human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Anemia in patients with solid tumors is a common problem that is associated with impaired exercise capacity , increased fatigue , and lower quality of life ( QoL ) . Erythropoiesis-stimulating agents ( ESAs ) have been shown to improve these outcomes ; however , it is unknown if additional benefits can be achieved with aerobic exercise training . METHODS We conducted a single-center , prospect i ve , r and omized , controlled trial in 55 mild-to-moderately anemic patients with solid tumors . Patients were r and omized to either darbepoetin alfa alone ( DAL , n = 29 ) or darbepoetin alfa plus aerobic exercise training ( DEX ; n = 26 ) . The DEX group performed aerobic exercise training three times per week at 60%-100 % of baseline exercise capacity for 12 weeks . The primary endpoint was QoL assessed by the Functional Assessment of Cancer Therapy-Anemia scale . Secondary endpoints were fatigue , cardiorespiratory fitness ( VO(2peak ) ) , hemoglobin ( Hb ) response , and darbepoetin alfa dosing . RESULTS Intention-to-treat analyses indicated significant improvements in QoL and fatigue in both groups over time but there were no between-group differences . The DEX group had a significantly greater VO(2peak ) than the DAL group ( mean group difference , + 3.0 ml/kg per minute ; 95 % confidence interval , 1.2 - 4.7 ; p = .001 ) and there were borderline significant differences in favor of the DEX group for Hb response and darbepoetin alfa dosing . CONCLUSIONS Aerobic exercise training did not improve QoL or fatigue beyond the established benefits of DAL but it did result in favorable improvements in exercise capacity and a more rapid Hb response with lower dosing requirements . Our results may be useful to clinicians despite the more recent restrictions on the indications for ESAs Goals of workProstate cancer patients receiving and rogen deprivation therapy ( ADT )  are vulnerable to a number of potentially debilitating side effects , which can significantly impact quality of life . The role of alternate therapies , such as physical activity ( PA ) , in attenuating these side effects is largely understudied for such a large population . Thus , the purpose of this study was to investigate the effects of PA intervention for men receiving ADT on PA behavior , quality of life , and fitness measures . Patients and methods One hundred participants were r and omized into an intervention ( n = 53 ) or a wait-list control group ( n = 47 ) , with 11 dropping out of the intervention group and 23 dropping out of the wait-list control group prior to post-testing . The intervention consisted of both an individually tailored home-based aerobic and light resistant training program and weekly group sessions .  PA , quality of life , fitness , and physiological outcomes were assessed pre and post the 16-week intervention . Results Significant increases in PA , supported by changes in girth measures and blood pressure , support the beneficial impact of the intervention . Positive trends were also evident for depression and fatigue . However , due to the high dropout rate , these results must be interpreted with caution . Conclusions PA effectively attenuates many of the side effects of ADT and should be recommended to prostate survivors as an alternate therapy . Determining the maintenance of this behavior change will be important for underst and ing how the long-term benefits of increased activity levels may alleviate the late effects of ADT Background The prognosis for men with non-aggressive prostate cancer is good , and several studies have investigated the impact of lifestyle changes including physical activity and diet on the prognosis . Despite positive results in animal studies and a few human interventions with whole-grain rye on markers of prostate cancer progression , the feasibility of trials investigating such dietary changes in combination with physical activity remains largely unstudied . The primary aim was to investigate the feasibility of an intervention with high whole-grain rye intake and vigorous physical activity for 6 months in men diagnosed with prostate cancer . Methods In total , 26 men ( 53–72 years ) recently diagnosed with non-aggressive prostate cancer and on active surveillance , were enrolled in 2011–2012 and r and omly assigned to an intervention or a control group . The intervention included 170 g/day of whole-grain rye and 3 × 45 minutes/week of vigorous physical activity . The duration of the intervention was 6 months and end of follow-up 12 