Androgen deprivation therapy is the backbone treatment for many men with prostate cancer.
It works by lowering testosterone to levels that starve the tumor of the hormone it needs to grow.
That same hormone drop also changes muscle, bone, and heart health in ways patients are not always warned about.
A conference talk from Innovinc Conferences discusses the POWER trial, which tests whether a tailored exercise program can improve cardiovascular risk factors in Black men receiving androgen deprivation therapy.
This article explains that trial’s design, what it has not yet proved, and the broader published evidence on exercise during androgen deprivation therapy.
What the Video Claims
The video is titled “Exercise as Medicine in Genitourinary Oncology: Reducing Health Disparities.”
It was recorded by Innovinc Conferences, a channel that posts recordings of medical conference sessions.
The listed speaker is Christina M. Dieli Conwright.
We could confirm she is a real, published exercise oncology researcher with a substantial body of peer reviewed work.
Her own published research is centered mainly on breast cancer patients, along with some work touching prostate, colorectal, and blood cancers.
We could not independently confirm every detail of her current title or institution from public sources checked for this article, so we are not stating those as fact here.
The talk’s framing argues two things at once.
First, that exercise can offset specific harms caused by androgen deprivation therapy.
Second, that access to structured exercise oncology programs is not equal across patient groups.
The first claim has a large, well established research base behind it, built mostly by a different group of researchers who specialize in prostate cancer exercise trials.
The disparity-focused study is the POWER trial itself. Its published protocol and Dana-Farber listing specify who is being recruited, what the exercise group does, and which cardiovascular measures researchers will compare. A protocol is a research plan, not evidence that the program has already prevented heart disease.
What the POWER Trial Is Actually Testing
Christina Dieli-Conwright is the principal investigator of the POWER trial listed by Dana-Farber Cancer Institute (NCT05327465). The research team published a study protocol in 2025. It specifically focuses on Black men with prostate cancer receiving ADT, a group historically underrepresented in exercise-oncology research.
The planned pilot randomized trial assigns 62 men in a one-to-one ratio to a 16-week exercise program or a comparison group that can receive the program later. The intervention combines aerobic and resistance training three times per week through a culturally tailored, home-based, virtually supervised format. This remote delivery may reduce some travel barriers to the exercise sessions, although participants still must travel for research assessments and eligibility requires medical clearance.
The trial’s primary outcome is cardiovascular risk estimated with the Framingham Risk Score, which uses factors such as age, cholesterol, blood pressure, and smoking. Researchers also plan to measure fitness, physical function, body composition, quality of life, cancer symptoms, and other outcomes. This is a test of risk factors, not a trial powered to prove fewer heart attacks or longer survival.
The reason for the focused design is substantial: the protocol reports that Black men in the United States are about 1.8 times more likely to develop prostate cancer and 2.2 times more likely to die from it than non-Hispanic White men. ADT can add cardiovascular and metabolic strain. The trial asks whether a tailored exercise intervention can improve measurable risk indicators in this specific group while standard cancer care continues.
No favorable POWER result should be presumed from the protocol alone. The older trials discussed below provide context for why exercise is worth testing during ADT, but their outcomes cannot be transferred automatically to this 62-person study or used to claim the POWER intervention has already protected participants’ hearts.
What Real Research Shows About Muscle Loss During ADT
Androgen deprivation therapy causes rapid loss of lean muscle mass in most men who start it.
This is not a minor side effect.
Researchers Daniel Galvão and Robert Newton, working with colleagues in Australia, have run some of the most cited trials on this exact problem.
In one early trial, men on androgen deprivation therapy who completed twenty weeks of combined resistance and aerobic training had significantly less fatigue and better physical function than men who received usual care (Galvão et al., 2006).
A later randomized controlled trial from the same research group went further.
Men who did twelve weeks of combined resistance and aerobic exercise actually reversed some of the muscle loss caused by the hormone therapy, while the usual care group kept losing lean mass (Galvão et al., 2010).
That is a meaningful finding.
It suggests the muscle loss from androgen deprivation therapy is not simply an inevitable, fixed cost of treatment.
Our article on losing weight without losing muscle mass covers the same basic principle in a general population, and the logic holds here too.
Resistance training gives muscle tissue a reason to stay, even when the hormonal environment is working against it.
Men who did twelve weeks of combined resistance and aerobic exercise reversed some of the muscle loss caused by androgen deprivation therapy, while men receiving usual care kept losing lean mass.
