Cyclists and prostate cancer

I bought a Cloud 9 bicycle seat for my bike. It looks big and uncool, but I'm old and married, so I don't care. It is soft and cushy, and I could never go back to a "normal" hard and narrow bike seat.

My oncologist said that a softer seat with a gap in the middle is probably a good idea.

I think that the number of cyclists commenting on prostate cancer is probably unsurprising. No other sport/activity (other than perhaps equestrian-type sports - and even then, the saddle is structured differently than bike seats) places direct pressure on the areas affected by PC treatments/surgeries (i.e., the perineum). As a multi-sport, "aging athlete" (karate, crossfit, skiing, hiking, racquet sports, and cycling), none of the non-cycling sports cause me specific concern regarding a return to the activity. Because cycling involves the application of direct pressure to the area affected by surgery, it becomes a relevant question. It can relate to recovery (continence, ED, etc.) as the neural bed sits under the "bike seat area". Issues of a "return plan" (distance/duration/type of cycling/etc.), seat selection, terrain selection (i.e., technical mountain biking involves more potential "hits" to the area, etc.) become important considerations for some.

@ozelli, you may be interested in the experiences and articles that other members have shared in this related discussion:
- Cycling after radical prostatectomy (RP)? Increase risk of recurrence? https://connect.mayoclinic.org/discussion/cycling-after-rp/

I wasn't thinking about recurrence but rather that long term, consistent cycling of long distances may naturally elevate PSA levels and possibly lead to overtreatment. I know that it is recommended not to cycle a few days prior to testing but what if their cycling activity is so great that inflammation is ongoing and unlikely to recede in just a few days.

Several question are implied here:

1. Are regular cyclists more likely than non-cyclists to get prostate cancer? This article from the British Journal of Sports Medicine in January of this year suggest not...https://bjsm.bmj.com/content/early/2024/02/26/bjsports-2023-107007

2. Does cycling result in a chronically elevated PSA? The answer is no, but... There is one study which showed an *immediate* (1 hour post cycling of 30-100 miles) rise on average of 10% from immediate pre-cycling levels. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3572135/) A meta-analysis of a number of studies (https://www.nature.com/articles/pcan201516) showed conflicting results, with some studies showing no difference, others showing varying levels of increase.

3. Do I regret having been a life-long cyclist, who has "done it all" - biked across the country, competed in over 100 triathlons, including 40 Ironman races, mountain biked for decades, cycled to work, etc. - and now having prostate cancer? No, cycling added so much to my quality of life that I can't imagine not having done it to lower my cancer risk, especially considering that my father, a non-cyclist, died of the disease at age 80.

I don't have an answer to your question, but I do know two things my urologist suggested about biking:
1) Don't bike for at least two days prior to a PSA test.
2) A recumbent bike is better for your prostate, if not, use a seat/saddle that has two separate sides.

Does cycling before a PSA test , affect your reading, if you no longer have a prostate ?

@ozelli I think why you see so many posts from bike riders is that it has been shown that bike riding can cause PSA levels to go up.

Also if you have a Space/Oar implanted for treatments you cannot ride you bike.

When my monitoring of PSA (by my PCP) showed continuous PSA climbing we both thought it was my long distant bike riding (25 miles on race seat). So we did a couple of PSA checks and not biking for a week prior. The PSA level continued to rise and sure enough MRI showed suspicious areas and biopsies confirmed protrate cancer.

No prostate = no release of PSA caused by irritation to the prostate (the reason why bike riding *might* cause a falsely high PSA).

We can all reserve the right to wonder, @ozelli . That is how we find new patterns inductively that were not noticed before. The study @trusam1 mentions asks did not find a "significant" increased risk, but a different way of looking at the data would be to question whether there are patterns of activity (like cycling) that correlate with risk of prostate cancer in general populations. With today's "big data" this is more of a possibility to explore, but I haven't seen any studies that attempt to link behavioral factors with prostate cancer risk. Can someone else provide some?
While I fell in love with cycling in Taiwan around age 40, I am one of three males in the last two generations on my mother's side. We all have prostate cancer and I'm the only cyclist. I don't think ukulele playing, sheet metal work, etc. have been linked behaviorally to PC either, right? But when we face an unexpected challenge, we sure would like to know why, right?