Sunday, September 25, 2022

Exercise And Prostate Cancer Progression

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Dont Forget About Prostate Cancer Screening

Mayo Clinic Minute: Importance of exercise for men with prostate cancer

Continue to discuss screening with your doctor. No matter how fit, no man can eliminate his risk: Marathon runners are not immune from prostate cancer, says Dr. Johnson.

Several screenings options are available. Together, you and your primary care physician or urologist can determine which is right for you.

How We’re Making Exercise A Lifesaver For Every Man With Prostate Cancer

A new trial looking at the effects of exercise on prostate cancer complements a host of our own research into the best healthy lifestyle for men after diagnosis.

We welcome today’s reports of a new year-long study by Sheffield Hallam University into the impacts of exercise on prostate cancer patients. As our Head of Research Funding, Simon Grieveson, told the Independent, we know that a healthy lifestyle can improve outcomes for men living with the disease.

Numerous studies have shown the benefits of physical activity after cancer and cancer treatment, with one finding that it reduced the risk of prostate cancer-specific mortality by approximately 30 per cent and slowed disease progression by up to 57 per cent. Scientists think it’s because exercise may help regulate the way cancer cells grow and repair DNA, but we still need a much clearer understanding of how and why these benefits occur.

Potential Role Of Exercise Induced Extracellular Vesicles In Prostate Cancer Suppression

  • 1Department of Physiology, Harbin Medical University, Harbin, China
  • 2Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia
  • 3School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
  • 4Department of Pathology, Harbin Medical University, Harbin, China
  • 5School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia
  • 6UQ Centre for Clinical Research, University of Queensland, Brisbane, QLD, Australia
  • 7Department of Urology, Royal Brisbane and Womens Hospital, Brisbane, QLD, Australia
  • 8QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia

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Implications For Future Research

Whereas initial clinical research shows mixed results, preclinical studies indicate that exercise may beneficially alter tumour physiology. In addition, one study in a PCa mouse model found that exercise increases the efficiency of radiotherapy, resulting in decreased tumour growth. These findings are promising and should encourage further investigation into this novel area of exercise and PCa research. However, given the paucity of research to date it is unclear what exercise prescription would deliver the desired outcome. Furthermore, specific tumour characteristics such as the initial degree of vascularity and metabolism will likely also influence outcome measures such as hypoxia and should be taken into consideration when designing future studies.

From a physiological perspective, the FITT principles of training, i.e. frequency, intensity, time and type of exercise should be considered as a starting point to formalise structured research questions. Different exercise intensities and types are associated with distinct biochemical as well as physiological adaptations that may differentially affect tumour physiology. Furthermore, not all frequency schedules will likely be feasible for a specific exercise intensity and carefully considered periodisation schedules will need to be employed to maintain exercise tolerability during treatment .

Blood Assessment And Analysis

Prostate cancer (overview, symptoms, causes, stages, diagnosis, treatment)

Resting blood samples were collected early in the morning for fasting specimens and at least 48h post any exercise. The collected blood samples were processed to serum and stored at 80°C until serum myokine analysis. Serum myokine levels for irisin, IL-6, IL-15, SPARC, OSM, and myostatin, were analysed using multiplex magnetic bead panels , and serum decorin , IGF-1 , and IGFBP-3 levels were analysed using appropriate enzyme-linked immunosorbent assay kits.

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Exercise Reduces Anxiety During Active Surveillance For Prostate Cancer

Newswise February 18, 2022In men undergoing active surveillance as an alternative to immediate treatment for prostate cancer, a supervised exercise program can reduce anxiety and fear of cancer progression, reports a study in The Journal of Urology®, an Official Journal of the American Urological Association . The journal is published in the Lippincott portfolio by Wolters Kluwer.

“In our study, a high-intensity interval training program yielded significant mental and physical health benefits for men who chose active surveillance for initial management of low-grade prostate cancer,” comments senior author Kerry S. Courneya, PhD, of the University of Alberta, Edmonton, Canada. “These findings may be especially important for the subgroup of patients who switch to surgery or other treatment as a result of anxiety or fear that their prostate cancer will progress during active surveillance.” The study was led by Dong-Woo Kang, PhD, who is now a postdoctoral fellow at the Dana-Farber Cancer Institute, Boston.

