by By Dr Eileen Sutton
Senior Research Associate, Qualitative Lead on the STAMINA Study
Centre for Academic Primary Care
STAMINA is a five-year study funded by the NIHR’s Programme Grants for Applied Research scheme and is led by researchers from Sheffield Hallam University, with collaborators from Sheffield Teaching Hospitals, University of Leeds, University of Sheffield, Queen Mary University London, University of Bristol, University of York, Cardiff University, University of Edinburgh and Queen’s University, Belfast in partnership with Nuffield Health.
Why are we doing the research?
Prostate cancer is the most common cancer in men in the UK, with around 47,000 cases diagnosed each year. Androgen deprivation therapy (ADT) is a standard treatment for men with advanced prostate cancer but it is associated with significant side-effects which include fatigue, depression, sexual dysfunction, impairment of memory and concentration, increased fat mass and loss of muscle strength. ADT also increases the risk of developing bone fractures, diabetes and heart and circulatory problems. Short-term exercise can help tackle some of these side-effects.
Current treatment guidelines from the National Institute for Health and Care Excellence (NICE) recommend 12 weeks of supervised exercise for men having ADT but in our previous research we found that, across the UK, very few treatment centres offer exercise, as it is currently not standardised or embedded in NHS cancer care.
What is the STAMINA study?
The STAMINA (Supported exercise Training for Men wIth prostate caNcer on Androgen deprivation therapy) study is the largest study of its kind anywhere in the world.
Research has shown that the benefits of exercise decline without ongoing support, so in the study we want to try to find out if offering a tailored exercise programme to men over a longer period will provide sustained benefits. The programme will be embedded in men’s usual cancer care and offered in gyms in their local communities.
The early survey work we are doing is helping us to get a better understanding of current variations in NHS care pathways and exercise provision for men on ADT. To develop the STAMINA intervention we have been consulting with men with prostate cancer, members of multidisciplinary healthcare teams and exercise professionals to ensure it can be embedded in NHS cancer care and that it is acceptable to the men themselves. A tailored training package will be developed and delivered to health and exercise professionals involved in a randomised controlled trial of the intervention.
In the trial itself around 1,000 men across 40 centres in the UK will be split randomly into two groups. One group will receive a 12-month individually tailored exercise programme delivered free of charge by Nuffield in one of their Fitness and Wellbeing Clubs. The other group will receive NHS best practice treatment based on the NICE guidelines. We will then be evaluating the effectiveness and cost-effectiveness of STAMINA versus usual care.
It is very exciting to be involved with a study that will provide valuable information to potentially improve best practice, provide benefits and reduce side-effects of ADT treatment for men with advanced prostate cancer. If the STAMINA model is successful it could potentially be applied to other long-term conditions.
For more information, and to follow the study’s progress, see the STAMINA study website.
About the Centre for Academic Primary Care
The Centre for Academic Primary Care (CAPC) at the University of Bristol is a leading centre for primary care research in the UK, one of nine forming the NIHR School for Primary Care Research. It sits within Bristol Medical School, an internationally recognised centre of excellence for population health research and teaching. Follow us on Twitter: @capcbristol.
About the National Institute for Health Research
The National Institute for Health Research (NIHR) is the nation’s largest funder of health and care research. The NIHR:
- funds, supports and delivers high quality research that benefits the NHS, public health and social care
- engages and involves patients, carers and the public in order to improve the reach, quality and impact of research
- attracts, trains and supports the best researchers to tackle the complex health and care challenges of the future
- invests in world-class infrastructure and a skilled delivery workforce to translate discoveries into improved treatments and services
- partners with other public funders, charities and industry to maximise the value of research to patients and the economy.
The NIHR was established in 2006 to improve the health and wealth of the nation through research, and is funded by the Department of Health and Social Care. In addition to its national role, the NIHR commissions applied health research to benefit the poorest people in low- and middle-income countries, using Official Development Assistance funding.