months after baseline . Clinic visits were scheduled at baseline and 3 , 6 and 12 months after baseline . Compliance with the intervention was evaluated by diaries , food frequency question naires , biomarkers , and heart rate monitor data . The effect of the intervention was evaluated by linear multiple regression analysis . Results In the intervention group , the mean daily intake of whole-grain rye measured from diaries was 146 g ( SD : 19 ) for the first 3 months and 125 g ( SD : 40 ) for the last 3 months of the intervention . The median level ( 5th and 95th percentiles ) of vigorous physical activity was 91 ( 17 , 193 ) min/week for the first 3 months and 66 ( 13 , 259 ) min/week for the last 3 months . No recordings of physical activity were done for the control group . Aerobic fitness ( VO2 peak ) increased in the intervention group compared to the control group after the intervention . No effects were found on other cardio-metabolic outcomes or prostate cancer progression . Conclusions The lifestyle intervention appeared feasible for 6 months among Danish men and the results are encouraging for conducting full-scale studies , where the impact of whole-grain rye and vigorous physical activity on prostate cancer progression and metabolic parameters can be evaluated . Trial registration Clinical Trials.gov , NCT01300104 . Registered on 18 February 2011 Background Prostate cancer can negatively impact quality of life of the patient and his spouse caregiver , but interventions rarely target the health of both partners simultaneously . We tested the feasibility and preliminary efficacy of a partnered strength training program on the physical and mental health of prostate cancer survivors ( PCS ) and spouse caregivers . Methods Sixty-four couples were r and omly assigned to 6 months of partnered strength training ( Exercising Together , N = 32 ) or usual care ( UC , N = 32 ) . Objective measures included body composition ( lean , fat and trunk fat mass ( kg ) , and % body fat ) by DXA , upper and lower body muscle strength by 1-repetition maximum , and physical function by the physical performance battery ( PPB ) . Self-reported measures included the physical and mental health summary scales and physical function and fatigue subscales of the SF-36 and physical activity with the CHAMPS question naire . Results Couple retention rates were 100 % for Exercising Together and 84 % for UC . Median attendance of couples to Exercising Together sessions was 75 % . Men in Exercising Together became stronger in the upper body ( p < 0.01 ) and more physically active ( p < 0.01 ) than UC . Women in Exercising Together increased muscle mass ( p = 0.05 ) and improved upper ( p < 0.01 ) and lower body ( p < 0.01 ) strength and PPB scores ( p = 0.01 ) more than UC . Conclusions Exercising Together is a novel couples-based approach to exercise that was feasible and improved several health outcomes for both PCS and their spouses . Implication s for cancer survivorsA couples-based approach should be considered in cancer survivorship programs so that outcomes can mutually benefit both partners . Trial registration Clinical Trials.gov Advice to rest and take things easy if patients become fatigued during radiotherapy may be detrimental . Aerobic walking improves physical functioning and has been an intervention for chemotherapy‐related fatigue . A prospect i ve , r and omized , controlled trial was performed to determine whether aerobic exercise would reduce the incidence of fatigue and prevent deterioration in physical functioning during radiotherapy for localized prostate carcinoma Background : Healthy lifestyle behaviors could have a role in ameliorating some of the adverse effects of and rogen suppression therapy  ( AST ) in men with prostate cancer . The primary aim of this study was to assess the feasibility of a tapered supervised exercise program in combination with dietary advice in men with advanced prostate cancer receiving AST . Methods : Advanced prostate cancer patients receiving AST for a minimum of 6 months were r and omized to a 12-week lifestyle program comprising aerobic and resistance exercise , plus dietary advice ( n = 25 ) , or st and ard care ( n = 25 ) . Exercise behavior , dietary macronutrient intake , quality of life , fatigue , functional fitness , and biomarkers associated with disease progression were assessed at baseline , after the intervention , and at 6 months . Results : The lifestyle group showed improvements in exercise behavior ( P < 0.001 ) , dietary fat intake ( P = 0.001 ) , total energy