This clinical trial tests the impact of different levels of social support on the benefits of exercise in older men with prostate cancer. This trial compares a socially-enhanced supervised group exercise program to a supervised group exercise program with no social enhancement, and an unsupervised home-based program on cancer loneliness, social isolation, mental and physical health in older prostate cancer survivors. All study arms exercise for 6 months and outcomes are measured at baseline, 3 and 6 months. The primary outcome is cancer loneliness with secondary outcomes of mental and physical health.

PRIMARY OBJECTIVE I. Determine the preliminary efficacy of socially-enhanced supervised group exercise on cancer loneliness and social isolation in older PCS.

SECONDARY OBJECTIVE:

I. Examine potential mediators of the effect of socially-enhanced supervised group exercise on cancer loneliness (social support for exercise, cancer-related negative social expectations and self-efficacy).

TERTIARY OBJECTIVE:

I. Determine the preliminary efficacy of socially-enhanced supervised group exercise on mental health (anxiety, depressive symptoms) and physical health (fatigue and physical function) in older PCS.

OUTLINE: PCS are randomized to 1 of 3 arms.

ARM I: PCS participate in online supervised group exercise training led by a certified exercise instructor over 60 minutes with additional 15-minute pre-exercise social time 3 times weekly over 6 months.

ARM II: PCS participate in online supervised group exercise training led by a certified exercise instructor over 60 minutes 3 times weekly over 6 months.

ARM III: PCS participate in independent exercise training following written manual and video over 60 minutes 3 times weekly over 6 months. Men have two individual training sessions with the trainer to learn the exercise program and then the trainer will check in monthly to adjust the program as necessary.

Inclusion Criteria:

• Age 65 years of age or older.
• Diagnosed with histologically confirmed prostate cancer.
• Completed surgery, chemotherapy, radiation and/or systemic treatment (other than ADT) for cancer > 3 months ago.
• Experiencing cancer loneliness.
• Able to ambulate independently; reliance on assistive devices other than a wheelchair is allowed.
• Willing to be randomized into any of the three study arms and attend 80% or more of planned exercise sessions.
• Home internet sufficient for videoconferencing.

Exclusion Criteria:

• Participating in regular group exercise and/or structured resistance training with other cancer survivors (> 1 exercise partner or groups of 3 or more).
• Health or medical condition that affects movement or neurological disorder, or medication that contraindicates participation in live remote resistance exercise.
• Cognitive difficulties that preclude answering the survey questions, participating in the intervention, or giving informed consent.
• Not fluent in English and therefore incapable of answer survey questions, following directions during exercise or performance testing, and providing informed consent in English.

All individual quantitative participant data collected during the trial, after deidentification.

Beginning 3 months following final publication.

Access will be provided to investigators who provide a methodologically sound proposal and complete a data sharing agreement that includes commitments to: (1) using the data only for research purposes and not to identify any individual participant, (2) securing the data using appropriate computer technology, and (3) destroying or returning the data after analyses are completed. Proposals should be directed to wintersk@ohsu.edu. To gain access to data, data requestors will need to sign a data sharing agreement.

To retain blinding of the research assistants who conduct the testing visits, the Project Director will send each participant an email that contains his random group assignment after baseline testing is complete.