Protective effect of regular physical activity on prostate cancer complications
Subject Areas : Sport Physiology
Fatemeh Jamshidirad
1
,
Hassan Matin Homaee
2
,
Mohammad Ali Azarbayjani
3
1 -
2 - Department of Exercise physiology, CT.C, Islamic Azad University, Tehran, Iran.
3 - Department of Physical Education and Sport Sciences, CT.C., Islamic Azad University, Tehran, Iran
Keywords: Aerobic exercise, Resistance exercise, Prostate cancer,
Abstract :
Prostate cancer (PCa) is one of the leading causes of cancer-related mortality and morbidity
among men worldwide. Although the number of deaths from this cancer has decreased over the
past decade, the incidence of PCa continues to rise globally. In addition to non-modifiable risk
factors, modifiable risk factors such as diet, tobacco and alcohol consumption, obesity, and
physical inactivity play a significant role in the development of PCa. Daily physical activity is an
important factor in PCa risk, and incorporating it into the daily routine of healthy individua ls can
substantially reduce the likelihood of developing PCa, while in affected individuals, it can
significantly slow disease progression. Reviewing the results of studies investigating the effects
of various exercise programs on PCa demonstrates that regular physical activity can markedly
reduce the negative impacts of PCa. These changes occur both at the prostate tumor level,
slowing tumor growth, and can also modulate treatment-related side effects such as quality of
life (QoL), physical function capacity, muscle mass, sexual function, and fatigue. Regular physical
activity exerts its protective effects in PCa patients through improving metabolic status,
enhancing antioxidant defense capacity, increasing tumor growth-inhibiting myokines, and a
range of other biological mechanisms. Based on the findings of this study, it is recommended that
regular physical activity, particularly a combination of aerobic and resistance training, be
integrated as an essential component of the management process for individu als with PCa.
1- Taitt H.E. Global Trends and Prostate Cancer: A Review of Incidence, Detection, and Mortality as Influenced by Race, Ethnicity, and Geographic Location. Am. J. Men’s Health. 2018;12:1807–1823.
2- Berenguer C.V., Pereira F., Câmara J.S., Pereira J.A.M. Underlying Features of Prostate Cancer-Statistics, Risk Factors, and Emerging Methods for Its Diagnosis. Curr. Oncol. 2023;30:2300–2321.
3- Plym A., Zhang Y., Stopsack K.H., Ugalde-Morales E., Seibert T.M., Conti D.V., Haiman C.A., Baras A., Stocks T., Drake I., et al. Early Prostate Cancer Deaths Among Men with Higher vs Lower Genetic Risk. JAMA Netw. Open. 2024;7:e2420034.
4- James N.D., Tannock I., N’Dow J., Feng F., Gillessen S., Ali S.A., Trujillo B., Al-Lazikani B., Attard G., Bray F., et al. The Lancet Commission on prostate cancer: Planning for the surge in cases. Lancet. 2024;403:1683–1722.
5- Obeagu EI. Prostate cancer risk reduction: promising prevention practices and insights. Ann Med Surg (Lond). 2025 May 30;87(7):4344-4355.
6- Pernar CH, Ebot EM, Wilson KM, Mucci LA. The epidemiology of prostate cancer. Cold Spring Harb Perspect Med. 2018;8(12): a030361.
7- Marino P., Mininni M., Deiana G., Marino G., Divella R., Bochicchio I., Giuliano A., Lapadula S., Lettini A.R., Sanseverino F. Healthy Lifestyle and Cancer Risk: Modifiable Risk Factors to Prevent Cancer. Nutrients. 2024;16:800.
8- Benke I.N., Leitzmann M.F., Behrens G., Schmid D. Physical activity in relation to risk of prostate cancer: A systematic review and meta-analysis. Ann. Oncol. 2018;29:1154–1179.
9- Ziglioli F., Patera A., Isgrò G., Campobasso D., Guarino G., Maestroni U. Impact of modifiable lifestyle risk factors for prostate cancer prevention: A review of the literature. Front. Oncol. 2023;13:1203791.
10- Ungvari Z, Fekete M, Varga P, Munkácsy G, Fekete JT, Lehoczki A, Buda A, Kiss C, Ungvari A, Győrffy B. Exercise and survival benefit in cancer patients: evidence from a comprehensive meta-analysis. Geroscience. 2025 Jun;47(3):5235-5255.
11- Tanaka R, Matsunaga-Myoji Y, Kubo S, Nagao N, Fujita K. Effects of light-intensity physical activity on health-related outcomes in cancer survivors: A systematic review. Jpn J Nurs Sci. 2025 Apr;22(2):e12653.
