A major NHS-backed study has found that a structured lifestyle programme combining exercise, dietary advice and behavioural support can significantly reduce the debilitating side effects experienced by men receiving hormone therapy for prostate cancer.
Published in The Lancet Oncology, the groundbreaking STAMINA trial is the largest study of its kind and provides compelling evidence that lifestyle interventions should become a routine part of prostate cancer care across the NHS.
Led by Professor Liam Bourke and researchers from Sheffield Hallam University and Sheffield Teaching Hospitals NHS Foundation Trust, the trial demonstrated that a low-cost programme focused on physical activity, nutrition and behavioural support delivers lasting improvements in quality of life while remaining highly cost-effective.
Around 600,000 men in the UK are currently living with prostate cancer, with up to half receiving androgen deprivation therapy (ADT). While ADT is an effective treatment that helps slow cancer growth by reducing testosterone levels, it is also associated with a range of challenging side effects.
Many patients experience severe fatigue, reduced muscle mass, weight gain, lower bone density, increased cardiovascular risk and significant emotional distress, all of which can negatively impact daily living and long-term health.
The STAMINA trial was designed to tackle these issues head-on by embedding lifestyle support within routine cancer care pathways.
Researchers recruited 700 men undergoing ADT treatment from 15 NHS hospitals across England. Participants were assigned either enhanced standard NHS care or the dedicated STAMINA Lifestyle Intervention.
The intervention brought together:
- Supervised aerobic exercise
- Resistance training programmes
- Personalised dietary guidance
- Behavioural support to encourage long-term lifestyle changes
The programme was delivered through 18 Nuffield Health Fitness and Wellbeing clubs. NHS teams received additional training to identify suitable patients and refer them directly to specially trained Nuffield Health personal trainers who were upskilled to operate as clinical exercise specialists.
The findings showed exceptionally strong engagement from participants and meaningful improvements in quality of life.
Key outcomes included:
- More than 80% attendance at scheduled exercise sessions over a 12-month period.
- Reduced fatigue and improved wellbeing, with men in the STAMINA programme reporting better physical, emotional and social health outcomes than those receiving standard care.
- Excellent value for money, with economic modelling showing the programme costs well below standard NHS thresholds for cancer interventions and is expected to remain cost-effective for up to a decade.
The results suggest that incorporating structured lifestyle services into routine prostate cancer pathways could improve outcomes for thousands of patients while also delivering value for the health service.
Researchers believe one of the trial's greatest strengths is its real-world design. Unlike many research studies, STAMINA was built with NHS implementation in mind from the outset, ensuring successful interventions can be readily integrated into existing services.
Professor Liam Bourke, Academic Programme Director of STAMINA at Sheffield Hallam University, said:
“STAMINA is a huge achievement – it has taken us nearly two decades of incredibly hard work to get here – and it offers a definitive step-change in how lifestyle programmes should be considered and integrated comprehensively into routine prostate cancer care.
“As the largest trial of its kind ever to be conducted, and the first to be designed to work in the NHS from day one, this study is really unique and ensures that the positive outcomes of the research will be delivered exactly where they need to be – to NHS patients during routine care."
Following the success of the trial, Nuffield Health has launched its Cancer Activity Programme, which will initially support men living with prostate cancer before expanding services to patients with breast and bowel cancers.
The organisation has committed to funding 50,000 programme places by 2030, potentially creating one of the largest exercise-based cancer rehabilitation initiatives in the UK.
The NIHR-funded trial brought together a wide range of academic and healthcare organisations, including Queen Mary University of London, the University of Leeds, the University of Sheffield, the University of Bristol, the University of York, the University of Edinburgh, Cardiff University and Nuffield Health. Additional support was provided by the NIHR Biomedical Research Centre: Barts.
The success of STAMINA marks an important milestone in cancer care, strengthening the evidence that lifestyle interventions can play a vital role alongside medical treatment to improve patient outcomes, wellbeing and long-term health.
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