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Niamh L Mundell Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia

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Robin M Daly Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia

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Helen Macpherson Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia

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Steve F Fraser Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia

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. 2005 , Grossmann & Zajac 2011 ). There is emerging evidence that exercise training can play an important role in minimising the risk of cognitive deterioration with advancing age in healthy older adults ( Colcombe & Kramer 2003 ). Importantly, regular

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Justin C Brown Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
LSU Health Sciences Center New Orleans School of Medicine, New Orleans, Louisiana, USA
Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA

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Kathleen Sturgeon Penn State College of Medicine, Hershey, Pennsylvania, USA

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David B Sarwer Temple University College of Public Health, Philadelphia, Pennsylvania, USA

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Andrea B Troxel New York University Grossman School of Medicine, New York, New York, USA

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Angela M DeMichele Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA

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Crystal S Denlinger Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA

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Kathryn H Schmitz Penn State College of Medicine, Hershey, Pennsylvania, USA

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physical activity and obesity are correlated with higher estrogen and testosterone and lower SHBG ( McTiernan et al. 2003 , 2006 ). These observations provided the scientific rationale to test the hypothesis that exercise alone, diet alone, and the

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Tim Schauer Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Anne-Sophie Mazzoni Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden

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Anna Henriksson Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden

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Ingrid Demmelmaier Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway

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Sveinung Berntsen Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway

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Truls Raastad Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway

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Karin Nordin Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden

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Bente K Pedersen Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Jesper F Christensen Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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circulating levels of CRP are associated with poor survival in breast cancer ( Pierce et al. 2009 ). Physical exercise training has gained considerable attention as a strategy to combat especially low-grade inflammation, that is, by reduction of visceral

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Christine M Friedenreich Department of Cancer Epidemiology and Prevention Research, Departments of Oncology and Community Health Sciences, Keck School of Medicine, School of Public Health, Cross Cancer Institute, Faculty of Physical Education and Recreation, CancerControl Alberta, Alberta Health Services, 2210 2nd Street Southwest, Calgary, Alberta, Canada T2S 3C3
Department of Cancer Epidemiology and Prevention Research, Departments of Oncology and Community Health Sciences, Keck School of Medicine, School of Public Health, Cross Cancer Institute, Faculty of Physical Education and Recreation, CancerControl Alberta, Alberta Health Services, 2210 2nd Street Southwest, Calgary, Alberta, Canada T2S 3C3

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Heather K Neilson Department of Cancer Epidemiology and Prevention Research, Departments of Oncology and Community Health Sciences, Keck School of Medicine, School of Public Health, Cross Cancer Institute, Faculty of Physical Education and Recreation, CancerControl Alberta, Alberta Health Services, 2210 2nd Street Southwest, Calgary, Alberta, Canada T2S 3C3

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Qinggang Wang Department of Cancer Epidemiology and Prevention Research, Departments of Oncology and Community Health Sciences, Keck School of Medicine, School of Public Health, Cross Cancer Institute, Faculty of Physical Education and Recreation, CancerControl Alberta, Alberta Health Services, 2210 2nd Street Southwest, Calgary, Alberta, Canada T2S 3C3

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Frank Z Stanczyk Department of Cancer Epidemiology and Prevention Research, Departments of Oncology and Community Health Sciences, Keck School of Medicine, School of Public Health, Cross Cancer Institute, Faculty of Physical Education and Recreation, CancerControl Alberta, Alberta Health Services, 2210 2nd Street Southwest, Calgary, Alberta, Canada T2S 3C3

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Yutaka Yasui Department of Cancer Epidemiology and Prevention Research, Departments of Oncology and Community Health Sciences, Keck School of Medicine, School of Public Health, Cross Cancer Institute, Faculty of Physical Education and Recreation, CancerControl Alberta, Alberta Health Services, 2210 2nd Street Southwest, Calgary, Alberta, Canada T2S 3C3

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Aalo Duha Department of Cancer Epidemiology and Prevention Research, Departments of Oncology and Community Health Sciences, Keck School of Medicine, School of Public Health, Cross Cancer Institute, Faculty of Physical Education and Recreation, CancerControl Alberta, Alberta Health Services, 2210 2nd Street Southwest, Calgary, Alberta, Canada T2S 3C3

