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EP insights: The role of exercise after a diagnosis

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Written by Exercise Physiologists Malek El-Hassan and Andrew Rivellese, in collaboration with Exercise & Sports Science Australia (ESSA).

After a diagnosis of Prostate Cancer (PCa), you may be recommended to commence Androgen Deprivation Therapy (ADT). ADT is a standard first line therapy for PCa that assists to shrink or prevent the tumour from continuing to grow.

Some common side effects while receiving ADT are fatigue, sexual dysfunction, loss of muscle strength, weight gain (in particular increased fat mass and reduced lean mass), low mood, loss of bone density, increased risk of diabetes, high cholesterol and heart disease.

Exercise can mitigate bone and muscle mass loss, thus reduce risk of fracture and preserve functionality. Participating in exercise can also reduce risk factors of metabolic syndrome, such as reducing visceral fat (waistline fat), blood pressure, keeping cholesterol levels and blood glucose levels in check. Regular exercise can assist to manage fatigue that is heightened during ADT. There is also some evidence that exercise may improve sexual health following treatment.

Being diagnosed and treated for PCa can be a stressful experience and raise depression and anxiety levels. Exercise causes certain hormonal changes that contribute to improvements in mood, cognitive function and mental well-being, making it easier to manage what is a stressful time. Another treatment method for those with PCa is radiation therapy, whereby x-rays are used to destroy cancer cells so they cannot multiply. During and between these sessions, patients can experience acute and chronic symptoms of fatigue, frequent urination, painful bowel movements and muscle weakness. Both resistance and aerobic exercise can help to mitigate these side-effects while also improving strength levels, quality of life and body fat percentage. It is recommended to seek advice from an Accredited Exercise Physiologist prior to undertaking a new exercise routine.

After newly diagnosed PCa, surgery may be required to remove it. In the preoperative stage, exercise can assist to prepare individuals for surgery psychologically and help to manage stress. There is also evidence that anxiety levels up to 6 months post-surgery may also be reduced if exercise is incorporated before surgery.

Exercising before surgery also makes it easier to return to functional capacity levels before surgery. There is also evidence that suggests that exercise post diagnosis can significantly reduce the growth of androgen responsive LNCaP prostate cancer cells in vitro, preventing it from growing larger and possibly metastasising. The acute effect of exercise on prostate cancer has been portrayed through the completion of incremental bicycle exercise for just 60-minutes which showed to have a growth inhibitory effect on LNCaP cells and reduce serum levels of growth stimulating hormones. Even in advanced and aggressive prostate cancer scenarios, consistent bouts of resistance or aerobic training can help to elevate myokine expressions and greater tumour-suppressive effects on serum which may slow disease progression.

You can find an Accredited Exercise Physiologist by visiting www.essa.org.au/find-aep and select ‘cancer’ as the speciality.

Alternatively, give PCFA’s Prostate Cancer Specialist Telenursing team a call on 1800 22 00 99 to talk about how you may be eligible for a subsidy to help reduce the costs associated with seeing an Exercise Physiologist.

Picture 1.pngReferences

Edmunds, K., Tuffaha, H., Scuffham, P., Galvão, D. A., & Newton, R. U. (2020). The role of exercise in the management of adverse effects of androgen deprivation therapy for prostate cancer: a rapid review. Supportive Care in Cancer, 28(12), 5661-5671.

Segal RJ, Reid RD, Courneya KS, Sigal RJ, Kenny GP, Prud'Homme DG, Malone SC, Wells GA, Scott CG, Slovinec D'Angelo ME. Randomized controlled trial of resistance or aerobic exercise in men receiving radiation therapy for prostate cancer. Journal of clinical oncology. 2009 Jan 20;27(3):344-51. 

Monga U, Garber SL, Thornby J, Vallbona C, Kerrigan AJ, Monga TN, Zimmermann KP. Exercise prevents fatigue and improves quality of life in prostate cancer patients undergoing radiotherapy. Archives of physical medicine and rehabilitation. 2007 Nov 1;88(11):1416-22.

Loughney, L., McGowan, R., O’Malley, K., McCaffrey, N., Furlong, B., & Walsh, D. (2021). Perceptions of wellbeing and quality of life following participation in a community-based pre-operative exercise programme in men with newly diagnosed prostate cancer: A qualitative pilot study. PloS one, 16(6), e0253018.

Santa Mina, D., Hilton, W. J., Matthew, A. G., Awasthi, R., Bousquet-Dion, G., Alibhai, S. M., ... & Carli, F. (2018). Prehabilitation for radical prostatectomy: a multicentre randomized controlled trial. Surgical oncology, 27(2), 289-298. 

TYMCHUK CN, BARNARD RJ, HEBER D, ARONSON WJ. Evidence of an inhibitory effect of diet and exercise on prostate cancer cell growth. The Journal of urology. 2001 Sep;166(3):1185-9.

Rundqvist H, Augsten M, Strömberg A, Rullman E, Mijwel S, Kharaziha P, Panaretakis T, Gustafsson T, Östman A. Effect of acute exercise on prostate cancer cell growth. Plos one. 2013 Jul 5;8(7):e67579.

Kim JS, Taaffe DR, Galvão DA, Hart NH, Gray E, Ryan CJ, Kenfield SA, Saad F, Newton RU. Exercise in advanced prostate cancer elevates myokine levels and suppresses in-vitro cell growth. Prostate cancer and prostatic diseases. 2022 Mar;25(1):86-92.


Help is Available

Prostate Cancer Specialist Telenursing Service

If your life has been impacted by prostate cancer, our Specialist Telenursing Service is available to help. If you would like to reach out to the PCFA Prostate Cancer Specialist Telenurse Service for any questions you have about your prostate cancer experience, please phone 1800 22 00 99 Monday - Friday 9am - 5pm, Wednesday 10am-8pm (AEST).

Prostate Cancer Support Groups

PCFA is proud to have a national network of affiliated support groups in each state and territory of Australia consisting of men and women who have a passion for assisting others who encounter prostate cancer. This network is made up of over 170 affiliated groups who meet locally to provide one-to-one support, giving a vision of life and hope after treatment. Call us on 1800 22 00 99 to find your local group.

MatesCONNECT Telephone-based peer support

MatesCONNECT is a telephone-based peer support program for men affected by prostate cancer. If you’ve recently been diagnosed with prostate cancer, our MatesCONNECT service can connect you to a trained volunteer who understands what you’re going through. All of our volunteers have been through prostate cancer. Simply call us on 1800 22 00 99 to be connected with a volunteer.

Newly diagnosed? or need to find more information? Access the PCFA resources here.

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