12- Kempin S, Buchner A, Brose SF, Schmidt-Hegemann N, May M, Wolff I, Kravchuk A, Stief C, Brookman-May SD, Enzinger B. The Effect of Resistance and/or Aerobic Training on Quality of Life, Fitness, and Body Composition in Prostate Cancer Patients-A Systematic Review and Meta-Analysis. Cancers (Basel). 2024 Dec 23;16(24):4286.
13- Muñoz-Carrillo FJ, Garcia de Herreros M, Carrillo D, Peralta O, Aversa C, Fernández-Mañas L, Ferrer-Mileo L, Altamirano M, Reig Torras Ò, Jimenez N, Mellado B. Exercise in patients with metastatic prostate cancer: A comprehensive review. Cancer Treat Rev. 2025 Sep;139:102996.
14- Naghizadeh, N., Riyahi Malayeri, S., Roozbahani, M., Khademi, A., Shirvani, H. The Effectiveness of Endurance Training and Nano Curcumin Supplementation on the Expression of Mir-21and P53 Genes in Brain Tumor Tissue in an Animal Model of Glioblastoma Multiform. Journal of Nutrition,Fasting and Health, 2024; 12(1): 26-35. doi: 10.22038/jnfh.2023.73964.1455.
15- Andersen MF, Midtgaard J, Bjerre ED (2022) Do patients with prostate cancer benefit from exercise interventions? A systematic review and meta-analysis. Int J Environ Res Public Health 19(2):972.
16- Cormie P, Zopf EM (2020) Exercise medicine for the management of androgen deprivation therapy-related side effects in prostate cancer. Urol Oncol Semin Orig Investig 38(2):62–70.
17- Edmunds K, Tuffaha H, Scuffham P, Galvão DA, Newton RU. The role of exercise in the management of adverse effects of androgen deprivation therapy for prostate cancer: a rapid review. Support Care Cancer. 2020 Dec;28(12):5661-5671.
18- Meeks JJ, Kern SQ, Dalbagni G, Eastham JA, Sandhu JS. The prevalence of persistent prostate cancer after radiotherapy detected at radical cystoprostatectomy for bladder cancer. J Urol. 2014 Jun;191(6):1760-3.
19- Windsor PM, Nicol KF, Potter J. A randomized, controlled trial of aerobic exercise for treatment-related fatigue in men receiving radical external beam radiotherapy for localized prostate carcinoma. Cancer. 2004 Aug 1;101(3):550-7.
20- Monga U, Garber SL, Thornby J, Vallbona C, Kerrigan AJ, Monga TN, Zimmermann KP. Exercise prevents fatigue and improves quality of life in prostate cancer patients undergoing radiotherapy. Arch Phys Med Rehabil. 2007 Nov;88(11):1416-22.
21- Segal RJ, Reid RD, Courneya KS, Sigal RJ, Kenny GP, Prud'Homme DG, Malone SC, Wells GA, Scott CG, Slovinec D'Angelo ME. Randomized controlled trial of resistance or aerobic exercise in men receiving radiation therapy for prostate cancer. J Clin Oncol. 2009 Jan 20;27(3):344-51.
22- Galvão DA, Taaffe DR, Spry N, Joseph D, Newton RU. Combined resistance and aerobic exercise program reverses muscle loss in men undergoing androgen suppression therapy for prostate cancer without bone metastases: a randomized controlled trial. J Clin Oncol. 2010 Jan 10;28(2):340-7.
23- Galvão DA, Spry N, Taaffe DR, Denham J, Joseph D, Lamb DS, Levin G, Duchesne G, Newton RU. A randomized controlled trial of an exercise intervention targeting cardiovascular and metabolic risk factors for prostate cancer patients from the RADAR trial. BMC Cancer. 2009 Dec 2;9:419.
24- Galvão DA, Spry N, Denham J, Taaffe DR, Cormie P, Joseph D, Lamb DS, Chambers SK, Newton RU. A multicentre year-long randomised controlled trial of exercise training targeting physical functioning in men with prostate cancer previously treated with androgen suppression and radiation from TROG 03.04 RADAR. Eur Urol. 2014 May;65(5):856-64.
25- Ndjavera W, Orange ST, O'Doherty AF, Leicht AS, Rochester M, Mills R, Saxton JM. Exercise-induced attenuation of treatment side-effects in patients with newly diagnosed prostate cancer beginning androgen-deprivation therapy: a randomised controlled trial. BJU Int. 2020 Jan;125(1):28-37.
26- Murphy K, Kehoe B, Denieffe S, Hacking D, Fairman CM, Harrison M. Comparing aerobic and resistance exercise emphasis during androgen deprivation and radiation therapy for prostate cancer: A randomised feasibility trial. Support Care Cancer. 2025 Jun 20;33(7):601.