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Sarah MacLaughlin Department of Cancer Epidemiology and Prevention Research, Departments of Oncology and Community Health Sciences, Keck School of Medicine, School of Public Health, Cross Cancer Institute, Faculty of Physical Education and Recreation, CancerControl Alberta, Alberta Health Services, 2210 2nd Street Southwest, Calgary, Alberta, Canada T2S 3C3

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Ciara Kallal Department of Cancer Epidemiology and Prevention Research, Departments of Oncology and Community Health Sciences, Keck School of Medicine, School of Public Health, Cross Cancer Institute, Faculty of Physical Education and Recreation, CancerControl Alberta, Alberta Health Services, 2210 2nd Street Southwest, Calgary, Alberta, Canada T2S 3C3

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Cynthia C Forbes Department of Cancer Epidemiology and Prevention Research, Departments of Oncology and Community Health Sciences, Keck School of Medicine, School of Public Health, Cross Cancer Institute, Faculty of Physical Education and Recreation, CancerControl Alberta, Alberta Health Services, 2210 2nd Street Southwest, Calgary, Alberta, Canada T2S 3C3

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Kerry S Courneya Department of Cancer Epidemiology and Prevention Research, Departments of Oncology and Community Health Sciences, Keck School of Medicine, School of Public Health, Cross Cancer Institute, Faculty of Physical Education and Recreation, CancerControl Alberta, Alberta Health Services, 2210 2nd Street Southwest, Calgary, Alberta, Canada T2S 3C3

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moderate-vigorous activity ( Canadian Society for Exercise Physiology 2011 ), and 75 min/week of vigorous activity ( World Health Organization 2011 , Kushi et al . 2012 ). Whether or not these recommendations are optimal for postmenopausal breast cancer

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Christine M Friedenreich Department of Population Health Research, Departments of Oncology and Community Health Sciences, Perinatal Epidemiology Research Unit, Prevention Center, Applied Research Program, Department of Medicine, Department of Obstetrics and Gynecology, Department of Statistics, Department of Public Health Sciences, Department of Epidemiology and Public Health, Department of Physical Therapy, Departments of Physical Therapy and Oncology, Department of Exercise and Sports Science, Faculty of Physical Education and Recreation, Alberta Health Services - Cancer Care, Calgary, Alberta, Canada T2N 4N2
Department of Population Health Research, Departments of Oncology and Community Health Sciences, Perinatal Epidemiology Research Unit, Prevention Center, Applied Research Program, Department of Medicine, Department of Obstetrics and Gynecology, Department of Statistics, Department of Public Health Sciences, Department of Epidemiology and Public Health, Department of Physical Therapy, Departments of Physical Therapy and Oncology, Department of Exercise and Sports Science, Faculty of Physical Education and Recreation, Alberta Health Services - Cancer Care, Calgary, Alberta, Canada T2N 4N2

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Heather K Neilson Department of Population Health Research, Departments of Oncology and Community Health Sciences, Perinatal Epidemiology Research Unit, Prevention Center, Applied Research Program, Department of Medicine, Department of Obstetrics and Gynecology, Department of Statistics, Department of Public Health Sciences, Department of Epidemiology and Public Health, Department of Physical Therapy, Departments of Physical Therapy and Oncology, Department of Exercise and Sports Science, Faculty of Physical Education and Recreation, Alberta Health Services - Cancer Care, Calgary, Alberta, Canada T2N 4N2

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Christy G Woolcott Department of Population Health Research, Departments of Oncology and Community Health Sciences, Perinatal Epidemiology Research Unit, Prevention Center, Applied Research Program, Department of Medicine, Department of Obstetrics and Gynecology, Department of Statistics, Department of Public Health Sciences, Department of Epidemiology and Public Health, Department of Physical Therapy, Departments of Physical Therapy and Oncology, Department of Exercise and Sports Science, Faculty of Physical Education and Recreation, Alberta Health Services - Cancer Care, Calgary, Alberta, Canada T2N 4N2

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Anne McTiernan Department of Population Health Research, Departments of Oncology and Community Health Sciences, Perinatal Epidemiology Research Unit, Prevention Center, Applied Research Program, Department of Medicine, Department of Obstetrics and Gynecology, Department of Statistics, Department of Public Health Sciences, Department of Epidemiology and Public Health, Department of Physical Therapy, Departments of Physical Therapy and Oncology, Department of Exercise and Sports Science, Faculty of Physical Education and Recreation, Alberta Health Services - Cancer Care, Calgary, Alberta, Canada T2N 4N2

