Why is exercise important for patients with localized prostate cancer?

Exercise improves survival and quality of life for patients whose prostate cancer is contained in the gland. Research consistently shows that regular physical activity helps conquer this disease. Whether a man is at risk for developing prostate cancer, or has already received a diagnosis, exercise can only make life better.

5 key benefits of exercise

The Sperling Prostate Center emphasizes four specific physical and mental ways in which exercise benefits prostate cancer patients:

1. It lowers cancer risk, including risk of prostate cancer.
2. It helps slow tumor activity for men who are on Active Surveillance.
3. It supports treatment success before, during and after any treatment.
4. It helps manage Prostate cancer anxiety.

How does exercise lower Prostate cancer risk?

Both cardio workouts and strength training create biological changes that help lower cancer risk. Vigorous physical activity builds muscle. Muscle cells, like virtually every cell in the body, emit tiny particles containing a type of molecular code that can alter the behavior of other cells that take these particles in. The particles are called EVs (extracellular vesicles). Exercise stimulates muscles to produce more EVs, which can be measured in the blood.

A biological analysis by Zhang et al puts forth a theory, based on clinical evidence, that exercise-induced EVs are a delivery system carrying “…a potential tumor-suppressive effect of skeletal muscle-derived factors (such as myokines and miRNAs).” They may alter Prostate cancer cells so they are nonthreats, or even self-destructive. Though more research is needed, this is a plausible explanation for prevention of Prostate cancer proliferation.

Also, exercise reduces the kind of systemic inflammation that is a cancer precursor. As noted by Guzzi et al, “Inflammatory processes are thought to contribute to the development and progression of prostate cancer (prostate cancer).” Inflammation is caused by things like unhealthy diet, stress, poor sleep, etc. These conditions generate a constant irritant the saps the body’s defenses. Exercise counteracts inflammation, thus freeing up the body’s ability to focus on nipping cancer in the bud.

Another positive impact of exercise is its effect on the immune system. According to Jurdana, it boosts cancer protection by increasing the number of the immune system’s detective and destructive cells, which attack and destroy invaders like bacteria, viruses, and cancer cells circulating in the body.

How does exercise slow prostate cancer activity for patients on Active Surveillance?

Patients diagnosed with early stage, low risk Prostate cancer may opt to go on Active Surveillance (AS). It’s a way to monitor their cancer while holding off on treatment as long as possible. Being on AS avoids the risk of treatment-related urinary or sexual side effects, but it’s crucial not to miss a treatment window since Prostate cancer tend to progress. If monitoring reveals progression, patients are reclassified to a higher risk level.

A study by Brassetti, et al. found that AS patients were statistically more likely to be reclassified depending on whether they were sedentary, moderately active, or active. Here is a summary table:

Risk of AS reclassification	Sedentary	Moderate	Active
At 2 years on AS	39%	21%	13%
At 5 years on AS	66%	35%	13%

A breakthrough 2008 study by Ornish, et al. may explain the Brassetti findings. The Ornish work showed that AS patients who made healthy lifestyle changes, including more exercise, experienced gene changes. The activity of anti-tumor genes goes up, while the activity of pro-tumor genes goes down. A Sperling blog reports clinical evidence that exercise lowers PSA during AS, proof of slower tumor growth.

Finally, a 12-week study of AS patients who participated in a high-intensity interval training experienced not only improved cardiovascular and respiratory function, they also had lower PSA levels, decreased PSA velocity (compared with usual care), and were found to have less growth of a specific Prostate cancer cell line. These results were reported by study authors Kang et al.

How does exercise support treatment success?

Exercise improves a patient’s physical condition, preparing him to maximize treatment and extend its results. Before treatment, losing weight and strengthening the cardiovascular and hormone systems prepares patients to go undergo prostate cancer treatments like surgery or radiation with better results and faster recovery.

With particular regard to patients who are having beam radiation, Xiong et al recommend a moderate-intensity continuous training aerobic exercise and resistance exercise program before and during treatment. Their review of published literature found that it was “superior to any other type of exercise in reducing cancer-related fatigue and improving quality of life.” 

Patients who prepare for treatment by exercising regularly tend to recover faster because their body is in better shape. Their immune system is more robust, reducing the risk of post-surgery infection and allowing it to attack any stray cancer cells that escaped the treatment’s effect.

According to one research team, an exercise routine long before a cancer diagnosis may induce what Sheinboim et al. call a “metabolic shield.” They write, “Exercise protects against cancer progression and metastasis by inducing a high nutrient demand in internal organs, indicating that reducing nutrient availability to tumor cells represents a potential strategy to prevent metastasis.” In other words, the exercising body has first claim on the fuels and resources immediately needed during a vigorous workout. It’s as if the cancer cells can’t compete.

How does exercise help manage Prostate cancer-related anxiety?

As mentioned earlier, during AS most Prostate cancer tumors tend to grow and/or become more aggressive. This knowledge sets up fear and anxiety in patients. Many AS patients are uncomfortable with the idea that Prostate cancer is living—and possibly growing—in their own body. Even with meticulous monitoring through PSA tests and MRI scans, worrying may linger.

High-intensity workouts have been found to ease prostate cancer-specific anxiety and fear of progression in men on AS. Regular exercise not only helps lower Prostate cancer anxiety but also supports overall mental well-being. The Sperling Prostate Center also offers a free ebook on managing Prostate cancer anxiety.

Frequently asked questions (FAQ)

Q: What kind of exercise is best?

A:  To maximize Prostate cancer benefits, experts recommend engaging in at least 3 hours of vigorous physical activity per week. The emphasis is on not being lazy about it. Compared to exercising less than an hour a week, more time working out has been linked with a 61% lower risk of dying from Prostate cancer.

That said, note that even a small increase in exercise has benefits for cancer patients, including those with Prostate cancer. In a 2025 paper by Mabena, et al., data from over 28,000 cancer patients showed that compared with those who had low to no physical activity in the 12 months before their diagnosis, those who had moderate to high physical activity (60 or more minutes per week) had 27% lower risk of cancer progression, and 47% lower risk of death from any cause.

Q: If exercise is making my body stronger, can it also make my cancer stronger and grow faster?

A: There is no evidence that exercise can make cancer worse or more aggressive. In fact, just the opposite. An exercising body demands immediate fuel and metabolic efficiency. The same resources that promote positive physical change and muscle development are also what cancer needs—but there’s only just so much to go around. Vigorous exercise gets the body’s top priority. Therefore, cancer gets the short end of the resource stick. The more you use working out, the less for cancer.

Content reviewed by Dr. Dan Sperling, M.D., DABR — updated October 2025.

NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.