Vigorous exercise may prevent progression of low-risk prostate cancer

The idea that exercise and physicial fitness may be associated with a reduction in risk of disease progression in men with relatively low-risk prostate cancer is hardly new, but a study to be presented today at the Genitourinary Cancer Symposium in San Francisco may put a whole new spin on this idea.

Magbanua et al. have carried out a sophisticated analysis of the expression of genes in normal prostate tissues of a group of 84 patients diagnosed with low-risk prostate cancer who were being managed with active surveillance. 

The 84 patients were all asked to complete a (brief) questionnaire about their physical activity and categorized into two groups as follows:

  • Men who took ≥ 3 hours of vigorous physical activity each week (Group A)
  • Men who took < 3 hours of vigorous physical activity each week (Group B)

They then set out to investigate whether there was any correlation between gene expression and level of physical activity among the patients.

Here is what they found:

  • 70/84 participants (83 percent) completed the questionnaire.
  • 23/70 participants met criteria for Group A.
  • 47/70 participants met criteria for Group B.
  • Gene expression analysis showed that
    • Men in Group A expressed 184 significant genes differently to men in Group B.
    • Up-regulated genes included the known tumor suppressors, BRCA1 and BRCA2.
    • Genes associated with cell cycle and DNA repair pathways were positively modulated in men in Group A compared to men in Group B.
    • The duration of vigorous PA was important.

The implication of this study is that men who take more exercise have a greater capacity for “normalization” of expression of genes that may impact a variety of factors that affect health over time, thus leading to a greater inbuilt capacity to resist progression of milder forms of prostate cancer.

It is relevant in considering these data to understand that in 2011 this reasearch team published data from two other studies, showing that

  • Men with prostate cancer who took ≥ 3 h of vigorous physical activity each week had about a 50 percent lower risk of death from all illnesses, and a 60 percent lower risk of death from prostate cancer, compared to men who took ≤ 1 h of vigorous physical activity each week (see Kenfield et al.)
  • Men who exercised by walking at ≥ 3 miles/h had about half the risk of prostate cancer progression as men who walked at ≤ 2 miles/h (see Richman et al.)

While it is far too early to be able to say with absolute conviction that 3+ hours of vigorous exercise each week can significantly lower risk of progressive prostate cancer in men with low-risk disease, there is an accumulating body of strong scientific evidence that is increasingly supportive of this concept. This evidence also suggests that men who exercise vigorously may also — de facto — be at lower risk for clinically significant prostate cancer.

We need data from larger, prospective studies to really appreciate the significance of these findings … but we already know that exercise is a good thing, particularly as one ages. Time to get off the couch guys!

5 Responses

  1. This did not work for me … nor has it slowed down progression but I still do it!

  2. Bill:

    Respectfully, I don’t think anyone has ever suggested that your diagnosis included the words “low risk.”

    This doesn’t mean that exercise for men with higher-risk prostate cancers is a bad thing, but it seems unlikely that exercise and dietary modifications alone are going to be able to significantly impact the progression of intermediate- and high-risk forms of prostate cancer.

  3. I had an RP 9 years ago when I was 65. After 3 years, my PSA started to rise again (0.2, 0.4, etc.) until it had reached 1.4 this past November. It seems to be climbing at the rate of 0.2 ng/ml/yr. I am very active physically, 5’9″ 180 lbs, winter or summer, with two wood-burning stoves; splitting my own wood gets me plenty of exercise plus a large veggie garden, etc.

    Would these PSA numbers climb higher if I sat on my butt and ate chips all day? I don’t know, because this study does not take into consideration diet and genetics of the patients. It is very interesting, however, and I certainly hope that it is indicative of accurate findings in this study. I just had a baseline bone scan done, and will speak with a radiologist in a week to see what they recommend. The doctor had told me that until my PSA reaches 20, they don’t normally get into aggressive treatment because I seem to have a low-grade growth of prostate cells. And coincidentally, who knows if these cells left over from the RP are just normal prostate cells that are regrowing, or they are cancer cells regrowing!

  4. Keep the faith, Bill — I’m sure it is slowing the rate of progression. I may see Peter Carroll at our quarterly advocates meeting on wednesday; if so I will ask about research re exercise and high-risk disease.

    MedaFit progresses — Hope to have a website up and running next week, but still seeking a national health club partner.

  5. Whoops … I was not trying to express an opinion on if it worked or not, just that I still do it no matter what (at least so far!!)

    Thinking about NYC Marathon with my daughter and maybe Ironman Florida 2013 with her. I am still pretty proud of completing Lake Placid Ironman this year while I was totally castrated!!!

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