I was very interested in a new study about cancer survivors and the need for exercise. The article I found in the Journal of the American Medical Association (JAMA) applies just as much to prostate cancer (PCa) survivors as any other cancer—and that includes our patients whose focal disease was treated with Focal Laser Ablation (FLA).
The article’s title got my immediate attention: “Association of Daily Sitting Time and Leisure-Time Physical Activity With Survival Among US Cancer Survivors” by Cao, et al.[i] It made me ask myself how many hours a day in general I spend sitting, and between my busy diagnosis/treatment practice and raising active kids, I have very little couch potato time. Even though I don’t have cancer, I have written many blogs on the benefits of exercise for both heart and prostate health. In other words, I try to practice what I preach in hopes of supporting a long and healthy life.
I want the same for my patients, whether or not they are found to be cancer-free, but particularly I want to spread the word about the Cao article. The authors remind us that currently in the U.S. there are nearly 17 million adults living with cancer, while each year over a million and a half new cases are diagnosed. In fact, at the rate we are going with better detection and an aging population, by 2030 the U.S. is projected to have 22.1 cancer survivors!
Thus, in the words of the authors, “there is a pressing need to identify accessible strategies that cancer survivors can use to improve their long-term health.” One such strategy is exercise—the more vigorous, the better—but “levels of physical activity are critically low among cancer survivors—more than one third of this population participates in little or no leisure-time physical activity (LTPA) while spending prolonged time sitting.”
Prolonged sitting is called sedentary behavior. Sedentary comes from the Latin sedere, meaning “to sit.” Sedentary behavior can actually be deadly. The researchers followed the cases of over 1500 cancer survivors for 4 ½ years. Guess what? The more they sat around, the greater their risk of all-cause death as well as cancer-specific death. According to the article, the highest risk was among those who were inactive or insufficiently active, with sitting time of more than 8 hours per day.
On the other hand, the benefits of exercise support longevity, as well as good health-related quality of life (QOL) while you’re aging. (Obvious examples of lower health-related QOL include spend one’s days in a wheelchair or going for dialysis three times a week.) Exercise actually promotes molecular changes in the body’s systems that can be identified and tracked by biomarkers in the blood. It can elicit beneficial changes in insulin-related pathways, downregulate inflammation and blood estrogen levels, and enhance oxidative, immune and cellular repair pathways.[ii] With specific regard to PCa, here are some key points about exercise and PCa:
- It protects against inflammation, which has been often identified as a precursor to PCa
- For patients on Active Surveillance, it can delay PCa progression.
- For patients with advanced PCa, it can extend life.
In fact, an Australian 17-year PCa survival study that was published in 2015 demonstrated that
men who survived at least 2 yr who were more physically active postdiagnosis or performed more recreational physical activity before and after diagnosis survived longer. Recreational physical activity after diagnosis was associated with a lower risk of PCa death.[iii]
To put it bluntly, one might say when it comes to PCa survival, exercise or die (sooner).
As I write this, it’s early January 2022—not too late for a New Year’s resolve to get off the couch and start moving. If a solid percentage of your leisure time is spent sitting around, I invite you to consider developing a habit of exercise. Any exercise is better than no exercise, and if you’re a PCa patients who’s not already doing so, there’s no time like the present to begin. If you already embrace a program of vigorous strength training and/or aerobics, I congratulate you. Here’s a virtual toast to improved health and a longer lifespan, beginning now.
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.
[i] Cao C, Friedenreich CM, Yang L. Association of Daily Sitting Time and Leisure-Time Physical Activity With Survival Among US Cancer Survivors. JAMA Oncol. 2022 Jan 6.
[ii] Thomas R, Kenfield SA, Yanagisawa Y, Newton RU. Why exercise has a crucial role in cancer prevention, risk reduction and improved outcomes. Br Med Bull. 2021 Sep 10;139(1):100-119.
[iii] Newton RU, Galvão DA. Accumulating Evidence for Physical Activity and Prostate Cancer Survival: Time for a Definitive Trial of Exercise Medicine? Eur Urol. 2016 Oct; 70(4): 586-7.