--- title: "Hormone Therapy for Prostate Cancer: Side Effects, and How Supervised Exercise Can Help" url: /prostate-cancer-exercise-hormone-therapy primary_question: "How can supervised exercise help with the side effects of hormone therapy (ADT) in prostate cancer?" sources: - "NICE NG131: Prostate cancer diagnosis and management, recommendation 1.4.19 (https://www.nice.org.uk/guidance/ng131)" --- # Hormone Therapy for Prostate Cancer: Side Effects, and How Supervised Exercise Can Help If hormone therapy has left you tired, flat or not quite yourself, you are not imagining it. A lot of men feel the same way. ## Does hormone treatment cause fatigue? Yes. Many men on hormone therapy for prostate cancer feel tired, flat or drained. Fatigue is a recognised effect of the treatment. NICE, the body that advises the NHS, recommends supervised exercise, which has been shown to reduce fatigue and improve quality of life (NICE NG131). This kind of tiredness is not the same as one bad night's sleep. It can sit in the background for weeks, and rest alone does not always shift it. That is a recognised, common effect of the treatment. It is not a sign you are doing anything wrong. Do tell your care team about any fatigue that is severe, new, worsening or otherwise concerning, so they can check for other causes. ## What are the side effects of hormone therapy for prostate cancer? Hormone therapy, also called androgen deprivation therapy or ADT, works by lowering testosterone. As testosterone falls, many men notice changes in energy, weight, muscle, mood and sleep. These effects vary from person to person, and your own care team will have talked through what to expect and how they keep it under review. Commonly reported effects include: - Fatigue: feeling tired, flat or short on energy - Hot flushes and night sweats - Changes in weight and body shape - Loss of muscle strength - Changes in mood - Disturbed sleep - Changes in sexual function - Effects on bone health, which your care team keeps under review Not everyone gets every effect, and they can come and go. Hormone therapy does an important job in your treatment, and the changes above are the trade-off many men live with while it does that job. ## Can exercise help with hormone therapy side effects? Yes, for some of them. Supervised exercise has been shown to reduce fatigue and improve quality of life (NICE NG131), and NICE recommends it for people starting or having hormone therapy. Exercise supports how you feel and function alongside your treatment. It does not treat the cancer itself, and it is not a substitute for the care of your own oncology team. NICE's guideline on prostate cancer, NG131, says: > "Offer people who are starting or having androgen deprivation therapy supervised resistance and aerobic exercise at least twice a week for 12 weeks to reduce fatigue and improve quality of life." The guideline names two benefits, reduced fatigue and improved quality of life, and points to supervised exercise built from two parts done at least twice a week: resistance (strength) work and aerobic (heart and lungs) work. Exercise rehabilitation supports side-effect management. It is not a cancer treatment. ## Should I rest or push through hormone-therapy fatigue? A middle path tends to work best. For fatigue linked to cancer treatment, guidance points toward gentle, regular activity matched to how you feel, rather than resting completely. NICE recommends supervised exercise to reduce fatigue and improve quality of life (NICE NG131). Agree any new activity with your care team first. Many men find that staying gently active helps them more than long spells of complete rest. This is never about pushing through pain or going past your limit. The better approach is gentler: find a level of activity you can repeat, then build on it slowly, with support. A supervised programme sets that level with you and adjusts it as your energy changes from week to week. ## What a supervised exercise programme works on A programme shaped around NICE NG131 gives equal weight to two things, both adapted to you: - Resistance (strength) work, aimed at muscle strength and everyday movement - Aerobic (heart and lungs) work, aimed at stamina and energy for daily life NICE recommends supervised resistance and aerobic exercise at least twice a week for 12 weeks. HealthySwitch sessions include both parts, resistance and aerobic, and are reviewed as you go. How often you see Piotr is agreed with you at the consultation, and he can advise on exercise between appointments. Supervised means you are guided one to one, with the plan adjusted around how you feel, your treatment and your other health needs. Within that plan, Piotr draws on adapted methods such as Tai Chi, Qigong, Pilates and progressive resistance training. These sit inside the programme, chosen and adjusted for you, never standalone products. Piotr Kardas is a Prostate Cancer Exercise Specialist, Registered Clinical Exercise Physiologist. Piotr delivers specialist exercise rehabilitation for men with prostate cancer, at a world-leading NHS cancer centre, as a clinical exercise physiologist. Sessions run online by video call anywhere in the UK, or as a home visit in London or Surrey, arranged with Piotr and priced for your circumstances. Please note: Always consult your oncologist or consultant before beginning any exercise programme. If you would like to talk this through, you can book a 15-minute online video consultation with Piotr. ## Related reading - Exercise and Prostate Cancer: /prostate-cancer-exercise - What NICE NG131 Says About Exercise and Prostate Cancer: /prostate-cancer-exercise-guidelines - More articles on exercise and prostate cancer: /blog