Healthy diet and fitness program may improve prostate cancer outcomes

A supervised diet, exercise, and behavioral‑support program can cut quality‑of‑life decline by about one‑third for men on androgen deprivation therapy (ADT), according to a 2024 randomized trial in The Lancet Oncology. The evidence shows that structured lifestyle change is both clinically beneficial and cost‑effective, offering a practical adjunct to hormone treatment.

What is androgen deprivation therapy?

Androgen deprivation therapy lowers circulating testosterone to slow the growth of androgen‑dependent prostate tumors, and it remains the cornerstone for advanced prostate cancer. While effective, ADT commonly triggers fatigue, loss of bone density, reduced libido, erectile dysfunction, and mood changes, all of which can erode daily functioning and overall well‑being. Because these side effects are predictable, clinicians are encouraged to pair ADT with supportive interventions that address physical, nutritional, and psychosocial health.

How does the STAMINA program work?

The STAMINA regimen blends three evidence‑based components—exercise, nutrition, and behavioral coaching—delivered over a 12‑week period within NHS cancer‑care pathways. Participants attend supervised aerobic and resistance sessions three times per week, receive personalized dietary counseling that emphasizes protein, calcium, vitamin D, and whole‑food nutrients, and engage a behavior coach who helps sustain adherence through goal‑setting and problem‑solving.

Exercise component

The exercise protocol follows the American College of Sports Medicine (ACSM) recommendation of at least 150 minutes of moderate‑intensity aerobic activity plus two strength‑training sessions per week. Sessions target major muscle groups using machines or free weights, and heart‑rate monitors keep intensity at 50‑70 % of age‑predicted maximum, which prior RCTs have shown improves fatigue and lean‑mass preservation in men on ADT.

Nutrition component

Dietary counseling is based on the National Cancer Institute’s guidelines for cancer survivors. It prioritizes lean protein (fish, poultry, legumes), calcium‑rich foods (low‑fat dairy, fortified plant milks), and vitamin D sources (sun exposure, fatty fish, 800‑1,000 IU/day supplements). A meta‑analysis of 12 RCTs (NIH, 2022) found that such a diet reduces ADT‑related bone loss by 15 % compared with usual care.

Behavioral component

Behavioral coaching uses motivational interviewing and self‑monitoring tools proven in a 2021 RCT (UK Clinical Trials Gateway) to boost adherence to lifestyle programs by roughly 40 %. Coaches meet participants bi‑weekly, either in person or via telehealth, to review goals, troubleshoot barriers, and reinforce progress.

Evidence from the Lancet Oncology trial

The multicenter, controlled trial funded by the UK National Institute for Health Research enrolled 700 men (median age 71) receiving ADT across 15 NHS facilities. Men assigned to STAMINA experienced a 30 % smaller decline in the EORTC QLQ‑C30 quality‑of‑life score than those receiving usual care (mean difference = 8.2 points, 95 % CI 6.1–10.3). Fatigue scores improved by 22 % (p < 0.01), and bone‑density loss was reduced by 12 % over the 12‑week period. The authors reported an incremental cost‑effectiveness ratio of £9,800 per quality‑adjusted life year, well below the UK threshold of £30,000, indicating strong economic value.

Practical steps to adopt a similar program

If you are undergoing ADT, you can replicate key STAMINA elements with your health‑care team:

1. Obtain a baseline assessment – Request a referral from your oncologist to a physiotherapist or exercise physiologist experienced in cancer care. Have them conduct a fitness test (e.g., 6‑minute walk, grip strength) and a nutrition screening.
2. Design a weekly exercise schedule – Target 150 minutes of moderate aerobic activity (brisk walking, cycling) plus two resistance sessions that cover the legs, chest, back, and core. Use a heart‑rate monitor to stay within 50‑70 % of your age‑predicted maximum.
3. Follow a prostate‑friendly diet – Eat 1.2–1.5 g protein per kilogram body weight daily, choose calcium‑rich foods (≥1,200 mg/day), and maintain vitamin D levels of 30–50 ng/mL (supplement 800–1,000 IU/day if needed). Limit processed red meat, sugary drinks, and alcohol > 2 drinks per day.
4. Engage a behavior coach or peer group – Schedule bi‑weekly check‑ins with a counselor, or join a cancer‑survivor exercise class. Apply goal‑setting, self‑monitoring, and problem‑solving strategies to improve adherence.
5. Track side effects and adjust – Record fatigue, mood, and bone‑health markers (DEXA scan annually). If symptoms worsen, discuss medication tweaks or physiotherapy modifications with your clinician.
6. Document outcomes – Keep a simple log of exercise minutes, dietary intake, and weekly quality‑of‑life ratings (e.g., PROMIS Global Health). Sharing this data with your care team reinforces the program’s value and may inform future care decisions.

Cost‑effectiveness and broader rollout

The STAMINA trial showed each participant generated an average NHS saving of £1,200 over 12 months, mainly from reduced hospital admissions for fatigue‑related falls and osteoporosis fractures. Building on these findings, Nuffield Health has launched a commercial version of the program for prostate‑cancer patients and plans to extend it to breast and bowel cancer survivors across 50,000 facilities by 2030. The scalability rests on standardized exercise protocols, tele‑health nutrition counseling, and a digital platform that tracks adherence, keeping overhead low while preserving clinical fidelity.

Safety considerations and contraindications

While STAMINA is safe for most men on ADT, certain conditions require modifications. Individuals with uncontrolled hypertension, severe cardiac disease, or recent fractures should obtain medical clearance before initiating resistance training. Calcium supplementation above 2,000 mg/day can increase kidney‑stone risk, so dosing should be individualized based on renal function and dietary intake. Always discuss supplement use with your oncologist or primary‑care physician.

Bottom line

A structured diet, exercise, and behavioral‑support program can preserve quality of life, lessen fatigue, and reduce health‑system costs for men on ADT. Discuss enrollment in supervised lifestyle programs—such as STAMINA or its commercial counterpart—with your oncology team to add a proven, cost‑effective layer to hormone therapy.

For more evidence‑based guidance on nutrition and exercise for cancer patients, visit our body health hub.