother or good sexual function had improvements of 12, 22 and 19 points on the EPIC-26, with wide intervals.

Weight loss alone did not improve how these men felt on the questionnaires. The subgroup results are exploratory and may be chance, so they support further study but not targeted prescribing.

• The intervention group lost 7.1% of body weight vs 1.8% in controls.
• There was no significant difference in overall quality of life, urinary symptoms or prostate cancer-specific anxiety.
• Exploratory subgroup improvements on EPIC-26 had wide intervals and may be chance.
• Lifestyle advice remains reasonable for general health, but do not promise symptom benefit.
• This analysis does not address whether lifestyle changes alter cancer progression.

Why it matters

It tempers the expectation that losing weight will by itself improve how men on surveillance feel.

Don't overread it

This secondary analysis was not powered for quality of life, and the subgroup findings were exploratory.

The statistics, in plain English

When a trial tests many subgroups on several questionnaires, some will look significant by chance. Intervals such as 0.1 to 24.0 almost touching zero show how fragile these subgroup findings are.

Read the rest in the app

You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.

Get Daily Doctor — free

Scan to keep reading on your phone. No account needed to start.