Exercise for Prostate Cancer
Brendan Cummins
Accredited Exercise Physiologist

In 2018, the Clinical Oncology Society of Australia (COSA) recognised the role exercise has to
play in the management of cancer. Based on the positive benefits that exercise has produced in
cancer patients over a growing body of research and evidence, it called for the following:
• “Exercise to be embedded as part of standard practice in cancer care and to be viewed as
an adjunct therapy that helps counteract the adverse effects of cancer and its treatment.”
• “All members of the multidisciplinary cancer team should promote physical activity and
recommend people with cancer adhere to exercise guidelines. “
• “Best practice cancer care should include referral to an Accredited Exercise Physiologist
and/or physiotherapist with experience in cancer care”

Prostate Cancer

Exercise can play a role in helping men through each stage of therapy. Across all modes,
understandably there is an element of psychological distress, anxiety, worry which can lead to lack
of sleep etc.
• Surgery can result in – urinary incontinence, erectile dysfunction etc
• Radiotherapy can result in – fatigue, urinary problems, bowel problems, erectile
• Chemotherapy – fatigue, compromised immunity, nausea, vomiting, peripheral
neuropathy, cognitive impairment, swelling
• Hormone therapy – fatigue, reduced libido, body comp changes, cardiometabolic risk,
cognitive impairment Hormone (or Androgen Deprivation) Therapy (ADT)

The main role of exercise in helping those who are on hormone treatment lies within its ability to
manage the side effects of the medication/drug. It is widely known that reducing testosterone
output can result in:
– Increased fatigue
– Reduce muscle mass (sarcopaenia)
– Reduce bone density
– Increase body fat
– Sexual dysfunction
– Increase cholesterol
– Increase risk of diabetes
– Increase risk of CVD
– Cognitive impairment risk
– Functional decline

ADT has shown to produce increased incidence of metabolic syndrome (abdominal obesity,
glucose, cholesterol etc.), and give rise to a significantly increased risk of Type II Diabetes,
cardiovascular disease and osteoporosis.

The good news is that exercise can counter ALL of these side effects, provided it’s
performed suitably and safely.

Exercise Guidelines for Prostate Cancer

Aerobic Exercise

*All people with cancer should avoid inactivity and return to normal ADLs as soon as possible
following diagnosis (be as physically active as current abilities and conditions allow).
* There is universal endorsement of exercise guidelines for people with cancer by major
organisations internationally, and that is that exercise should aim to mirror guidelines for general
population. Specifically, that means trying to progress towards and maintain > 150mins
moderate, or 75mins vigorous intensity.

Examples of aerobic activity include;
1. Brisk Walking
2. Cycling
3. Swimming
4. Rowing

Resistance Training

* In addition to aerobic exercise, bouts of resistance-based exercise (or strength training) is
equally important, as it is more effective in combatting some of the side effects of hormone
therapy, such as improving muscle mass, improving glucose storage and maintaining bone
mineral density. It is also important in maintaining function (eg. ability to perform activities of daily
living such as climbing stairs, getting out of a chair, lifting/carrying etc).
* Specifically, the goal is to progress towards achieving 2-3x resistance training sessions per
week of moderate-vigorous intensity exercise targeting major muscle groups

Special Considerations

Certainly, individual variability must be considered in undertaking any exercise program. The
above recommendations serve as a guide, however we know that many men are faced with
various issues when it comes to fulfilling these parameters such as arthritis, chronic pain,
incontinence, injury history, availability of facilities/equipment etc.

As such, referral to an Accredited Exercise Physiologist and/or Physiotherapist can help in the
design and implementation of an exercise program that takes such concerns and limitations into
account. It is important to realise that there is always something that can be done, and that
starting somewhere is better than not starting at all.

For further advice/information:
– please feel free to contact me via brendan@exerciseinpractice.com.au
– search for a local Accredited Exercise Physiologist via www.essa.org.au

Please note, Accredited Exercise Physiologists are Allied Health Professionals. Our
services are recognised by most private health funds, Medicare and DVA.
Speak to your GP for more information, or for a referral