Prostate cancer (PCa) is the most commonly diagnosed cancer in U.S. men and disproportionately affects black men more than any other racial or ethnic group. Despite this disparity, black men have been underrepresented in previous studies. PCa is commonly treated using androgen deprivation therapy (ADT). However, ADT induces numerous adverse side effects, including loss of muscle mass, strength, power, and physical function with concomitant increases in fat mass, fatigue, and bone fractures. Because strength training (ST) can reverse these factors in healthy older adults, it was hypothesized that ST would be effective in PCa patients on ADT but with an attenuated response. Therefore, the purpose of this study was 1) to examine the effects of ST on musculoskeletal and body composition side effects in black men on ADT, 2) to compare ST responses of black PCa patients on ADT to those of black healthy reference controls, and 3) to determine if changes in musculoskeletal health and body composition with ST are associated with changes in fatigue, physical function, and quality of life (QoL).

PCa patients (N=17) completed a 12 week ST program, which produced many beneficial effects on factors adversely affected by ADT, including substantial gains in muscle power, size, strength, and endurance (all P < 0.001), resulting in a more favorable body composition (P < 0.001) and increased physical function (all P < 0.05). ST also improved fatigue perception and QoL (both P < 0.05). Compared with healthy reference controls (N=20), PCa patients responded to ST with similar gains in muscle power, strength, and mass, which was contrary to expectations. However, PCa patients had higher fat mass and lower muscle power and strength than controls at baseline (all P < 0.05). Finally, the changes in physical function, fatigue perception, and QoL were associated with some of the changes in muscle function with training. The findings in this study provide support for the hypothesis that ST improves musculoskeletal health and body composition in black men with PCa on ADT by demonstrating significant improvements in muscle power, mass, strength, and endurance, which can enhance physical function and QoL.