Psychological benefits of exercise training during AS for prostate cancer

In a study called the ERASE trial , the researchers evaluated a supervised, 12-week, high-intensity interval exercise training program for men undergoing AS. Published last year, the main study results showed significant improvement in cardiovascular fitness and reduced PSA levels in men assigned to the exercise program.

About The Journal of Urology®

About the American Urological Association

Growth Of Prostate Cancer Cells

Growth rates of the cell lines NIH 3T3 and LNCaP cells, previously used in Augsten et al a total of either 2×103 fibroblasts or 5×104 LNCaP cells were seeded in 96-well plates. Fibroblasts were grown in DMEM supplemented with 5% FCS and either 5% rest or exercise serum, whereas LNCaP cells were cultured in RPMI 1640 medium supplemented with 5% FCS and either 5% rest or exercise serum for 24, 48 and 96 hours. 2×104 22rv1 and Du145 cells, previously used in were cultured in RPMI 1640 medium supplemented with 5% FCS and either 5% rest or exercise serum for 96 hours. Cell numbers were determined by fixating the cells with 4% PFA for 20 minutes, followed by incubation with crystal violet solution for 20 min at room temperature. The stained cell layer was rinsed thoroughly with tap water, air dried and incubated with SDS solution for 30 min at room temperature. Meanwhile crystal violet was completely released from the cells into the supernatant. The supernatant was scanned in a DU Series 70 Beckman spectrophotometer and read at a fixed wavelength of 600 nm.

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Xenograft Model Of Tumor Growth

Xenograft tumors were generated by incubation of LNCaP cells in medium supplemented with rest serum or exercise serum for 48 hours and NIH-3T3 cells in medium supplemented with rest serum. Cells were trypsinized, re-suspended in medium, and counted with a cell counter . For co-injection analysis, 2×106 LNCaP cells and 0.5×106 NIH-3T3 cells were washed, combined, and re-suspended in 100 µL of cold PBS. Subsequently, the 100 µL cell suspensions were injected subcutaneously in the right lateral flank of 78 week-old, male SCID mice from Taconic, DK, n=10 per group. Animals were monitored daily, and tumor size measured every 34 days using external caliper. Experiments were terminated when individual tumors reached a volume of 1 cm3 or at day 49. Tumors were excised and split before either fixation in 4% paraformaldehyde overnight at 4°C followed by transfer to 70% ethanol, or snap frozen in liquid nitrogen.

Before You Get Started

Could exercise be a treatment for prostate cancer?

If youve decided to start an exercise plan, check in with your doctor first. Every man is different and, as a result, routines and goals should vary based on your current health, points out Dr. Johnson. Your primary care provider can help you set realistic goals, refer you to an exercise specialist, and build a team of experts who can support you in maintaining both prostate and overall health.

To reap the benefits of exercise, you should start slow and make a commitment. Its much better to keep a consistent routine than to burn yourself out with a high-intensity schedule and quit, says Dr. Johnson. For a good balance, find an activity that you enjoy doing, he suggests.

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Strengths And Limitations Of This Study

  • This is the first randomised controlled trial to examine exercise and overall survival in men with prostate cancer.
  • This is a novel multinational, multicentre and multidisciplinary RCT with 24 months of supervised tapered to self-managed exercise with behavioural and psychosocial support, compared with self-directed exercise with psychosocial support alone, in men with metastatic castrate-resistant prostate cancer .
  • The study proposed will determine the efficacy of an individually tailored, progressive and autoregulated aerobic and resistance exercise programme, supervised by accredited exercise physiologists in addition to usual medical care, in parallel with a health economics analysis to assess the health benefits, additional costs and potential savings of including exercise therapy as standard of care for men with mCRPC.
  • The study has a translational team to investigate biomarkers associated with three candidate pathways: systemic inflammation, insulin/glucose metabolism and androgen biosynthesis to study how they mediate the association between exercise and overall survival and to establish a blood, urine and tissue biobank for future biomarker discovery or validation.
  • The outcomes of this phase III RCT are limited to men with mCRPC.

