Body Composition, Physical Fitness, Functional Performance, Quality of Life, and Fatigue Benefits of Exercise for Prostate Cancer Patients: A Systematic Review

Abstract

Context: Prostate cancer patients, especially those on androgen deprivation therapy (ADT) experience many symptoms that make it difficult to maintain their independence and quality of life. As ADT act via reducing testosterone production, exercise may offset many of the ADT side-effects and that of the cancer itself. Objectives: This article sought to conduct a systematic review of the literature on whether exercise could reduce symptoms and improve quality of life for prostate cancer patients. Methods: Using relevant databases and keywords, 12 training studies were found meeting the inclusion and exclusion criteria. Results: Grade A level evidence was observed for the benefits of exercise in improving muscular endurance, aerobic endurance and overall quality of life as well as reducing fatigue in prostate cancer patients. Grade B evidence also suggested that exercise may improve prostate cancer patients' muscle mass, muscular strength, functional performance (walking and sit to stand speed) as well as health-related, social and physical quality of life. These effects appeared greater for group-rather than home-based exercise; especially if these programs including resistance training. Conclusion: It is recommended that most prostate cancer patients be encouraged to exercise regularly by their clinicians and significant others. Where possible, this exercise should be group-based and include some resistance training. Future research in this area should directly compare group-and home-based as well as resistance, aerobic and combined resistance and aerobic training to better elucidate the most effective forms of exercise for this population and what factors affect initiation and adherence to such programs.

Benefits and Barriers of Cancer Practitioners Discussing Physical Activity with their Cancer Patients

“…Based on the strong evidence for the benefits of PA for cancer survivorship [7,11,16], health professionals, universities, hospitals and national healthcare accreditation organisations are encouraged to consider the conversational value and implementation processes of PA promotion as part of their usual care for all cancer patients, not just those for those who are subjectively assessed by health professionals to need it. We recommend that evidence-based practice educational modules include discussions on the benefits of PA as well the behavioural change models that may best increase PA levels for cancer patients.…”

“…Of the health professionals who promoted PA, they also endorsed evidence-based aerobic activities such as walking for weight loss, cardiovascular health, improved mental health and quality of life [16]. Considerably fewer promoted resistance training as a form of PA to their patients, despite resistance training being more beneficial than aerobic activity in counteracting the substantial declines in muscle mass, strength and physical performance seen with common cancer treatments [7]. Most importantly, the survey data revealed that there are many barriers to PA promotion for these health professionals.…”

“…There is growing evidence demonstrating that physical activity (PA), be it aerobic, resistance (strength) or a combination thereof produces physical and psychosocial benefits [7,11,16] that counteract many of the adverse effects of common cancer treatments [8,17]. Such research has led professional organisations, including the American Cancer Society, to develop position statements outlining the importance of PA and recommending that physically inactive patients become more active.…”

Quality of life issues in men undergoing androgen deprivation therapy: a review

“…59 A systematic literature review found grade A evidence that regular exercise, especially group-based and including some resistance training, improved muscular strength, aerobic endurance and overall QoL, as well as reduced fatigue. 60 However, in older men (.65 years) and those on ADT, it has been shown that only resistance exercise improves body composition and muscular fitness. 61 Despite this knowledge, many men do not engage in appropriate physical activity levels.…”

Investigating the Effects of Regular Resistance Training and Prostatic Massage on Proinflammatory Markers and Serum Prostate-Specific Antigen Levels in Males with Prostate Cancer

“…Often, men with PC live longer post-diagnosis, with recent statistics indicating survival rates of up to 76.5% five years after diagnosis (2). The high rate of cancer survival is likely related to advances in early detection such as through the screening of prostate-specific antigen (PSA) and treatment modalities such as surgery (e.g., radical prostatectomy), androgen deprivation therapy (ADT), and radiation therapy (3). Regardless of the treatment strategies, PC survivors often experience a very high rate of morbidity caused by cancer and its treatments, particularly ADT.…”