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Qinggang Wang Department of Population Health Research, Departments of Oncology and Community Health Sciences, Perinatal Epidemiology Research Unit, Prevention Center, Applied Research Program, Department of Medicine, Department of Obstetrics and Gynecology, Department of Statistics, Department of Public Health Sciences, Department of Epidemiology and Public Health, Department of Physical Therapy, Departments of Physical Therapy and Oncology, Department of Exercise and Sports Science, Faculty of Physical Education and Recreation, Alberta Health Services - Cancer Care, Calgary, Alberta, Canada T2N 4N2

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Rachel Ballard-Barbash Department of Population Health Research, Departments of Oncology and Community Health Sciences, Perinatal Epidemiology Research Unit, Prevention Center, Applied Research Program, Department of Medicine, Department of Obstetrics and Gynecology, Department of Statistics, Department of Public Health Sciences, Department of Epidemiology and Public Health, Department of Physical Therapy, Departments of Physical Therapy and Oncology, Department of Exercise and Sports Science, Faculty of Physical Education and Recreation, Alberta Health Services - Cancer Care, Calgary, Alberta, Canada T2N 4N2

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Charlotte A Jones Department of Population Health Research, Departments of Oncology and Community Health Sciences, Perinatal Epidemiology Research Unit, Prevention Center, Applied Research Program, Department of Medicine, Department of Obstetrics and Gynecology, Department of Statistics, Department of Public Health Sciences, Department of Epidemiology and Public Health, Department of Physical Therapy, Departments of Physical Therapy and Oncology, Department of Exercise and Sports Science, Faculty of Physical Education and Recreation, Alberta Health Services - Cancer Care, Calgary, Alberta, Canada T2N 4N2

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Frank Z Stanczyk Department of Population Health Research, Departments of Oncology and Community Health Sciences, Perinatal Epidemiology Research Unit, Prevention Center, Applied Research Program, Department of Medicine, Department of Obstetrics and Gynecology, Department of Statistics, Department of Public Health Sciences, Department of Epidemiology and Public Health, Department of Physical Therapy, Departments of Physical Therapy and Oncology, Department of Exercise and Sports Science, Faculty of Physical Education and Recreation, Alberta Health Services - Cancer Care, Calgary, Alberta, Canada T2N 4N2

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Rollin F Brant Department of Population Health Research, Departments of Oncology and Community Health Sciences, Perinatal Epidemiology Research Unit, Prevention Center, Applied Research Program, Department of Medicine, Department of Obstetrics and Gynecology, Department of Statistics, Department of Public Health Sciences, Department of Epidemiology and Public Health, Department of Physical Therapy, Departments of Physical Therapy and Oncology, Department of Exercise and Sports Science, Faculty of Physical Education and Recreation, Alberta Health Services - Cancer Care, Calgary, Alberta, Canada T2N 4N2

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Yutaka Yasui Department of Population Health Research, Departments of Oncology and Community Health Sciences, Perinatal Epidemiology Research Unit, Prevention Center, Applied Research Program, Department of Medicine, Department of Obstetrics and Gynecology, Department of Statistics, Department of Public Health Sciences, Department of Epidemiology and Public Health, Department of Physical Therapy, Departments of Physical Therapy and Oncology, Department of Exercise and Sports Science, Faculty of Physical Education and Recreation, Alberta Health Services - Cancer Care, Calgary, Alberta, Canada T2N 4N2

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Melinda L Irwin Department of Population Health Research, Departments of Oncology and Community Health Sciences, Perinatal Epidemiology Research Unit, Prevention Center, Applied Research Program, Department of Medicine, Department of Obstetrics and Gynecology, Department of Statistics, Department of Public Health Sciences, Department of Epidemiology and Public Health, Department of Physical Therapy, Departments of Physical Therapy and Oncology, Department of Exercise and Sports Science, Faculty of Physical Education and Recreation, Alberta Health Services - Cancer Care, Calgary, Alberta, Canada T2N 4N2

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Kristin L Campbell Department of Population Health Research, Departments of Oncology and Community Health Sciences, Perinatal Epidemiology Research Unit, Prevention Center, Applied Research Program, Department of Medicine, Department of Obstetrics and Gynecology, Department of Statistics, Department of Public Health Sciences, Department of Epidemiology and Public Health, Department of Physical Therapy, Departments of Physical Therapy and Oncology, Department of Exercise and Sports Science, Faculty of Physical Education and Recreation, Alberta Health Services - Cancer Care, Calgary, Alberta, Canada T2N 4N2