intake ( P = 0.005 ) , fatigue ( P = 0.002 ) , aerobic exercise tolerance ( P < 0.001 ) , and muscle strength ( P = 0.033 ) compared with st and ard care controls . Although a high rate of attrition ( 44 % ) was observed at 6 months , the improvements in key health outcomes were sustained . No effects on clinical prostate cancer disease markers were observed . Conclusions : This preliminary evidence suggests that pragmatic lifestyle interventions have potential to evoke improvements in exercise and dietary behavior , in addition to other important health outcomes in men with advanced prostate cancer receiving AST . Impact : This study shows for the first time that pragmatic lifestyle interventions are feasible and could have a positive impact on health behaviors and other key outcomes in men with advanced prostate cancer receiving AST . Cancer Epidemiol Biomarkers Prev ; 20(4 ) ; 647–57 . © 2011 AACR BACKGROUND During radiotherapy ( RT ) , prostate cancer ( PCa ) patients may report cancer related fatigue ( CRF ) , which impairs functional capacity , psychological status , and quality of life ( QoL ) . RT can induce cytokine responses that could play a role in mediating radiation toxicity by increasing inflammation . While it is known that physical exercise plays an important anti-inflammatory role in healthy adults , its specific anti-inflammatory effects in PCa patients with CRF have not yet been determined . AIM Previous studies have shown that physical exercise in cancer patients undergoing RT improves cardiac fitness , muscle strength , and QoL , however it is still unknown how physical exercise affects inflammation and its specific consequences in PCa patients . Therefore , the purpose of this trial was to examine the effect of supervised physical exercise on inflammatory blood markers , as well as the relationship of these parameters with functional capacity , fatigue , and QoL in high-risk PCa patients undergoing RT .  DESIGN This was a prospect i ve , two-arm r and omized controlled clinical trial . SETTING The study was performed in our out patients center . POPULATION Fifty-four high-risk PCa men were r and omly allocated to two groups prior to undergoing RT . METHODS Twenty-seven patients performed supervised , moderate-intensity physical exercise ( exercise group ; EG )  and the other 27 formed a control group that carried out normal daily physical activity ( usual group ; UG ) . The following parameters were assessed before and after RT : functional capacity , changes in blood count variables and production of pro-inflammatory cytokines ( interleukin [IL]-1β , IL-6 , tumor necrosis factor [TNF]-α ) , fatigue , and QoL ( using FACT-F score and EORTC question naires ) . RESULTS No significant differences existed between the study groups at baseline assessment . After RT , there was a significant improvement in functional capacity ( P<0.05 ) and a decrease in pro-inflammatory cytokine levels ( P>0.05 ) and fatigue ( P<0.05 ) in the EG compared to the UG . Fatigue level was significantly higher in the UG ( F[2.126 ] ; P<0.05 ) after RT than before . Physical exercise had no effect on the correlation between inflammatory blood markers and functional capacity and fatigue scores provided by study participants . CONCLUSIONS Regular , moderate-intensity physical exercise improves functional capacity , decreases the production of inflammatory markers and fatigue , and has a positive influence on QoL in high-risk PCa patients during RT . CLINICAL REHABILITATION IMPACT This is one of the first studies to examine the effects of supervised exercise training on pro-inflammatory cytokine levels during RT in PCa patients by measuring functional capacity , fatigue , and UNLABELLED Erectile dysfunction ( ED ) is a major adverse effect of radical prostatectomy ( RP ) . We conducted a r and omized controlled trial to examine the efficacy of aerobic training ( AT ) compared with usual care ( UC ) on ED prevalence in 50 men ( n=25 per group ) after RP . AT consisted of five walking sessions per week at 55 - 100 % of peak oxygen uptake ( VO2peak ) for 30 - 60 min per session following a nonlinear prescription . The primary outcome was change in the prevalence of ED , as measured by the International Index of Erectile Function ( IIEF ) , from baseline to 6 mo . Secondary outcomes were brachial artery flow-mediated dilation ( FMD ) , VO2peak , cardiovascular ( CV ) risk profile ( eg , lipid profile , body composition ) , and patient-reported outcomes ( PROs ) . The prevalence of ED ( IIEF score ≤ 21 ) decreased by 20 % 