What Real Research Shows About Bone Density and Fracture Risk
Testosterone helps protect bone density.
When androgen deprivation therapy removes most of that testosterone, bone loss speeds up.
Over years of treatment, this raises real fracture risk.
Kerri Winters-Stone and colleagues studied whether resistance training combined with impact exercise, like light jumping or stepping drills, could protect bone in prostate cancer survivors already on long term androgen deprivation therapy.
Men in the exercise group showed better preservation of bone mineral density at the hip compared to men who did not train this way (Winters-Stone et al., 2014).
The impact component of that program matters.
Bone tends to respond to load, especially load that arrives in short, varied bursts rather than steady, repetitive motion alone.
That is one reason exercise oncology programs for these patients usually pair resistance training with some form of controlled impact work, not resistance training alone.
It is also why this kind of program needs supervision, since impact loading has to be matched to each man’s bone health and fracture risk.
What Real Research Shows About Cardiovascular and Metabolic Risk
Androgen deprivation therapy does not only affect muscle and bone.
It also raises fat mass, worsens insulin sensitivity, and is linked to higher cardiovascular risk over time.
Prue Cormie and colleagues tested whether starting supervised exercise right when a man begins androgen deprivation therapy could blunt these early treatment effects.
In their randomized controlled trial, men who began a supervised exercise program at the same time they started hormone therapy showed better outcomes across several treatment toxicity measures than men who received usual care (Cormie et al., 2015).
Separately, a United Kingdom based trial tested a broader lifestyle program, combining exercise with dietary counseling, in men already on long term androgen deprivation therapy.
That trial found meaningful improvements in disease specific quality of life for the men in the lifestyle intervention group compared to usual care (Bourke et al., 2014).
Quality of life is not the same as a lab value, but it is a real, patient centered outcome that matters during a treatment that can last years.
Taken together, these trials point the same direction as the muscle and bone research.
Starting exercise early, and staying with it, appears to matter more than starting late.
The Mechanism
The reason all of this connects back to one hormone is not complicated.
Testosterone normally supports muscle protein synthesis, the process that keeps muscle fibers repaired and maintained.
Androgen deprivation therapy removes most circulating testosterone, so that support largely disappears.
Resistance training creates its own separate signal for muscle repair and growth, one that does not depend on testosterone the same way.
That is likely why lifting against resistance can partly compensate for the hormonal loss, as shown in the Galvão trials above.
Bone works on a similar logic.
Testosterone normally helps slow the rate at which bone is broken down and rebuilt.
Mechanical load from resistance and impact exercise sends its own signal to bone forming cells, independent of hormone levels.
Our piece on whether lifting weights keeps your brain young looks at a different downstream effect of the same basic exercise stimulus, which shows up across many body systems, not just muscle.
For metabolic and cardiovascular effects, the mechanism is more indirect.
Exercise improves how muscle tissue uses insulin and tends to reduce the buildup of visceral fat that androgen deprivation therapy encourages.
None of these mechanisms require exercise to change hormone levels themselves.
They work around the hormonal change, not against it.
What This Evidence Does Not Prove
These trials are genuinely encouraging, but they do not prove everything the video’s framing might suggest.
They do not prove that exercise can replace androgen deprivation therapy or any other prescribed prostate cancer treatment.
Exercise is a supportive intervention studied alongside standard treatment, never as a substitute for it.
The trials above are also mostly modest in size, typically a few dozen to roughly one hundred men per study.
They tell us these programs work for the men who were able to enroll and complete them.
That is an important caveat, because the video’s own framing raises a fair point about health disparities in access to exercise oncology care.
The POWER trial directly addresses an evidence gap by enrolling Black men on ADT, but its design does not itself quantify disparities in access to exercise oncology care by race, income, or geography. Those access questions need separate measurement.
What we can point to honestly is a 2021 systematic review that found a real gap between exercise recommendations in oncology guidelines and actual rehabilitation use in practice (Stout et al., 2021).
That gap is consistent with an access problem, but it is not the same as a study proving which specific groups are underserved and by how much.
We are stating that distinction plainly rather than implying more certainty than the evidence supports.
Who Should Work With a Clinical Team
Every man considering exercise during androgen deprivation therapy should loop in his treatment team first, not after.
This matters even more if there is any history of bone metastases, since impact exercise needs to be adjusted or avoided in that case.
It also matters for men with existing heart disease, since exercise intensity needs to be set by someone who knows their cardiac history.
