Prostate Cancer and Exercise
Cancer is a disease largely associated with aging: most survivors are older than 65 years. In the last two decades, it has become clear that exercise plays a vital role in cancer prevention and control.
In 2010, the American College of Sports Medicine (ACSM) published updated guidelines on exercise and physical activity in patients who are undergoing active treatment for cancer or who have completed treatment. Specific guidelines, including objectives, goals, and contraindications, are available for patients with breast, prostate, colon, gynecologic, and hemtologic cancers.
The guidelines indicate that exercise training is safe during and after cancer treatment and results in improved physical functioning, quality of life, and cancer-related fatigue for many cancer survivor groups, but implications for disease outcomes and survival are still unknown.
The guidelines noted the numerous issues need to be addressed before physical activity becomes fully integrated into cancer treatments, including expanding the ranks of fitness professionals who understand the issues and needs faced by patients with cancer and survivors. View full guidelines.
Physical Activity and Cancer Fact Sheet
Highlights: Prostate Cancer and Exercise
- More research is needed-however numerous studies focusing on physical exercise interventions in prostate cancers patients demonstrate positive physiological and psychological effects.
- Men with prostate cancer retain the ability to increase their aerobic and muscular fitness through exercise training. However, exercise can influence their health in other ways. Urinary incontinence, erectile dysfunction, fatigue as well as fears and depression rank among the most common complaints in patients with prostate cancer, resulting in a reduced participation in daily life and social isolation.
- The leading cause of death in men with prostate cancer is cardiovascular disease, for which the protective effects of exercise are clear. Prostate cancer generally occurs in older men, in whom cardiovascular disease and mortality are relatively common; therefore men with prostate cancer should undergo cardiac screening prior to commencing an exercise program.
- All studies that have been conducted and report on safety concluded that exercise is safe in prostate cancer survivors. The potential for exercise to negatively alter prostate-specific antigen (PSA) levels has also been investigated and the few studies reporting on this indicate that PSA is not negatively affected by exercise.
- The effect on overall quality of life is non-conclusive some studies indicate there is no positive effect of exercise training on quality of life, with slightly more indicating there is a positive effect.
- A handful of studies demonstrated the efficacy of aerobic or resistance exercise training to reduce fatigue among prostate cancer survivors. The reduction in fatigue was reported among survivors undergoing androgen deprivation therapy, radiation therapy, or both. Limited home-based aerobic and/or low-intensity resistance exercise also has been shown to reduce fatigue in survivors undergoing androgen deprivation therapy or radiation.
- Physical Function seems to respond well to exercise training. Again, there are limited studies one of which is the Reach out to Enhance Wellness in Older Survivors trial, in which 41% of the 641 long-term cancer survivors had prostate cancer and where the telephone counselling and tailored mailed material intervention produced a reduction in the rate of physical function decline compared with a wait-list control.
- Beyond the above outcomes, the limited data currently available on the effects of exercise training on persistent cancer treatment. Issues in prostate cancer survivors, such as sexual functioning, incontinence, preclude definitive outcome direction. For example, one study indicates that, for men who received external beam radiation therapy within the past 18 months, levels of physical activity are positively associated with sexual functioning. An observational study found lower incontinence in prostate cancer survivors who were normal weight and physically active compared with survivors who were obese and sedentary.
- The amount of exercise tolerated by an individual living with cancer will vary- but these individuals can benefit from a well-designed exercise program.
Dr. Liza Stathokostas PhD, Western Researcher