Examining the benefits of physical exercise during active surveillance

This review examined findings on lifestyle interventions for men with prostate cancer managed with active surveillance. The authors reported preliminary evidence on the benefits of physical exercise for men undergoing active surveillance.

Due to advances in the early detection of prostate cancer, many prostate tumors currently being diagnosed are localized and low-risk. Many men may benefit from delaying treatment. Active surveillance (AS) refers to actively monitoring tumor growth without actually administering treatment. The main aim of AS is to reduce overtreatment while also preserving treatment opportunities in patients with disease progression. There is some evidence to suggest that lifestyle and exercise interventions can delay disease progression in men undergoing AS.

The aim of this review was to examine evidence on the benefits of lifestyle interventions for prostate cancer managed with AS.

One early study investigated the benefit of a combination of lifestyle changes among 92 men undergoing AS. These included stress management, dietary changes, and physical activity (walking for 30 minutes 6 days per week). None of the patients undertaking lifestyle changes required active treatment after 1 year. In contrast, 6 men in the group not undertaking lifestyle changes required active treatment. After 2 years, only 5% of patients in lifestyle changes group had undergone active treatment. This was significantly lower compared to those not undertaking lifestyle changes (27%).

In another study, 71 patients engaging in 3 or more hours of vigorous exercise per week after prostate cancer diagnosis showed changes in their genetic makeup. These genetic changes included an increased expression of genes that promote healthy cell activity.

A recent study reported that those patients who engaged in regular brisk walking were 48% more likely to have larger prostate tumor blood vessels, and were 59% more likely to have regularly shaped blood vessels. Together, this can reduce the risk of disease progression.

An analysis of 16 separate studies involving 26,479 patients undergoing active treatment examined the effect of higher BMI (body mass index, measure of body fat that takes height and weigh into account) on treatment outcomes. Analysis showed that every 5 kg increase BMI increased the risk of disease recurrence by 21%. A separate analysis involving 6 studies and 18,203 patients reported that the same increase in BMI increased the risk of prostate cancer mortality by 20%.

Authors concluded that physical exercise can benefit men with prostate cancer managed with AS. The authors also advised that more studies are needed to confirm preliminary findings.

Discuss with your physician what type of exercise might be safe and effective for you.