27- Newton RU, Mavropalias G, Fragala MS, Kraemer WJ, Häkkinen K, Taaffe DR, Spry N, Joseph D, Galvão DA. Radiotherapy before or during androgen-deprivation therapy does not blunt the exercise-induced body composition protective effects in prostate cancer patients: A secondary analysis of two randomized controlled trials. Exp Gerontol. 2021 Aug;151:111427.
28- Martin EA, Battaglini CL, Hands B, Naumann F. Higher-Intensity Exercise Results in More Sustainable Improvements for VO2peak for Breast and Prostate Cancer Survivors. Oncol Nurs Forum. 2015 May;42(3):241-9.
29- Xiong X, Zeng B, Zhang S, Du J, Liao X, Hu S, Su X, Qiu S, Yang L. Which Type of Exercise During Radiation Therapy Is Optimal to Improve Fatigue and Quality of Life in Men with Prostate Cancer? A Bayesian Network Analysis. Eur Urol Open Sci. 2022 Aug 12;43:74-86.
30- Taaffe DR, Newton RU, Spry N, Joseph D, Chambers SK, Gardiner RA, Wall BA, Cormie P, Bolam KA, Galvão DA. Effects of Different Exercise Modalities on Fatigue in Prostate Cancer Patients Undergoing Androgen Deprivation Therapy: A Year-long Randomised Controlled Trial. Eur Urol. 2017 Aug;72(2):293-299.
31- Langlais CS, Chen YH, Van Blarigan EL, Chan JM, Ryan CJ, Zhang L, Borno HT, Newton RU, Luke A, Bang AS, Panchal N, Tenggara I, Schultz B, Lavaki E, Pinto N, Aggarwal R, Friedlander T, Koshkin VS, Harzstark AL, Small EJ, Kenfield SA. Quality of life for men with metastatic castrate-resistant prostate cancer participating in an aerobic and resistance exercise pilot intervention. Urol Oncol. 2023 Mar;41(3):146.e1-146.e11.
32- Kim JH, Jeong IG, Khandwala YS, Hernandez-Boussard T, Brooks JD, Chung BI. Prevalence of Postprostatectomy Incontinence Requiring Anti-incontinence Surgery After Radical Prostatectomy for Prostate Cancer: A Retrospective Population-Based Analysis. Int Neurourol J. 2021 Sep;25(3):263-270.
33- Swain DP, Wynne JL, Wilson PB. Aerobic Recovery after Radical Prostatectomy: A Case Study. Med Sci Sports Exerc. 2020 Feb;52(2):296-302.
34- Ashton RE, Aning JJ, Tew GA, Robson WA, Saxton JM. Supported progressive resistance exercise training to counter the adverse side effects of robot-assisted radical prostatectomy: a randomised controlled trial. Support Care Cancer. 2021 Aug;29(8):4595-4605.
35- Singh F, Newton RU, Taaffe DR, Lopez P, Thavaseelan J, Brown M, Ooi E, Nosaka K, Hayne D, Galvão DA. Prehabilitative versus rehabilitative exercise in prostate cancer patients undergoing prostatectomy. J Cancer Res Clin Oncol. 2023 Dec;149(18):16563-16573.
36- Van Blarigan EL, Kenfield SA, Olshen A, Panchal N, Encabo K, Tenggara I, Graff RE, Bang AS, Shinohara K, Cooperberg MR, Carroll PR, Jones LW, Winters-Stone K, Luke A, Chan JM. Effect of a Home-based Walking Intervention on Cardiopulmonary Fitness and Quality of Life Among Men with Prostate Cancer on Active Surveillance: The Active Surveillance Exercise Randomized Controlled Trial. Eur Urol Oncol. 2024 Jun;7(3):519-526.
37- Galvão DA, Newton RU, Taaffe DR, Cormie P, Schumacher O, Nelson CJ, Gardiner RA, Spry N, Joseph D, Tang C, Luo H, Chee R, Hayne D, Chambers SK. Exercise and Psychosexual Education to Improve Sexual Function in Men With Prostate Cancer: A Randomized Clinical Trial. JAMA Netw Open. 2025 Mar 3;8(3):e250413.
38- Brown JC, Huedo-Medina TB, Pescatello LS, Ryan SM, Pescatello SM, Moker E, LaCroix JM, Ferrer RA, Johnson BT. The efficacy of exercise in reducing depressive symptoms among cancer survivors: a meta-analysis. PLoS One. 2012;7(1):e30955.
39- Fang YY, Lee YH, Chan JC, Chiou PY, Chou XY, Chiu WT, Hung CT. Effects of exercise interventions on social and cognitive functioning of men with prostate cancer: a meta-analysis. Support Care Cancer. 2020 May;28(5):2043-2057.
40- Ahmadi H, Daneshmand S. Androgen deprivation therapy: evidence-based management of side effects. BJU Int. 2013 Apr;111(4):543-8.