Physical Activity And Prevention

The link between exercise and prostate cancer development has been investigated extensively however, a direct correlation has not been made, given the multifactorial and complex nature of prostate cancer carcinogenesis.1-3

For example, a study by Reiter-Brennan et al noted no significant association between cardiorespiratory fitness and the risk of developing advanced prostate cancer. Within their large cohort of 22,827 men with no prior prostate cancer diagnosis undergoing prostate cancer screening, those with higher fitness defined as at least 12 metabolic equivalents calculated on a single exercise test session were 29% more likely to be screened for prostate cancer and ultimately diagnosed vs men with fewer than 6 METs on baseline exercise testing. The study authors noted that the higher incidence of prostate cancer diagnosis observed among the group of men with a higher activity level may only be partially attributed to the higher rate of screening.4

Conversely, a systematic review reported that although increased physical activity likely has a protective effect on prostate cancer development, there is a large amount of heterogeneity in the studies investigating the impact of both leisure and occupational exercise on prostate cancer incidence.1

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Clinical Trial A First In Testing Benefits Of Exercise On Prostate Cancer Progression

Faculty of Physical Education and Recreation PhD candidate to start clinical trial in 2018

Nicole Graham – 17 November 2017

Kang believes that lack of exercise intervention during active surveillance may play a role in why more than half of prostate cancer patients eventually need medical treatments.

According to Faculty of Physical Education and Recreation doctoral candidate Dong-Woo Kang, approximately one third of Canadian men diagnosed with low-grade prostate cancer undergo “active surveillance” opting for this monitoring program option over surgery, radiation or hormonal therapy-aggressive therapies that can have side effects such as urinary and sexual dysfunction.

Active surveillance is a treatment option recommended to low grade cancer patients where tumor growth and cancer progression can be closely monitored for a period of time before more aggressive treatment plans are put into effect. Prostate cancer patients on active surveillance typically undergo blood testing every three months and a biopsy once every year to a year-and-a-half. Some cases of prostate cancer can remain in active surveillance for up to five, 10 and even 20 years before needing surgery, radiation or hormonal therapy.

Previous studies informing Dong-Woo’s trial have shown that exercise increases immune function, which is important for cancer patients.

Effect Of An Exercise Bout On Skeletal Muscle

Can exercise delay transition to active therapy in men with low

Emerging clinical exercise trials are building our understanding of the effect of exercise bouts on exercise-derived EVs in both human and animal models . Frühbeis and colleagues showed that the level of small EVs of 100-130 nm that carry proteins characteristic of exosomes in plasma increased by an average of 5.2 times in 12 healthy individuals in response to cycling or running until exhaustion. Similarly, another acute exhaustive exercise trial involving 16 healthy subjects also demonstrated a significant increase of EVs in serum at the peak exercise workload compared to at rest , indicating an effect of exhaustive exercise in increasing circulating EVs concentration.

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Combat Prostate Cancer With Exercise

Reviewed By:

Michael Hiroshi Johnson, M.D.

Exercise can help you look buff, trim your waistline and boost heart health, but research suggests that physical activity may offer an additional benefit: better odds against prostate cancer one of the most common malignancies in men.

Urologist Michael Johnson, M.D., explains the connection between prostate cancer and exercise, and offers tips for getting started with a new workout routine.

Exercise As Adjunct Therapy In Cancer Treatment

In the field of exercise oncology, i.e. the application of exercise as medicine in the oncology setting, there is consistent evidence that greater levels of physical activity, commonly defined as any bodily movement produced by skeletal muscles that results in energy expenditure , are associated with a lower risk of developing certain types of cancer as well as decreased all-cause and cancer-specific mortality for patients diagnosed with breast, colorectal, or PCa . For example, Kenfield et al. found that men with PCa who did 3h/week of vigorous physical activity had a 49% lower risk of all-cause mortality and a 61% lower risk of dying from PCa compared to men who did < 1h/week of vigorous physical activity. Furthermore, Richman et al. reported that men with localised PCa who walked at a brisk pace for 3h/week had a 57% lower risk of disease progression compared to men who walked at an easy pace for < 3h/week. This association between walking pace and reduced risk of cancer progression was independent of walking duration , suggesting that not only the volume of physical activity but also the intensity of physical activity is an important factor regarding clinical outcomes in PCa. It is important to note, however, that these findings are based on observational data and randomised controlled trials are currently investigating the impact of exercise on overall survival in patients with PCa as well as colon cancer .

