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Prostate Cancer & Exercise

Prostate cancer is known to be the most common cancer in Australian men. It is estimated that there are around 20,000 new cancer cases and 3,300 deaths related to Prostate Cancer each year in Australia, making it the second most prevalent cause of death from cancer).

There is strong evidence that regular exercise after diagnosis of cancer can increase survival rates by 50-60% with the strongest effects for breast, colorectal and prostate cancers.

There are a number of treatment options available for Prostate Cancer including:

  • Prostate Removal
  • Radiation Therapy
  • Chemotherapy
  • Hormone Suppression (ADT)

Cancer and conjunctive treatment options (medications) can cause significant changes to an individual’s body and have many other side effects including:

  • Limited range of movement
  • Weight gain or loss
  • Depression
  • Reduced bone mineral content
  • Reduced muscle flexibility

Side Effects of Prostate Cancer Treatment

  • Incontinence
  • Reduce muscle related disorders including: decreased bone mass, reduced muscle strength, increased risk of fracture. Just 12 months of ADT treatment can see men lose 5-10x bone mineral compared to those who are on other treatment methods
  • Early onset of cardiovascular disease – particularly Heart Attack.
  • Increased risk of Type 2 Diabetes
  • Reduced cognitive function
  • Nausea, vomiting
  • Increased fatigue

Benefits of Exercise

If you have been diagnosed with prostate cancer, then exercise is an important adjunct therapy to your treatment in order to reduce your symptoms, decrease the side effects of such radiation and drug therapies, and improve your psychological wellness and increase survival rate.

Numerous men with prostate cancer often experience reductions in fitness levels, loss of muscle and bone mass and increases in body fat.

These aforementioned effects are partly caused by a reduction in physical activity levels, poor nutrition and often depression. Muscle loss and the associated low levels of strength and power capacity can increase the risk of falls.

Often, functional capacity is reduced in these circumstances, whereby there is a decrease in the ability to perform the tasks of daily living and quality of life.

An appropriately prescribed exercise program has been demonstrated to provide the following benefits:

  • Maintain or increase muscular strength
  • Maintain or improve cardiovascular endurance
  • Improve day to day functioning
  • Reduced risk of depression and anxiety
  • Reduce risk of secondary conditions
  • Reduced fatigue and improved mood
  • Reduced symptoms such as nausea and pain
  • Preserved or improved immune function
  • Improved recovery outcomes
  • Reduce bone loss due to ADT

Exercise you should do

Strengthening the Pelvic Floor

Men undergoing prostate cancer treatment should pay special attention to ensuring they have good pelvic floor strength in order to decrease the side effects of treatment.

Your pelvic floor is made up of a group of muscles and connective structures found in the region of your pelvis between your legs, supporting the functions of the bladder.

Essentially, your pelvic floor muscles aid in urinary continence.

The pelvic floor is often compromised in men after undergoing prostate cancer treatment. During treatment, whether it be surgical or radiation, the prostate is targeted or removed. This process can often lead to damage caused to the surrounding tissues, including the muscles within the pelvic floor. When these muscles are compromised, or damaged, this can lead to weakness, pain and dysfunction.

It is ideal that pelvic floor strengthening commence prior to undergoing prostate cancer treatment with surgery or radiation. The earlier you begin to strengthen the pelvic floor muscles and implement these exercises as part of your regular routine, the better the outcomes will be post surgery.

Pelvic floor strengthening exercises are simple and do not require any special exercise equipment. Your pelvic floor muscles are engaged and strengthened by contracting as you are stopping your urine stream. This exercise is performed by lying down (with your knees bent and feet flat on the floor) or sitting in a chair, depending on your comfort. Contract your pelvic floor for 10 seconds, followed by a 10 second rest. Repeat this 5 times. Perform this exercise 3 times a day until your surgery.

The below table outlines exercise recommendations to elicit the most health benefits for those that have been diagnosed with prostate cancer and are to undergo consequential prostate cancer treatment.

Prostate Guidelines

Other types of exercise to consider include:

  • Balance: reduce muscle mass after treatment can affect balance and stability particularly in older males.
  • Pelvic Floor and Core strengthening: these types of training can help to reduce the impact of incontinence after treatment options such as prostate removal and radiation therapy
  • High Impact Loading: To reduce the effects of ADT and preserve bone mineral

After Surgery

It is important to talk with your nurse or doctor about when to resume exercise post surgery. In terms of strengthening the pelvic floor, start with gentle contractions that are less than 100% effort whilst lying down. Hold the contraction for 3 seconds and then relax for 15 seconds. Do 5 repetitions, 3 times a day. Increase the intensity of the contraction when you feel comfortable and with the advice of a health professional. The next step is to then perform these exercises seated. Repeat the same intervals as mentioned above. You should notice a gradual improvement in incontinence. It is important to consult with your GP or a health professional in terms of when and what exercise you can do post surgery.

There are also a number of precautions and contraindications to exercise when it comes to prostate cancer which should be taken into consideration.Therefore it is recommended that a suitable exercise program be employed in a controlled environment under the supervision of an Accredited Exercise Physiologist. Accredited Exercise Physiologists can assist in addressing any significant neuromuscular weakness so that you are able to maintain your muscle function and reduce your risk of falls.

In Conclusion

A referral provided by your specialist or GP to an Accredited Exercise Physiologist will then allow them to conduct a full initial assessment of your health, by looking at your levels of strength, cancer-related fatigue, cardiovascular health and current health status.

In doing so, they will then be able to create and prescribe an individualised and appropriate exercise program to assist in the recovery of your prostate cancer treatment.

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