Introduction

Prostate cancer is the uncontrolled growth of abnormal cells in the prostate gland, a male reproductive organ. The prostate is a small walnut-shaped gland in males, located just below the bladder and in front of the rectum, surrounding the urethra (the tube that drains pee from the bladder).¹ It is responsible for producing seminal fluid, which nourishes and transports sperm.

Prostate cancer is one of the most common types of cancer. In most cases, it grows slowly and is only limited to the prostate gland, where it might not be able to cause sufficient damage. It may only need little or no treatment but other types of prostate cancer are aggressive and spread rapidly.

The highest chance of successful therapy for prostate cancer patients is when it is still restricted to the prostate gland.²

Physical activity for prostate cancer prevention and management

Physical activity can help fight prostate cancer, prevent it from happening again (recurrence), and manage side effects. You may think that only running, weight machines, or going to the gym count as physical activity but many other activities do also count such as: 

• Walking
• Gardening
• Playing with grandchildren 
• Doing chores

Exercise can be defined as what causes you to breathe harder and increase your heart rate. Therefore, anything that causes those effects can be counted as physical activity. 

You should aim for at least 150 minutes (2 and a half hours) of moderate-intensity activity per week, or 30 minutes five days a week.³

Understanding prostate cancer

Risk factors

Factors which can increase your risk of prostate cancer include:

• Older age
  • Prostate cancer is rare in men younger than 40 years old
  • The likelihood of getting prostate cancer increases dramatically beyond the age of 50⁴
• Ethnicity
  • Black men are more likely to develop prostate cancer than White men
  • It is even less common in Asian men
• Family history
  • Your risk of developing prostate cancer increases if your close family member has had prostate cancer
  • A close family member includes your father, brother, uncle and grandfather
• Inherited faulty genes
  • If you have faulty versions of the BRCA1 and BRCA2 genes then you are more likely to develop different types of cancer including prostate cancer
  • Men with Lynch syndrome, which is due to faults in a number of genes such as MLH1 and MLH2, are also more likely to develop a variety of cancers, including prostate cancer
• Obesity and weight 
  • If you are overweight or obese, your chance of developing metastatic or advanced prostate cancer (a cancer that began in the prostate but has spread to other parts of the body) increases

• Being taller
  • There may be a higher risk of prostate cancer in people who are taller in adulthood. 
  • This may also be the same for those who weighed more at birth
• Hormone levels
  • If you have high levels of insulin-like growth factor 1 (IGF-1 - a hormone that regulates normal cell growth) then you have an increased chance of getting prostate cancer
• Pesticides
  • Research shows that if you are exposed to high quantities of pesticides then you are more likely to develop prostate cancer
• Other factors
  • There is not sufficient information but some factors, which may raise the chance of prostate cancer, are like:
    • Having a vasectomy 
    • Inflammation of the prostate called prostatitis
    • Being exposed to cadmium, a sort of metal found in tobacco and other foods⁵

Symptoms

Prostate cancer usually does not cause symptoms until it has grown large enough to put pressure on the urethra, which transports urine from the bladder out of the penis.

Symptoms of prostate cancer may include:

• Urgency to use the restroom.
• Frequent need to pee often during the night.
• Trouble starting to pee.
• Weak flow.
• Straining or taking a long time to pee.
• Feeling like your bladder hasn't fully emptied.
• Blood in urine or semen.

These symptoms might not always mean that you have prostate cancer because prostates naturally tend to grow as people are assigned male at birth age. This is due to a non-cancerous disease known as benign prostate enlargement.

Symptoms which indicate that cancer may have spread are:⁶ 

• Loss of appetite
• Bone pain
• Back pain
• Testicular pain
• Unintentional weight loss

Diagnostic procedures

If you have symptoms that may be caused by prostate cancer then a general practitioner is likely to perform a urine sample test, prostate-specific antigen (PSA) blood test and digital rectal exam.

You may need additional tests or procedures if screenings show you may have prostate cancer like imaging and biopsy.⁷

Physical activity in prostate cancer prevention

Studies 

Regular physical activity can improve health and reduce the risk of prostate cancer. According to studies, men with prostate cancer, who lead and maintain an active lifestyle, have an increased chance of survival compared to those who do not. 

According to one study, men who exercise every week, equivalent to 1-3 hours of walking are 86% less likely to develop aggressive prostate cancer. Further research revealed that three or more hours of strenuous exercise reduced the chance of prostate cancer death by 61%.³

Mechanisms

Regular moderate to intense physical activity affects the amounts of biologically available sex hormones, thereby reducing the risk of hormone-related cancers such as prostate cancer. 

High levels of certain androgens ( sex hormones which are needed for different processes like growth, reproduction and well-being in people assigned male at birth) in people assigned male at birth have been linked to an increased risk of prostate cancer. Increased SHBG (sex hormone binding globulin) production during physical activity may help prevent prostate cancer by lowering levels of biologically available testosterone, a male sex hormone that is made in the testicles and is important to normal male sexual development and function).⁸

Recommended physical activity guidelines for prostate cancer prevention

Doctors recommend that you follow the Department of Health's general activity guidelines, which suggest that every adult should strive for at least one of the following:

• 2 ½ hours of moderate activity each week such as
  • brisk walking 
  • swimming
  • cycling
• 75 minutes of strenuous activity each week, such as
  • running 
  • climbing stairs
  • other sports
• A combination of both moderate and intensive activity

Depending on how much activity you're used to, this can be spaced out across the week and divided into 10-minute intervals or longer. The guidelines also recommend that individuals engage in some type of activity to build muscle strength at least two days per week, this can include carrying heavy bags or weight lifting in the gym.⁹ Prostate cancer survivors benefit greatly from staying active because it reduces fatigue, improves mood, and potentially lowers the risk of recurrence. 

FAQs

How is prostate cancer diagnosed?

It is diagnosed by:

• Urine sample test
• Prostate-specific antigen (PSA) blood test
• Digital rectal exam
• Imaging
• Biopsy

Can exercise help during prostate cancer treatment?

Yes, exercise can reduce fatigue, manage side effects, and potentially improve treatment success.

How can physical activity benefit prostate cancer survivors?

By elevating your mood, reducing fatigue, improving your fitness, and reducing the risk of recurrence.

Summary

• Whether aiming for preventing or managing prostate cancer, incorporating at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous exercise per week is recommended
• Strength training is also important
• To reduce your chance of developing prostate cancer, improve treatment outcomes, and manage side effects, exercise is important
• Prostate cancer survivors benefit greatly from staying active because it reduces fatigue, improves mood, and potentially lowers the risk of recurrence