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Margaret L McNeely Department of Population Health Research, Departments of Oncology and Community Health Sciences, Perinatal Epidemiology Research Unit, Prevention Center, Applied Research Program, Department of Medicine, Department of Obstetrics and Gynecology, Department of Statistics, Department of Public Health Sciences, Department of Epidemiology and Public Health, Department of Physical Therapy, Departments of Physical Therapy and Oncology, Department of Exercise and Sports Science, Faculty of Physical Education and Recreation, Alberta Health Services - Cancer Care, Calgary, Alberta, Canada T2N 4N2

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Kristina H Karvinen Department of Population Health Research, Departments of Oncology and Community Health Sciences, Perinatal Epidemiology Research Unit, Prevention Center, Applied Research Program, Department of Medicine, Department of Obstetrics and Gynecology, Department of Statistics, Department of Public Health Sciences, Department of Epidemiology and Public Health, Department of Physical Therapy, Departments of Physical Therapy and Oncology, Department of Exercise and Sports Science, Faculty of Physical Education and Recreation, Alberta Health Services - Cancer Care, Calgary, Alberta, Canada T2N 4N2

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Kerry S Courneya Department of Population Health Research, Departments of Oncology and Community Health Sciences, Perinatal Epidemiology Research Unit, Prevention Center, Applied Research Program, Department of Medicine, Department of Obstetrics and Gynecology, Department of Statistics, Department of Public Health Sciences, Department of Epidemiology and Public Health, Department of Physical Therapy, Departments of Physical Therapy and Oncology, Department of Exercise and Sports Science, Faculty of Physical Education and Recreation, Alberta Health Services - Cancer Care, Calgary, Alberta, Canada T2N 4N2

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to examine the impact of exercise on proposed biomarkers for breast cancer risk has been widely recognized ( McTiernan et al . 1999 , Friedenreich 2001 , IARC Working Group 2002 , Kushi et al . 2006 , Physical Activity Guidelines Advisory

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Justin C Brown Dana-Farber Cancer Institute, Boston, Massachusetts, USA

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Michael R Rickels University of Pennsylvania, Philadelphia, Pennsylvania, USA

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Andrea B Troxel New York University, New York, New York, USA

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Babette S Zemel University of Pennsylvania, Philadelphia, Pennsylvania, USA
Childrens Hospital of Philadelphia, Philadelphia, Pennsylvania, USA

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Nevena Damjanov University of Pennsylvania, Philadelphia, Pennsylvania, USA

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Bonnie Ky University of Pennsylvania, Philadelphia, Pennsylvania, USA

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Andrew D Rhim MD Anderson Cancer Center, Houston, Texas, USA

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Anil K Rustgi University of Pennsylvania, Philadelphia, Pennsylvania, USA

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Kerry S Courneya University of Alberta, Edmonton, Alberta, Canada

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Kathryn H Schmitz Penn State College of Medicine, Hershey, Pennsylvania, USA

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exists a need to identify additional therapies that reduce the risk of recurrent disease in this population. The prescription of physical activity or exercise is a potential therapy that has been reported in observational studies to be associated with a

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Laisa Teleni School of Nursing, Faculty of Health Sciences and Medicine, West Moreton Hospital and Health Service, Department of Pharmacy, Oncology Pharmacy, Department of Nutrition and Dietetics, Department of Urology, Australian Prostate Cancer Research Centre – Queensland, Department of Diabetes and Endocrinology, School of Medicine, Division of Cancer Services, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
School of Nursing, Faculty of Health Sciences and Medicine, West Moreton Hospital and Health Service, Department of Pharmacy, Oncology Pharmacy, Department of Nutrition and Dietetics, Department of Urology, Australian Prostate Cancer Research Centre – Queensland, Department of Diabetes and Endocrinology, School of Medicine, Division of Cancer Services, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia

