PURPOSE/OBJECTIVES: To determine whether exercise could reduce biomarkers of cancer progression in prostate cancer survivors (PCSs) on androgen-deprivation therapy (ADT). DESIGN: Randomized, controlled trial. SETTING: Oregon Health and Science University School of Nursing. SAMPLE: 51 PCSs randomized to one year of resistance and impact training or a stretching control group. METHODS: The authors investigated changes in body composition and cancer-related biomarkers, and the influence of age and fat loss on changes in biomarkers. MAIN RESEARCH VARIABLES: Body composition (total fat, trunk fat, and lean mass), insulin, insulin-like growth factor-1, and sex hormone-binding globulin. FINDINGS: In the 36 PCSs with baseline and 12-month data, total fat (p = 0.02) and trunk fat (p = 0.06) mass decreased in the training group compared to gains in controls. Loss of total and trunk fat each mediated the relationship between groups and one-year change in insulin (p < 0.05). Age moderated the insulin response to exercise where insulin reductions were smaller with increasing age (p = 0.03). CONCLUSIONS: Resistance and impact exercise may reduce body fat among PCSs undergoing ADT, in turn exerting an insulin-lowering effect. IMPLICATIONS FOR NURSING: Nurses should counsel PCSs to exercise to reduce the risk of obesity and associated conditions, including cancer progression.

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