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The Effects Of Exercise Before And After A Prostate Cancer Diagnosis

Christine Ibilibor, MD, MScUrology Times Journal

“This article serves as a summary of the literature published in the past 3 years, documenting the impact of exercise and physical activity on prostate cancer development and on cancer-specific, treatment-related, and patient-reported outcomes,” writes Christine Ibilibor, MD, MSc.

Ibilibor is an assistant professor of urology at the University of Virginia in Charlottesville.

Prostate cancer remains a common malignancy among men, particularly those in good health. The effects of global health status and physical activity on prostate cancer prevention and survival after diagnosis are gaining increased attention as the prevalence of obesity and sedentariness increase in our population. Men with risk factors for prostate cancer development and men newly diagnosed with prostate cancer are increasingly interested in how natural and noninvasive strategies such as exercise can contribute to prostate cancer prevention and survivorship.

This article serves as a summary of the literature published in the past 3 years, documenting the impact of exercise and physical activity on prostate cancer development and on cancer-specific, treatment-related, and patient-reported outcomes. Additional studies outside this time frame were reviewed to provide further context.

Your Bike Seat And Your Health

Exercises at home for men affected by prostate cancer.
  • Pick a wide seat with plenty of padding. Look for gel-filled and anatomy-friendly seats.
  • Wear padded bike shorts.
  • Dont tilt your seat forward. This increases pressure on the perineum.
  • Make sure the seat height is correct. Your legs should not be completely extended at the bottom of your pedal stroke.
  • Raise the handlebars so your position is more upright.
  • Be sure the top bar of the frame is at least two inches below your crotch. Cover the bar with padding to protect your genitals if you fall.

No matter what activity you choose , avoid sporadic bouts of high-intensity activity. For one thing, the health benefits of exercise depend on the total amount of exercise rather than its intensity. But more importantly, higher-intensity activity raises your chances for muscle or joint injury and for sudden death as a result of heart rhythm disturbances, especially if youre a weekend warrior or you havent had a medical check-up to clear you for intense exertion.

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Experimental Model For The Acute Exercise Study

Ten healthy male subjects were included in the study. Their median age, height and weight were 25 yrs, 180 cm and 77 kg, respectively. Median maximal oxygen uptake determined prior to the experiments was 3.7 L*min1. The exercise was performed on an electro-dynamically loaded cycle ergo meter. The subjects performed about 65 min of exercise. For the first 20 min, subjects cycled at 60 rpm at a median work rate of 125 watts , chosen to correspond to 50% of VO2-max, after which the work rate was increased to 165 W, corresponding to 65% of VO2-max for another 40 min. Teflon catheters were inserted into both femoral veins and the femoral artery, at the level of the inguinal ligament. Blood samples were drawn simultaneously from the femoral artery and the ipsilateral femoral vein as described in . In short, resting samples and samples collected 120 min after the end of exercise were used for further analyses.

How Can I Strengthen My Muscles

The muscle that surrounds the prostate may be weakened from cancer surgery or other treatments. This can cause urinary incontinence, which is a loss of bladder control. There are different types of incontinence, ranging from mild to severe. For example, stress incontinence can cause a person to leak urine during activities such as coughing, laughing, sneezing, or exercising. Urge incontinence is loss of urine with a sudden, urgent need to urinate, while continuous incontinence is not being able to control the bladder at all.

Kegel exercises can strengthen your pelvic floor muscles. These muscles support the bladder and bowel and are used to stop the flow of urine. Kegels are great for men with prostate cancer because they can help control incontinence without medication or surgery, as well as may improve erectile issues.

Its smart to start Kegel exercises before surgery and other treatments. To perform a Kegel, tighten and release your pelvic floor muscles. To activate them, pretend youre stopping and starting a flow of urine. Perform 10 Kegels, holding the stopping contraction tight for 5 seconds each time. Take a 5-second break between each repetition. Try to do 4 sets per day. It may take several weeks or months to work up to these recommendations.

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