STAMINA RCT in Lancet Oncology Shows Supervised Exercise and Diet Cut Quality-of-Life Decline by One-Third in Men on ADT

The STAMINA trial randomized participants at 15 NHS sites to a structured regimen of twice-weekly supervised aerobic and resistance sessions plus dietary counseling versus standard supportive care. Primary endpoints were prostate-cancer-specific quality of life and fatigue measured at baseline, 3, 6, and 12 months. More than 80 percent attendance was achieved; the intervention group showed statistically significant preservation of quality-of-life scores and lower fatigue, with cost-effectiveness demonstrated within the UK health-economic framework. The cohort was 97 percent White and median age 71, limiting generalizability.

Prior observational data and smaller trials had suggested lifestyle benefits, yet few had tested an embedded, supervised model at this scale. The study addresses a gap noted in ACS guidelines that most lifestyle evidence remains breast-cancer focused. However, the trial did not report progression-free survival or skeletal-event rates, leaving open whether quality-of-life gains translate into oncologic benefit.

Nuffield Health has begun rolling out a version of the program; expansion to breast and colorectal cancers is planned. Next steps require replication in more diverse populations and linkage to long-term clinical endpoints such as metastasis or overall survival.