lunes, 11 de junio de 2018

Prostate Cancer and Exercise

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By Lois Zoppi, BA

Exercise can help to improve cardiovascular health, build muscle strength, increase self-esteem, and reduce anxiety levels. It can also help to regulate side effects from certain cancer treatments, including fatigue.

Image Credit: l i g ht p o e t / Shutterstock

It is common for men to reduce their levels of physical activity after a prostate cancer diagnosis as they deal with the surgery, side effects from medication, and emotional challenges that arise after a cancer diagnosis. However, exercise is very beneficial in managing both physical and mental wellbeing after a diagnosis.

Effects of exercise on developing prostate cancer

Keeping a healthy weight in accordance with your age, gender, and height is important for many health reasons, and is widely promoted as an important element in leading a healthy life. Exercise not only helps to maintain a healthy weight but also strengthens the immune system, reduces oxidative stress, and prevents obesity.

Although results vary, clinical trials have been carried out to examine the exact effects of exercise on the progression of prostate cancer.

One such international study included 900 men with advanced prostate cancer continuing their normal therapy and medication routines, half of which also followed a high-intensity exercise routine. The results suggested a positive correlation between increased life expectancy in prostate cancer patients and exercise.

Another study carried out by the American Cancer Society found that men with high levels of physical activity were 30% less likely to die of prostate cancer. This study focused on over 10,000 men aged 50-93 years who had localized prostate cancer, meaning the cancer had not metastasized to other parts of the body.

The study supported the belief that physicians should promote physically active lifestyles in conjunction with other medications and therapies when treating prostate cancer patients.

Managing the side effects of prostate cancer treatments with exercise

Medications to treat and manage prostate cancer can cause side effects that have a significant negative impact on the patients’ overall quality of life. The pelvic floor is often adversely affected during prostate cancer treatment due to tissue damage caused by radiation or surgery.

Maintaining pelvic floor strength can improve pain, weakness, or dysfunction experienced after surgery, though it is beneficial to have strong pelvic floor muscles throughout life. Strength can be built up through Kegel exercises, which are performed by repeatedly contracting the pelvic floor muscles several times a day, and do not require any special equipment.

Prostate cancer needs relatively high levels of androgens (male hormones such as testosterone) to develop. As such, androgen deprivation therapy, alternatively called hormone therapy, which decreases or blocks male hormone activity, is used to control the growth of cancerous prostate cells. However, prostate cancer continues to develop even when androgen levels are extremely low.

Androgen deprivation therapy has a number of side effects such as erectile dysfunction, reduction in bone density, bone fractures, loss of muscle mass and strength, weight gain, fatigue, and mood swings.

Osteoporosis (weakened bones from hormone changes or calcium or Vitamin D deficiencies) developed from androgen deprivation therapy can be prevented with regular weight-bearing exercise.

Gentle walking for three hours a week or brisk walking for 90 minutes a week has also proven to be beneficial, additionally improving problems with sexual dysfunction, fatigue, depression, and problems with bowel function.

Recommended exercises for prostate cancer

Weight training for all major muscle groups
Aerobic exercise for 20-60 minutes, three to five times a week
Two to four sets of flexibility exercises

Potential risks of exercising with prostate cancer

As androgen deprivation therapy can significantly reduce bone density, the risk of injury while exercising, such as bone breaks and fractures, is increased. Bisphosphonates can be given to men on androgen deprivation therapy as they increase bone mineral density.

Conclusion

It is beneficial to undertake regular exercise to maintain a healthy weight and therefore lower the risk of a number of health problems and diseases, ranging from mental and cardiovascular health and certain types of cancer.

After diagnosis and treatment, exercise can help to alleviate and manage the side effects of prostate cancer treatment and promote positive mental health.

There have been numerous studies carried out worldwide, but their results have been varied, and it is generally believed that more research needs to be done to solidify the existing evidence that suggests that exercise can improve survival rates of men with prostate cancer.

Reviewed by HH Patel, M.Pharm