Men who are newly diagnosed with osteoporosis or a prior fragility fracture need a bone health specialist involved before starting any impact based program.
A physical therapist or exercise physiologist with oncology experience is the right person to design the actual program.
These specialists know how to scale resistance training and impact work to a person’s current fitness, fatigue level, and bone scan results.
None of the research described here suggests that exercise should ever delay or replace androgen deprivation therapy itself.
It is additive care, done alongside the treatment a patient’s oncologist has already prescribed.
A Practical Takeaway
The clearest, most repeated finding across these trials is simple.
Starting supervised exercise early in androgen deprivation therapy, ideally close to when treatment begins, produced better outcomes than starting late or not at all.
A program built on real evidence generally includes two to three resistance training sessions a week, using major muscle groups, cleared in advance by a clinician.
Our comparison of weightlifting versus running as a training preference is a useful read here, since resistance work carries most of the proven benefit for this specific population.
Some form of low impact loading, like supervised stepping or light jumping drills, can be added once a clinician confirms it is safe for that individual’s bone health.
On top of that, simply walking more during the day supports cardiovascular health and helps manage fatigue.
Our guide on daily steps and mortality lays out what the general walking research shows, and there is no reason to think the basic logic changes for men on hormone therapy.
The honest summary is that exercise will not undo androgen deprivation therapy’s core hormonal effect.
What it can do, based on real trial data, is meaningfully soften several of that treatment’s most damaging side effects on muscle, bone, and cardiovascular health.
Watch the video
Want more like this? Subscribe to WorkoutHealthy Insider for practical explanations behind popular fitness claims.
References
- Bourke, L., Gilbert, S., Hooper, R., Steed, L. A., Joshi, M., Catto, J. W. F., Saxton, J. M., & Rosario, D. J. (2014). Lifestyle changes for improving disease-specific quality of life in sedentary men on long-term androgen-deprivation therapy for advanced prostate cancer: A randomised controlled trial. European Urology, 65(5), 865 to 872. https://doi.org/10.1016/j.eururo.2013.09.040
- Cormie, P., Galvão, D. A., Spry, N., Joseph, D., Chee, R., Taaffe, D. R., Chambers, S. K., & Newton, R. U. (2015). Can supervised exercise prevent treatment toxicity in patients with prostate cancer initiating androgen-deprivation therapy: A randomised controlled trial. BJU International, 115(2), 256 to 266. https://doi.org/10.1111/bju.12646
- Galvão, D. A., Nosaka, K., Taaffe, D. R., Spry, N., Kristjanson, L. J., McGuigan, M. R., Suzuki, K., Yamaya, K., & Newton, R. U. (2006). Resistance training and reduction of treatment side effects in prostate cancer patients. Medicine & Science in Sports & Exercise, 38(12), 2045 to 2052. https://doi.org/10.1249/01.mss.0000233803.48691.8b
- Galvão, D. A., Taaffe, D. R., Spry, N., Joseph, D., & Newton, R. U. (2010). Combined resistance and aerobic exercise program reverses muscle loss in men undergoing androgen suppression therapy for prostate cancer without bone metastases: A randomized controlled trial. Journal of Clinical Oncology, 28(2), 340 to 347. https://doi.org/10.1200/JCO.2009.23.2488
- Stout, N. L., Santa Mina, D., Lyons, K. D., Robb, K., & Silver, J. K. (2021). A systematic review of rehabilitation and exercise recommendations in oncology guidelines. CA: A Cancer Journal for Clinicians, 71(2), 149 to 175. https://doi.org/10.3322/caac.21639
- Winters-Stone, K. M., Dobek, J. C., Bennett, J. A., Maddalozzo, G. F., Ryan, C. W., & Beer, T. M. (2014). Skeletal response to resistance and impact training in prostate cancer survivors. Medicine & Science in Sports & Exercise, 46(8), 1482 to 1488. https://doi.org/10.1249/MSS.0000000000000265
- POWER trial investigators. Exercise to enhance cardiovascular health among Black men with prostate cancer with androgen deprivation therapy (the POWER trial): A study protocol. Contemporary Clinical Trials, 155 (2025), 107973. https://doi.org/10.1016/j.cct.2025.107973. Trial registration NCT05327465.
This article is for general information only and is not medical advice. If you have an injury, ongoing pain, or a medical condition, talk to a doctor or physical therapist before you change how you train or eat.
