Exercise and Prostate Cancer
The rising rate of prostate cancer necessitates developing better methods to prevent and treat prostate cancer. Prostate cancer is the third leading cause of cancer death among U.S. men, according to the American Cancer Society. The country’s 3.3 million prostate cancer survivors account for 21 percent of all cancer survivors.
There are many reasons why a cancer patient should stay as active as possible through cancer treatment and recovery. I will begin by pointing out a few studies that show how exercise can benefit cancer patients. These studies demonstrate how exercise can reduce certain side effects from treatment, increase energy, decrease stress, and improve quality of life. In the last article of this series, I will suggest ways to develop an exercise program that is based on an individual’s needs and is safe and effective.
There is evidence to support the use of exercise in prostate treatment. Exercise plays a role in the all around improved physical and mental health and therefore should be considered in the treatment plan. We know that exercise can decrease recurrence for some cancers and the role it plays in weight control, which is correlated with some cancers. For prostate cancer specifically, data indicates that obesity increases the aggressiveness of prostate cancer, and thus mortality. Men receiving androgen deprivation therapy are at higher risk for depression. Exercise reduces depression.
Studies do have their limitations. Some use self-reported data about lifestyle and exercise. Moreover, there may be a low number of minority participants who may often have higher cancer rates. The following are a few of the published studies, which confirm that exercise should be included in the treatment plan for prostate cancer patients.
Studies have suggested that patients with high levels of physical activity had a lower rate of disease progression and also reduced mortality from prostate cancer. Ying Wang, PhD, a senior epidemiologist in the Epidemiology Research Program at the American Cancer Society in Atlanta, and colleagues analyzed data on 10,067 men diagnosed with non-metastatic prostate cancer between 1992 and 2011. Men with prostate cancer, which hasn’t spread may have longer survival the more they exercise. A study demonstrated that men who were the most physically active had a 34% lower risk of dying from prostate cancer when compared with men who were the least physically active. Men who either maintained or increased their exercise level also benefited. Prostate cancer patients who kept up a moderate to high level of physical activity also had better survival prognoses compared with their more sedentary counterparts. Those men who were more active before diagnosis were more likely to have lower-risk cancer tumors and a history of prostate screenings. They were also leaner, more likely to be nonsmokers and vitamin users and they ate more fish. Wang concludes, “Our results support evidence that prostate cancer survivors should adhere to physical activity guidelines, and suggest that physicians should consider promoting a physically active lifestyle to their prostate cancer patients.”
Androgen Deprivation Therapy leads to numerous side effects, which can be decreased through exercise. Side effects of ADT include loss of muscle, increase in fat mass and osteoporosis. Risk for diabetes and heart disease also increases. Brian Focht, reported at the November AICR convention, that functional ability increased dramatically as did quality of life for those that exercise, and side effects of ADT were reversed.
Exercise can decrease blood sugar levels, which lower insulin levels and also helps to lower inflammation. There does appear to be a positive association between insulin levels, inflammation and prostate cancer risk.
The evidence for physical activity in reducing anxiety and depression, while increasing general-well being is fairly substantial. Improving well-being can have a dramatic beneficial effect on sexual function. Consistent exercise will also help to lower insulin, blood sugar, and improve overall cardiovascular health, all of which have positive impact on erectile dysfunction and libido.
In 2016, Rider and Wilson studied the connection between ejaculation and prostate cancer, which was published in European Urology. Men that reported higher ejaculatory frequency were less likely to be diagnosed with prostate cancer. This study showed a beneficial role of frequent ejaculation particularly for low-risk disease.
Some doctors have traditionally told patients to rest during this time but Favil Singh’s research confirms the importance of getting fit prior to surgery. Singh’s research published in the journal Integrative Cancer Therapies has shown that a regular dose of physical activity prior to surgery helps the recovery process. This reduces time in the hospital.
Singh stated "This is the first time we've been able to demonstrate the benefits of 'pre-habilitation' for prostate cancer patients. It is safe, side effect-free and can be done while undergoing chemo or radiotherapy. Just two sessions a week of resistance and exercise training for six weeks can make a difference to recovery."
Often, there is a waiting period in between diagnosis and surgery. If fitness level can be improved before surgery the patient, then the patient goes into the surgery stronger and may have a better recovery.
The American Cancer Society and American College of Sports Medicine recommends at least 150 minutes of moderate physical activity or 75 minutes of vigorous exercise each week. This advice is a good goal for those who have been inactive. Unfortunately, in my view this is insufficient for a significant number of cancer patients. Having worked with cancer patients for over 20 years, I believe that this recommendation needs to be changed. It is impossible to include aerobic exercise, strength training, and other exercise methods in the current recommended time frame.
Contact me at caroljmichaels@gmail or go to CarolMichaelsFitness.com to find out about cancer exercise programs in New Jersey or https://www.nfpt.com/product/cancer-recovery-specialist for cancer continuing education courses.