Exercise, Physical Activity & Prostate Cancer

Exercise is a great way to improve both your mental and physical health. Being physically active can help fight prostate cancer, prevent recurrence, and help with side effect management. 

When you think of physical activity or exercise, you might imagine running, weight machines, and gyms. However, there are many activities that qualify as physical activity. Some include walking, gardening, dancing, or even playing with grandkids. If it makes you breathe harder and your heart beat faster, it’s probably exercise.

It is recommended to get at least 150 minutes of moderate intensity activity each week, or for 30 minutes 5 days a week.
 

Moderate physical activities include:

• Walking briskly (about 3 ½ miles per hour, or mph)
  • Walking has many benefits for prostate cancer patients
• Bicycling (less than 10 mph)
• General gardening (raking, trimming shrubs)
• Dancing
• Golf (walking and carrying clubs)
• Tennis (doubles)

Vigorous physical activities include:

• Running/jogging (5 mph)
• Speed walking (4 ½ mph)
• Bicycling (more than 10 mph)
• Swimming (freestyle laps)
• Basketball (competitive)
• Tennis (singles)

Benefits of regular exercise during and after cancer treatment

Regular physical activity can have a positive impact on health and prostate cancer. Studies have found that among men with prostate cancer, those who lead active lifestyles have better survival rates than those who do not. One study found men who exercise the equivalent of only one to three hours of walking each week have an 86% lower risk of aggressive prostate cancer. Further research has demonstrated three or more hours of vigorous exercise lowered the risk of prostate cancer death by 61%.

In addition, exercise can help to:

• Reduce anxiety and fatigue
• Improve self-esteem
• Increase feelings of optimism
• Improve heart health
• Maintain a healthy weight
• Boost muscle strength and endurance
• Maintain bone density and fight bone loss

Side effects from cancer and certain treatments such as fatigue or sleep problems can make it difficult to find the motivation and energy to be active. It may be helpful to speak with a certified health and fitness professional or a physical therapist. Talk with your treatment team for suggestions and a referral to a skilled professional. 
 

Managing side effects through exercise

Bone health

Treatment with androgen deprivation therapy (ADT) can result in the loss of bone density. Hormones, such as testosterone, protect against bone loss. When these hormones are blocked, bones become weaker, less dense, and more likely to break. This is known as osteoporosis.

The best exercise for bones is weight-bearing exercise that forces your body to work against gravity. Weight-bearing activities can help prevent bone loss and provide other benefits as well. Adequate calcium and vitamin D intake, as well as exercise, can help keep your bones strong. Learn more about prostate cancer and bone health. 

Physical activities for bone health include:

• Weight training/ lifting
• Walking
• Climbing stairs

Urinary incontinence & erectile dysfunction

Men undergoing prostate cancer treatment should give special attention to ensuring good pelvic floor strength in order to reduce the side effects of treatment and improve urinary and sexual function.

The pelvic floor is a group of muscles and connective tissue that are found in your pelvis between your legs, supporting the functions of the bowel, bladder, and sexual organs. 

Surgery or radiation can damage the surrounding tissues, including the muscles of the pelvic floor. When the pelvic floor muscles are compromised, it can lead to weakness, pain, and dysfunction.

Pelvic floor strengthening, or Kegel exercises, ideally begins before treatment with surgery or radiation. The earlier you strengthen the pelvic floor muscles and make these exercises part of your regular routine, the better the outcomes.

How to perform Kegel exercises

Kegel exercises are simple and do not require any special equipment or space. To identify your pelvic floor muscles, tighten the muscles that stop urination midstream or from passing gas. Laying down might make it easier to identify these muscles. These muscles that you feel contracting are your pelvic floor muscles.

To perform Kegels:

• Tighten your pelvic floor muscles
• Hold the contraction for five seconds
• Slowly relax for five seconds. When you get to five, you should be fully relaxed.
• Try it a few times in a row.
• Repeat this contract-and-relax sequence for 20 repetitions.
• Do this sequence 3-5 times per day

It’s best and easiest to incorporate these exercises into your daily routine by identifying patterns or activities. 

For example:

• Identify a routine task, such as brushing your teeth, and do a set of Kegel exercises at that time.
• Do another set after you urinate.
• Just before and during an activity that puts pressure on your abdomen (heavy lifting, coughing, sneezing) contract your pelvic floor muscles.

The beauty of these exercises is that they can be done virtually anywhere and in any position, once you get the hang of them. They are easily done without anyone noticing. Don’t worry if it takes you a little while to properly isolate and consciously engage your pelvic floor muscles. It can take some practice.