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Anemia in patients with solid tumors is a common problem that is associated with impaired exercise capacity , increased fatigue , and lower quality of life ( QoL ) . Erythropoiesis-stimulating agents ( ESAs ) have been shown to improve these outcomes ; however , it is unknown if additional benefits can be achieved with aerobic exercise training . METHODS We conducted a single-center , prospect i ve , r and omized , controlled trial in 55 mild-to-moderately anemic patients with solid tumors . Patients were r and omized to either darbepoetin alfa alone ( DAL , n = 29 ) or darbepoetin alfa plus aerobic exercise training ( DEX ; n = 26 ) . The DEX group performed aerobic exercise training three times per week at 60%-100 % of baseline exercise capacity for 12 weeks . The primary endpoint was QoL assessed by the Functional Assessment of Cancer Therapy-Anemia scale . Secondary endpoints were fatigue , cardiorespiratory fitness ( VO(2peak ) ) , hemoglobin ( Hb ) response , and darbepoetin alfa dosing . RESULTS Intention-to-treat analyses indicated significant improvements in QoL and fatigue in both groups over time but there were no between-group differences . The DEX group had a significantly greater VO(2peak ) than the DAL group ( mean group difference , + 3.0 ml/kg per minute ; 95 % confidence interval , 1.2 - 4.7 ; p = .001 ) and there were borderline significant differences in favor of the DEX group for Hb response and darbepoetin alfa dosing . CONCLUSIONS Aerobic exercise training did not improve QoL or fatigue beyond the established benefits of DAL but it did result in favorable improvements in exercise capacity and a more rapid Hb response with lower dosing requirements . Our results may be useful to clinicians despite the more recent restrictions on the indications for ESAs Goals of workProstate cancer patients receiving and rogen deprivation therapy ( ADT )  are vulnerable to a number of potentially debilitating side effects , which can significantly impact quality of life . The role of alternate therapies , such as physical activity ( PA ) , in attenuating these side effects is largely understudied for such a large population . Thus , the purpose of this study was to investigate the effects of PA intervention for men receiving ADT on PA behavior , quality of life , and fitness measures . Patients and methods One hundred participants were r and omized into an intervention ( n = 53 ) or a wait-list control group ( n = 47 ) , with 11 dropping out of the intervention group and 23 dropping out of the wait-list control group prior to post-testing . The intervention consisted of both an individually tailored home-based aerobic and light resistant training program and weekly group sessions .  PA , quality of life , fitness , and physiological outcomes were assessed pre and post the 16-week intervention . Results Significant increases in PA , supported by changes in girth measures and blood pressure , support the beneficial impact of the intervention . Positive trends were also evident for depression and fatigue . However , due to the high dropout rate , these results must be interpreted with caution . Conclusions PA effectively attenuates many of the side effects of ADT and should be recommended to prostate survivors as an alternate therapy . Determining the maintenance of this behavior change will be important for underst and ing how the long-term benefits of increased activity levels may alleviate the late effects of ADT Background The prognosis for men with non-aggressive prostate cancer is good , and several studies have investigated the impact of lifestyle changes including physical activity and diet on the prognosis . Despite positive results in animal studies and a few human interventions with whole-grain rye on markers of prostate cancer progression , the feasibility of trials investigating such dietary changes in combination with physical activity remains largely unstudied . The primary aim was to investigate the feasibility of an intervention with high whole-grain rye intake and vigorous physical activity for 6 months in men diagnosed with prostate cancer . Methods In total , 26 men ( 53–72 years ) recently diagnosed with non-aggressive prostate cancer and on active surveillance , were enrolled in 2011–2012 and r and omly assigned to an intervention or a control group . The intervention included 170 g/day of whole-grain rye and 3 × 45 minutes/week of vigorous physical activity . The duration of the intervention was 6 months and end of follow-up 12 months after