Modifying Metabolic Syndrome and Cardiovascular Risk for Prostate Cancer Patients on ADT Using a Risk Factor Modification Program and Continuous Fitbit Monitoring

Inclusion Criteria: * Willing and able to provide written informed consent * Histologically or cytologically confirmed adenocarcinoma of the prostate * Presence of metastatic disease documented on imaging studies (bone scan, computed tomography \[CT\] and/or magnetic resonance imaging \[MRI\]) or biochemical recurrence/refractoriness following local therapy (prostatectomy or radiation) * Stable or improving disease activity as demonstrated by stable or improving PSA over at least 2 months * On gonadotropin-releasing hormone (GnRH) agonist or GnRH antagonist or status post-surgical castration for at least 3 months * Combination ADT with abiraterone or enzalutamide is permitted * Anticipation to remain hypogonadal for at least 6 months subsequently * Asymptomatic bone metastasis is permissible (exercise will be modified and patients monitored) * Eastern Cooperative Oncology Group (ECOG) performance status of =\< 2 * Patients must be able to finish a maximal exercise stress test which will be assessed by cardiopulmonary exercise testing using a standardized protocol \^70 supervised by a cardiologist * Hemoglobin \>= 9.0 g/dL independent of transfusion and/or growth factors within 3 months prior to enrollment * Platelet count \>=75,000/uL independent of transfusion and/or growth factors within 3 months prior to enrollment * Access to a smart phone with android or iPhone OS (iOS) operating systems * Able to speak and comprehend English Exclusion Criteria: * Current use of any other systemic therapy for prostate cancer with the exception of gonadotrophin releasing hormone (GnRH) agonists/antagonists, abiraterone, enzalutamide, bisphosphonates or RANK-ligand inhibitors (for bone metastases) which are allowed * Any underlying comorbid medical or psychiatric condition, which in the opinion of the Investigator, will make participation in our exercise intervention hazardous or obscure the interpretation of adverse events * Inability to walk 400 meters or undertake upper and lower limb exercise, and resistance training in the previous 3 months * Chemotherapy treatment within 28 days of study enrollment * Symptomatic bone metastasis * Any investigational pharmaceutical products * Radiation therapy or surgical intervention for prior bone metastasis * Clinically significant active malignancy other than prostate cancer * Prolonged corrected QT (QTc) interval on pre-entry electrocardiogram (\>= 450 m/sec) * Clinically significant heart disease that may impact safety of independent or supervised exercise including preexisting coronary artery disease, myocardial infarction or arterial thrombotic events in the past 6 months, severe or unstable angina, history of clinically significant ventricular arrhythmias (such as ventricular tachycardia, ventricular fibrillation, or Torsade de pointes), New York Heart Association Class III-IV heart disease or cardiac ejection fraction measurement of \< 40% at baseline * Untreated symptomatic spinal cord compressions * Prisoners or subjects who are involuntarily incarcerated * Subjects who are compulsorily detained for treatment of either a psychiatric or physical (e.g. infectious disease) illness