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This study assessed the feasibility of a home-based physical activity and\/or metformin intervention in men with non-metastatic prostate cancer following radical treatment (surgery or radiotherapy) or active surveillance.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A 2\u2009\u00d7\u20092 factorial design randomised men into one of four groups for 6\u00a0months: (1) physical activity (defined as brisk walking\u2009\u2265\u200930\u00a0min for\u2009\u2265\u20095\u00a0days per week, aiming for\u2009\u2265\u200910,000 steps a day); (2) metformin (one 500\u00a0mg slow-release tablet daily); (3) physical activity and metformin; and (4) control. Men were recruited from a single tertiary referral centre in the South West of England, UK, (September 2018\u2013March 2020 which terminated slightly early due to the COVID-19 pandemic). Co-primary outcomes were rates of randomisation and adherence which was defined as\u2009men brisk walking \u226530 minutes on\u00a0at least 5\u00a0days with\u00a010,000 steps daily (measured over\u00a0one week 6-months after randomisation) with \u2265\u200960% adherence to metformin between 3- and 6\u00a0months post-randomisation using returned pill count. Secondary outcomes included self-reported adverse events and physical activity, feasibility of wearing activity monitors and questionnaire completion.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>In total, 295 men were eligible and 110 were randomised (37.3%, 95% confidence interval [CI] 31.8 to 43.1). Adherence to the physical activity and metformin interventions was 46.9% (95% CI 32.5 to 62.0) and 47.1% (95% CI 32.9 to 61.5) respectively. Adherence was\u2009&gt;\u200960% for both the physical activity and metformin interventions on a complete case basis. Adverse events were infrequent (<jats:italic>n<\/jats:italic>\u2009=\u20097) across randomised groups. Completion of self-reported measures of physical activity, urinary incontinence, sexual function, quality of life and stages of change was over 80%. Step counts were not higher in men wearing activity monitors that alerted them about their step counts and sedentary behaviour. Retention over 6\u00a0months was 91.3% (95% CI 84.2 to 96.0). Follow up and intervention prompts were impacted by the pandemic.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Home-based physical activity and metformin interventions show some promise for men with prostate cancer following radical treatment or active surveillance.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Trial registration<\/jats:title>\n            <jats:p>ISRCTN, ISRCTN13543667. Registered 2 August 2018, <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.isrctn.com\/ISRCTN13543667\" ext-link-type=\"uri\">https:\/\/www.isrctn.com\/ISRCTN13543667<\/jats:ext-link>\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s40814-025-01654-0","type":"journal-article","created":{"date-parts":[[2025,5,24]],"date-time":"2025-05-24T14:43:43Z","timestamp":1748097823000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The Prostate cancer\u2013Exercise and Metformin randomised controlled feasibility Trial (Pre-EMpT) in men following active surveillance, radical prostatectomy and radiotherapy"],"prefix":"10.1186","volume":"11","author":[{"given":"Luke A.","family":"Robles","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"McGeagh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Aning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Bahl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amarnath","family":"Challapalli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Koupparis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raj","family":"Persad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Rowe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constance","family":"Shiridzinomwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard M.","family":"Martin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7578-4925","authenticated-orcid":false,"given":"J. 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