baseline . Clinic visits were scheduled at baseline and 3 , 6 and 12 months after baseline . Compliance with the intervention was evaluated by diaries , food frequency question naires , biomarkers , and heart rate monitor data . The effect of the intervention was evaluated by linear multiple regression analysis . Results In the intervention group , the mean daily intake of whole-grain rye measured from diaries was 146 g ( SD : 19 ) for the first 3 months and 125 g ( SD : 40 ) for the last 3 months of the intervention . The median level ( 5th and 95th percentiles ) of vigorous physical activity was 91 ( 17 , 193 ) min/week for the first 3 months and 66 ( 13 , 259 ) min/week for the last 3 months . No recordings of physical activity were done for the control group . Aerobic fitness ( VO2 peak ) increased in the intervention group compared to the control group after the intervention . No effects were found on other cardio-metabolic outcomes or prostate cancer progression . Conclusions The lifestyle intervention appeared feasible for 6 months among Danish men and the results are encouraging for conducting full-scale studies , where the impact of whole-grain rye and vigorous physical activity on prostate cancer progression and metabolic parameters can be evaluated . Trial registration Clinical Trials.gov , NCT01300104 . Registered on 18 February 2011 Background Prostate cancer can negatively impact quality of life of the patient and his spouse caregiver , but interventions rarely target the health of both partners simultaneously . We tested the feasibility and preliminary efficacy of a partnered strength training program on the physical and mental health of prostate cancer survivors ( PCS ) and spouse caregivers . Methods Sixty-four couples were r and omly assigned to 6 months of partnered strength training ( Exercising Together , N = 32 ) or usual care ( UC , N = 32 ) . Objective measures included body composition ( lean , fat and trunk fat mass ( kg ) , and % body fat ) by DXA , upper and lower body muscle strength by 1-repetition maximum , and physical function by the physical performance battery ( PPB ) . Self-reported measures included the physical and mental health summary scales and physical function and fatigue subscales of the SF-36 and physical activity with the CHAMPS question naire . Results Couple retention rates were 100 % for Exercising Together and 84 % for UC . Median attendance of couples to Exercising Together sessions was 75 % . Men in Exercising Together became stronger in the upper body ( p < 0.01 ) and more physically active ( p < 0.01 ) than UC . Women in Exercising Together increased muscle mass ( p = 0.05 ) and improved upper ( p < 0.01 ) and lower body ( p < 0.01 ) strength and PPB scores ( p = 0.01 ) more than UC . Conclusions Exercising Together is a novel couples-based approach to exercise that was feasible and improved several health outcomes for both PCS and their spouses . Implication s for cancer survivorsA couples-based approach should be considered in cancer survivorship programs so that outcomes can mutually benefit both partners . Trial registration Clinical Trials.gov Advice to rest and take things easy if patients become fatigued during radiotherapy may be detrimental . Aerobic walking improves physical functioning and has been an intervention for chemotherapy‐related fatigue . A prospect i ve , r and omized , controlled trial was performed to determine whether aerobic exercise would reduce the incidence of fatigue and prevent deterioration in physical functioning during radiotherapy for localized prostate carcinoma Background : Healthy lifestyle behaviors could have a role in ameliorating some of the adverse effects of and rogen suppression therapy  ( AST ) in men with prostate cancer . The primary aim of this study was to assess the feasibility of a tapered supervised exercise program in combination with dietary advice in men with advanced prostate cancer receiving AST . Methods : Advanced prostate cancer patients receiving AST for a minimum of 6 months were r and omized to a 12-week lifestyle program comprising aerobic and resistance exercise , plus dietary advice ( n = 25 ) , or st and ard care ( n = 25 ) . Exercise behavior , dietary macronutrient intake , quality of life , fatigue , functional fitness , and biomarkers associated with disease progression were assessed at baseline , after the intervention , and at 6 months . Results : The lifestyle group showed improvements in exercise behavior ( P < 0.001 ) , dietary fat intake ( P = 0.001 ) , total energy intake ( P = 