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Raymond J Chan School of Nursing, Faculty of Health Sciences and Medicine, West Moreton Hospital and Health Service, Department of Pharmacy, Oncology Pharmacy, Department of Nutrition and Dietetics, Department of Urology, Australian Prostate Cancer Research Centre – Queensland, Department of Diabetes and Endocrinology, School of Medicine, Division of Cancer Services, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
School of Nursing, Faculty of Health Sciences and Medicine, West Moreton Hospital and Health Service, Department of Pharmacy, Oncology Pharmacy, Department of Nutrition and Dietetics, Department of Urology, Australian Prostate Cancer Research Centre – Queensland, Department of Diabetes and Endocrinology, School of Medicine, Division of Cancer Services, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia

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Alexandre Chan School of Nursing, Faculty of Health Sciences and Medicine, West Moreton Hospital and Health Service, Department of Pharmacy, Oncology Pharmacy, Department of Nutrition and Dietetics, Department of Urology, Australian Prostate Cancer Research Centre – Queensland, Department of Diabetes and Endocrinology, School of Medicine, Division of Cancer Services, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
School of Nursing, Faculty of Health Sciences and Medicine, West Moreton Hospital and Health Service, Department of Pharmacy, Oncology Pharmacy, Department of Nutrition and Dietetics, Department of Urology, Australian Prostate Cancer Research Centre – Queensland, Department of Diabetes and Endocrinology, School of Medicine, Division of Cancer Services, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia

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Elisabeth A Isenring School of Nursing, Faculty of Health Sciences and Medicine, West Moreton Hospital and Health Service, Department of Pharmacy, Oncology Pharmacy, Department of Nutrition and Dietetics, Department of Urology, Australian Prostate Cancer Research Centre – Queensland, Department of Diabetes and Endocrinology, School of Medicine, Division of Cancer Services, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
School of Nursing, Faculty of Health Sciences and Medicine, West Moreton Hospital and Health Service, Department of Pharmacy, Oncology Pharmacy, Department of Nutrition and Dietetics, Department of Urology, Australian Prostate Cancer Research Centre – Queensland, Department of Diabetes and Endocrinology, School of Medicine, Division of Cancer Services, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia

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Ian Vela School of Nursing, Faculty of Health Sciences and Medicine, West Moreton Hospital and Health Service, Department of Pharmacy, Oncology Pharmacy, Department of Nutrition and Dietetics, Department of Urology, Australian Prostate Cancer Research Centre – Queensland, Department of Diabetes and Endocrinology, School of Medicine, Division of Cancer Services, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
School of Nursing, Faculty of Health Sciences and Medicine, West Moreton Hospital and Health Service, Department of Pharmacy, Oncology Pharmacy, Department of Nutrition and Dietetics, Department of Urology, Australian Prostate Cancer Research Centre – Queensland, Department of Diabetes and Endocrinology, School of Medicine, Division of Cancer Services, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia

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Warrick J Inder School of Nursing, Faculty of Health Sciences and Medicine, West Moreton Hospital and Health Service, Department of Pharmacy, Oncology Pharmacy, Department of Nutrition and Dietetics, Department of Urology, Australian Prostate Cancer Research Centre – Queensland, Department of Diabetes and Endocrinology, School of Medicine, Division of Cancer Services, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
School of Nursing, Faculty of Health Sciences and Medicine, West Moreton Hospital and Health Service, Department of Pharmacy, Oncology Pharmacy, Department of Nutrition and Dietetics, Department of Urology, Australian Prostate Cancer Research Centre – Queensland, Department of Diabetes and Endocrinology, School of Medicine, Division of Cancer Services, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia

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Alexandra L McCarthy School of Nursing, Faculty of Health Sciences and Medicine, West Moreton Hospital and Health Service, Department of Pharmacy, Oncology Pharmacy, Department of Nutrition and Dietetics, Department of Urology, Australian Prostate Cancer Research Centre – Queensland, Department of Diabetes and Endocrinology, School of Medicine, Division of Cancer Services, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
School of Nursing, Faculty of Health Sciences and Medicine, West Moreton Hospital and Health Service, Department of Pharmacy, Oncology Pharmacy, Department of Nutrition and Dietetics, Department of Urology, Australian Prostate Cancer Research Centre – Queensland, Department of Diabetes and Endocrinology, School of Medicine, Division of Cancer Services, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
School of Nursing, Faculty of Health Sciences and Medicine, West Moreton Hospital and Health Service, Department of Pharmacy, Oncology Pharmacy, Department of Nutrition and Dietetics, Department of Urology, Australian Prostate Cancer Research Centre – Queensland, Department of Diabetes and Endocrinology, School of Medicine, Division of Cancer Services, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia

