Impact of a dietary and exercise intervention on health-related quality of life of prostate cancer patients on active surveillance with overweight/obesity: a secondary analysis of a randomized controlled trial
In brief
Losing 7% of body weight did not improve quality of life in men
In a secondary analysis of 100 men with overweight or obesity on active surveillance, a six-month diet and exercise program led to 7.1% average weight loss, versus 1.8% with guideline advice, but did not significantly improve overall, urinary, or prostate cancer-related quality of life or cancer anxiety. Exploratory subgroup gains in bowel and sexual-function measures were not broad effects, leaving quality-of-life benefits uncertain.
- Journal
- Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer (Q1)
- Published
- 12 October 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Alex Zhu, Jeannette M Schenk, Roman Gulati, Sarah J Beatty, Matthew VanDoren, Daniel W Lin, et al.
- PMID
- 42862393
- DOI
- 10.1007/s00520-026-11298-2
Why clinicians should know about it
- Picked for Urology (top studies of the week, 8 November 2026): 6‑month diet/exercise RCT secondary QOL analysis
Abstract
PURPOSE: Quality of life (QOL) is important for men on active surveillance (AS) for prostate cancer (PCa). To improve QOL, interventions such as those focused on diet and exercise have been proposed. However, their effectiveness remains unclear, especially in individuals with overweight/obesity. METHODS: We previously conducted and published a randomized controlled trial of a lifestyle intervention for PCa patients on AS with overweight/obesity. Men were randomized to as follows: (1) 6-month diet and exercise intervention with a 7% weight loss goal vs (2) provided US Dietary and Physical Activity Guidelines. Herein, we report the secondary QOL findings from the trial. QOL was assessed at baseline and conclusion of the intervention via four validated questionnaires. Linear regression and two-sided t-tests evaluated mean differences. Subset analyses of the questionnaires were performed using cut-points correlating with clinical assessments. RESULTS: Between 2016 and 2020, 100 men completed the trial. The intervention group had a mean weight loss of 7.1% vs 1.8% in controls. Despite this, no significant difference was observed between groups in general QOL (EQ-5D-5L), urinary QOL (IPSS), PCa-related QOL (EPIC-26), or PCa specific anxiety (MAX-PC). However, exploratory subgroup analyses demonstrated that participants with poor "bowel function," low "sexual bother," and good "sexual function" had clinically significant improvements of 12 (95% CI 0.1-24.0), 22 (95% CI 4.2-39.0), and 19 points (95% CI 4.4-34.0) on the EPIC-26. CONCLUSION: In this secondary analysis of a previously published randomized trial, a 6-month diet and exercise intervention did not improve overall QOL among men with overweight/obesity on AS for PCa. While diet and exercise interventions may not universally improve QOL in this population, they remain important for broader health benefits and may offer targeted value for certain patients.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.