0.005 ) , fatigue ( P = 0.002 ) , aerobic exercise tolerance ( P < 0.001 ) , and muscle strength ( P = 0.033 ) compared with st and ard care controls . Although a high rate of attrition ( 44 % ) was observed at 6 months , the improvements in key health outcomes were sustained . No effects on clinical prostate cancer disease markers were observed . Conclusions : This preliminary evidence suggests that pragmatic lifestyle interventions have potential to evoke improvements in exercise and dietary behavior , in addition to other important health outcomes in men with advanced prostate cancer receiving AST . Impact : This study shows for the first time that pragmatic lifestyle interventions are feasible and could have a positive impact on health behaviors and other key outcomes in men with advanced prostate cancer receiving AST . Cancer Epidemiol Biomarkers Prev ; 20(4 ) ; 647–57 . © 2011 AACR BACKGROUND During radiotherapy ( RT ) , prostate cancer ( PCa ) patients may report cancer related fatigue ( CRF ) , which impairs functional capacity , psychological status , and quality of life ( QoL ) . RT can induce cytokine responses that could play a role in mediating radiation toxicity by increasing inflammation . While it is known that physical exercise plays an important anti-inflammatory role in healthy adults , its specific anti-inflammatory effects in PCa patients with CRF have not yet been determined . AIM Previous studies have shown that physical exercise in cancer patients undergoing RT improves cardiac fitness , muscle strength , and QoL , however it is still unknown how physical exercise affects inflammation and its specific consequences in PCa patients . Therefore , the purpose of this trial was to examine the effect of supervised physical exercise on inflammatory blood markers , as well as the relationship of these parameters with functional capacity , fatigue , and QoL in high-risk PCa patients undergoing RT .  DESIGN This was a prospect i ve , two-arm r and omized controlled clinical trial . SETTING The study was performed in our out patients center . POPULATION Fifty-four high-risk PCa men were r and omly allocated to two groups prior to undergoing RT . METHODS Twenty-seven patients performed supervised , moderate-intensity physical exercise ( exercise group ; EG )  and the other 27 formed a control group that carried out normal daily physical activity ( usual group ; UG ) . The following parameters were assessed before and after RT : functional capacity , changes in blood count variables and production of pro-inflammatory cytokines ( interleukin [IL]-1β , IL-6 , tumor necrosis factor [TNF]-α ) , fatigue , and QoL ( using FACT-F score and EORTC question naires ) . RESULTS No significant differences existed between the study groups at baseline assessment . After RT , there was a significant improvement in functional capacity ( P<0.05 ) and a decrease in pro-inflammatory cytokine levels ( P>0.05 ) and fatigue ( P<0.05 ) in the EG compared to the UG . Fatigue level was significantly higher in the UG ( F[2.126 ] ; P<0.05 ) after RT than before . Physical exercise had no effect on the correlation between inflammatory blood markers and functional capacity and fatigue scores provided by study participants . CONCLUSIONS Regular , moderate-intensity physical exercise improves functional capacity , decreases the production of inflammatory markers and fatigue , and has a positive influence on QoL in high-risk PCa patients during RT . CLINICAL REHABILITATION IMPACT This is one of the first studies to examine the effects of supervised exercise training on pro-inflammatory cytokine levels during RT in PCa patients by measuring functional capacity , fatigue , and UNLABELLED Erectile dysfunction ( ED ) is a major adverse effect of radical prostatectomy ( RP ) . We conducted a r and omized controlled trial to examine the efficacy of aerobic training ( AT ) compared with usual care ( UC ) on ED prevalence in 50 men ( n=25 per group ) after RP . AT consisted of five walking sessions per week at 55 - 100 % of peak oxygen uptake ( VO2peak ) for 30 - 60 min per session following a nonlinear prescription . The primary outcome was change in the prevalence of ED , as measured by the International Index of Erectile Function ( IIEF ) , from baseline to 6 mo . Secondary outcomes were brachial artery flow-mediated dilation ( FMD ) , VO2peak , cardiovascular ( CV ) risk profile ( eg , lipid profile , body composition ) , and patient-reported outcomes ( PROs ) . The prevalence of ED ( IIEF score ≤ 21 ) decreased by 20 % 
    Output:
    