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, symptoms and lifestyle needs. In cancer survivors, exercise has been shown to improve cardiovascular fitness, muscle strength, body composition, fatigue, anxiety, depression and some aspects of QoL ( Rock et al . 2012 ). Similarly, an individualised

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Stephen J Foulkes Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia

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Robin M Daly Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia

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Steve F Fraser Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia

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Androgen deprivation therapy (ADT) is now considered a mainstay in the treatment of metastatic and locally advanced prostate cancer (PCa). Despite well-established benefits of ADT in relation to overall survival, this treatment has been associated with a number of adverse effects, particularly with regard to key cardiometabolic risk factors including the development of insulin resistance, dyslipidemia and increases in total and regional fat mass. In non-ADT populations, increased levels of visceral adipose tissue (VAT) are thought to be a key mediator of the increased cardiometabolic risk associated with weight gain, but this has received limited attention in men treated with ADT. VAT is best assessed using tools such as computed tomography or magnetic resonance imaging; however, these tools are not readily accessible for the majority of researchers or clinicians. Recent advances allow for a method of estimating VAT using a whole-body dual-energy X-ray absorptiometry (DXA) scan that shows promise as a practical tool for researchers to evaluate changes in body fat distribution during ADT. The aim of this narrative review is to (1) review the available evidence with regard to the relationship between ADT and cardiometabolic risk; (2) discuss the role of body fat distribution on cardiometabolic risk in non-ADT populations, with a particular emphasis on the importance of visceral adiposity; (3) examine the potential influence of ADT on body fat distribution and visceral adiposity and (4) provide an overview of current tools used to measure changes in body fat distribution in men treated with ADT, highlighting the potential utility of a recently developed DXA-derived measure of VAT.

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David A Potter Division of Hematology, Oncology and Transplantation, Masonic Cancer Center, University of Minnesota, 420 Delaware Street SouthEast, MMC 480, Minneapolis, Minnesota 55455-0392, USA

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Douglas Yee Division of Hematology, Oncology and Transplantation, Masonic Cancer Center, University of Minnesota, 420 Delaware Street SouthEast, MMC 480, Minneapolis, Minnesota 55455-0392, USA

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Zhijun Guo Division of Hematology, Oncology and Transplantation, Masonic Cancer Center, University of Minnesota, 420 Delaware Street SouthEast, MMC 480, Minneapolis, Minnesota 55455-0392, USA

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Mariangellys Rodriguez Division of Hematology, Oncology and Transplantation, Masonic Cancer Center, University of Minnesota, 420 Delaware Street SouthEast, MMC 480, Minneapolis, Minnesota 55455-0392, USA

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( Coughlin et al . 2004 , Xue & Michels 2007 , Barone et al . 2008 , Lipscombe et al . 2008 ); and animal models are needed to inform the development of trials testing dietary, exercise, and pharmacologic interventions designed to increase recurrence

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Georgios K Dimitriadis The Arden NET CoE, Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals of Coventry and Warwickshire NHS Trust, Coventry, UK
Division of Translational and Experimental Medicine, Warwick Medical School, University of Warwick, Coventry, UK
Division of Endocrinology and Investigative Medicine, Imperial College London, Hammersmith Campus, London, UK

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Martin O Weickert The Arden NET CoE, Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals of Coventry and Warwickshire NHS Trust, Coventry, UK
Division of Translational and Experimental Medicine, Warwick Medical School, University of Warwick, Coventry, UK
Centre for Applied Biological and Exercise Sciences, Coventry University, Coventry, UK

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Harpal S Randeva The Arden NET CoE, Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals of Coventry and Warwickshire NHS Trust, Coventry, UK
Division of Translational and Experimental Medicine, Warwick Medical School, University of Warwick, Coventry, UK
Centre for Applied Biological and Exercise Sciences, Coventry University, Coventry, UK

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Gregory Kaltsas The Arden NET CoE, Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals of Coventry and Warwickshire NHS Trust, Coventry, UK
Division of Pathophysiology, National and Kapodistrian University of Athens Medical School, Athens, Greece
Oxford Center for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK

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Ashley Grossman Oxford Center for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK

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specific precipitants, lifestyle adjustments in patients with CS may need to be considered and implemented. Patients with diarrhoea should avoid known precipitants such as strenuous exercise, consumption of spicy foods and excessive alcohol intake

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