41- Teleni L, Chan RJ, Chan A, Isenring EA, Vela I, Inder WJ, McCarthy AL. Exercise improves quality of life in androgen deprivation therapy-treated prostate cancer: systematic review of randomised controlled trials. Endocr Relat Cancer. 2016 Feb;23(2):101-12.
42- Yunfeng G, Weiyang H, Xueyang H, Yilong H, Xin G. Exercise overcome adverse effects among prostate cancer patients receiving androgen deprivation therapy: An update meta-analysis. Medicine (Baltimore). 2017 Jul;96(27):e7368.
43- Andersen MF, Midtgaard J, Bjerre ED. Do Patients with Prostate Cancer Benefit from Exercise Interventions? A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2022 Jan 15;19(2):972.
44- Shao W, Zhang H, Qi H, Zhang Y. The effects of exercise on body composition of prostate cancer patients receiving androgen deprivation therapy: An update systematic review and meta-analysis. PLoS One. 2022 Feb 15;17(2):e0263918.
45- Ussing A, Mikkelsen MK, Villumsen BR, Wejlgaard J, Bistrup PE, Birkefoss K, Bandholm T. Supervised exercise therapy compared with no exercise therapy to reverse debilitating effects of androgen deprivation therapy in patients with prostate cancer: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis. 2022 Sep;25(3):491-506.
46- Riyahi Malayeri S, Hoseini M. The Effect of Acute Exercise on Vaspin and Chemerin Levels in Obese Men. jbrms 2021; 8 (1) :58-66.
47- Langelier DM, D'Silva A, Shank J, Grant C, Bridel W, Culos-Reed SN. Exercise interventions and their effect on masculinity, body image, and personal identity in prostate cancer-A systematic qualitative review. Psychooncology. 2019 Jun;28(6):1184-1196.
48- Barnard RJ, Leung PS, Aronson WJ, Cohen P, Golding LA. A mechanism to explain how regular exercise might reduce the risk for clinical prostate cancer. Eur J Cancer Prev. 2007 Oct;16(5):415-21.
49- Baldelli G, De Santi M, Gervasi M, Annibalini G, Sisti D, Højman P, Sestili P, Stocchi V, Barbieri E, Brandi G. The effects of human sera conditioned by high-intensity exercise sessions and training on the tumorigenic potential of cancer cells. Clin Transl Oncol. 2021 Jan;23(1):22-34.
50- Hwang JH, McGovern J, Minett GM, Della Gatta PA, Roberts L, Harris JM, Thompson EW, Parker TJ, Peake JM, Neubauer O. Mobilizing serum factors and immune cells through exercise to counteract age-related changes in cancer risk. Exerc Immunol Rev. 2020;26:80-99.
51- Kim JS, Wilson RL, Taaffe DR, Galvão DA, Gray E, Newton RU. Myokine Expression and Tumor-Suppressive Effect of Serum after 12 wk of Exercise in Prostate Cancer Patients on ADT. Med Sci Sports Exerc. 2022 Feb 1;54(2):197-205.
52- Barnard RJ, Aronson WJ. Benign prostatic hyperplasia: does lifestyle play a role? Phys Sportsmed. 2009 Dec;37(4):141-6.
53- Santa Mina D, Connor MK, Alibhai SM, Toren P, Guglietti C, Matthew AG, Trachtenberg J, Ritvo P. Exercise effects on adipokines and the IGF axis in men with prostate cancer treated with androgen deprivation: A randomized study. Can Urol Assoc J. 2013 Nov-Dec;7(11-12):E692-8.
54- Hvid T, Lindegaard B, Winding K, Iversen P, Brasso K, Solomon TP, Pedersen BK, Hojman P. Effect of a 2-year home-based endurance training intervention on physiological function and PSA doubling time in prostate cancer patients. Cancer Causes Control. 2016 Feb;27(2):165-74.
55- Veljkovic M, Dopsaj V, Dopsaj M, Branch DR, Veljkovic N, Sakarellos-Daitsiotis MM, Veljkovic V, Glisic S, Colombatti A. Physical activity and natural anti-VIP antibodies: potential role in breast and prostate cancer therapy. PLoS One. 2011;6(11):e28304.
56- Rebillard A, Lefeuvre-Orfila L, Gueritat J, Cillard J. Prostate cancer and physical activity: adaptive response to oxidative stress. Free Radic Biol Med. 2013 Jul;60:115-24.
57- Ashcraft KA, Peace RM, Betof AS, Dewhirst MW, Jones LW. Efficacy and Mechanisms of Aerobic Exercise on Cancer Initiation, Progression, and Metastasis: A Critical Systematic Review of In Vivo Preclinical Data. Cancer Res. 2016 Jul 15;76(14):4032-50.
