The Impact of Exercise Interventions on Low-Risk Prostate Cancer Patients Under Active Surveillance

Prostate cancer (PCa) remains one of the most common malignancies among men, posing significant health risks. Active surveillance (AS) is commonly recommended for low-risk PCa patients, aiming to delay or avoid the side effects of aggressive treatments. A recent Bayesian Network Meta-Analysis (NMA) based on six Randomized Control Trials (RCTs) comprising 222 patients has provided valuable insights into the effect of different exercise interventions on low-risk PCa patients under AS.

Exercise Interventions and Cardiorespiratory Fitness

The study revealed that high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) showed significant benefits in improving cardiorespiratory fitness compared to usual care. This is a significant finding as improving cardiorespiratory fitness can potentially reduce the risk of cardiovascular diseases, which are commonly associated with cancer and its treatments. This aligns with emerging evidence suggesting that exercise could play a crucial role in cancer treatment and mitigating cardiotoxic treatment effects.

HIIT and Serum PSA Levels

Furthermore, the meta-analysis revealed that HIIT showed a significant improvement in serum Prostate-Specific Antigen (PSA) levels compared to usual care. PSA is a protein produced by both normal and malignant cells in the prostate gland. Elevated levels of PSA can suggest the presence and progression of PCa, thus this finding indicates potential benefits of HIIT in preventing biochemical progression of localized PCa.

No Significant Difference in PSADT or Testosterone Levels

Despite these promising results, the study did not identify any significant difference in Prostate-Specific Antigen Doubling Time (PSADT) or testosterone levels between the exercise intervention groups and usual care. PSADT is used to measure the rate at which the level of PSA rises, and a shorter PSADT can indicate a more aggressive cancer.

Need for Further Research

The study highlighted the need for longer intervention periods, larger sample sizes, and well-blinded multicentered trials in future study designs. This will provide more robust data and potentially confirm the benefits of exercise interventions in PCa management.

Exercise as a Disease Management Option

From the findings, it's clear that exercise interventions, particularly HIIT and MICT, may be considered as disease management options for localized PCa patients under AS. Not only do they improve cardiorespiratory fitness, but they also potentially prevent the biochemical progression of the disease.

The Role of Diet and Other Integrative Therapies

The importance of a healthy lifestyle in managing PCa extends beyond exercise. A study found that a healthy Western style diet and exercise intervention improved blood pressure and may moderate the risk of cardiovascular disease in individuals treated with androgen deprivation therapy for prostate cancer. Furthermore, integrative, complementary medicine and holistic approaches have been identified as important therapeutic resources for oncological patients, supporting their psychological, emotional, social, and financial functioning.

Conclusion

While the evidence is promising, it's evident that more well-designed studies are required to provide stronger recommendations for exercise and dietary interventions in managing PCa. However, the potential benefits of exercise in improving cardiorespiratory fitness and possibly preventing the progression of the disease offer hope for patients under AS. As such, PCa patients and healthcare professionals are encouraged to consider incorporating exercise into their disease management plan.