Exercise Oncology...what say you?

Posted by handera @handera, Jul 6 8:27am

Ran the July 4th Atlanta PeachTree 10K, along with 52,000 other participants.

What types of exercise, weekly regularity and for how long have you implemented additional exercise, since being diagnosed with PCa?

Have you observed any measurable benefits since implementing your post diagnosis exercise efforts?

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

Curious, how old are you? I have been on hormone treatment for 11 months. I am 76 years old han have been running races since 1982. But since on orgovyx, my running endurance has really gone down. I jog 3 times a week and do some other exercises but my overall endurance is down.

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Profile picture for handera @handera

Actually my exercise oncology protocol is based on the “gold standard” of medical studies; the randomized clinical trial (RCT)….there’s nothing “magic” about it….of course there is never ANY guarantee with ANY PCa treatment protocol.

For example, everyone should know that 20-40% of men who undergo radical prostatectomy will experience biochemical recurrence within 10 years and there are also no guarantees with any exercise oncology protocol.

That said, randomized clinical trials often follow stricter regulatory protocols than other randomized control trials, including ethical oversight (e.g., Institutional Review Boards) and compliance with standards like Good Clinical Practice (GCP).

Single or double blinding is only possible in drug based RCT’s.

The randomized clinical trial is the “gold standard” when comparing protocols such as different surgical techniques, where “blinding” is not possible.

The exercise protocol I’ve adopted is based on the ERASE randomized clinical trial (published in August 2021); whose conclusion follows:

“The ERASE trial demonstrated that HIIT increased cardiorespiratory fitness levels and decreased PSA levels, PSA velocity, and prostate cancer cell growth in men with localized prostate cancer who were under active surveillance.“
https://jamanetwork.com/journals/jamaoncology/fullarticle/2783273

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Thanks for the clarification. Yes, an RCT does attempt to allow for confounders, employ longitudinal studies for context, track changes in behaviour, etc to reduce exposure to accidental correlations, but that's really limited to known knowns. As we've seen recently (e.g. in the WHO's 180° reversal on the supposed benefits of red wine), it's really easy to miss a little detail that would completely change the conclusion.

(Irrelevant nerd note: The gold standard was a major contributing factor to the Great Depression and several economic depressions before that, which is why all rich countries abandoned it after WW2 in favour of fiat currencies, but that doesn't seem to have harmed its use as a metaphor. 😉)

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Profile picture for donald76 @donald76

Curious, how old are you? I have been on hormone treatment for 11 months. I am 76 years old han have been running races since 1982. But since on orgovyx, my running endurance has really gone down. I jog 3 times a week and do some other exercises but my overall endurance is down.

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I’m 69 and was diagnosed at 67.

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Profile picture for northoftheborder @northoftheborder

Thanks for the clarification. Yes, an RCT does attempt to allow for confounders, employ longitudinal studies for context, track changes in behaviour, etc to reduce exposure to accidental correlations, but that's really limited to known knowns. As we've seen recently (e.g. in the WHO's 180° reversal on the supposed benefits of red wine), it's really easy to miss a little detail that would completely change the conclusion.

(Irrelevant nerd note: The gold standard was a major contributing factor to the Great Depression and several economic depressions before that, which is why all rich countries abandoned it after WW2 in favour of fiat currencies, but that doesn't seem to have harmed its use as a metaphor. 😉)

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Well…if you prefer magic to RCT’s…it’s a free country….give it a spin 😉

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Profile picture for handera @handera

Well…if you prefer magic to RCT’s…it’s a free country….give it a spin 😉

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❝Well…if you prefer magic to RCT’s…it’s a free country….give it a spin❞

🙂 Not at all. I just treat individual RCTs as important but non-definitive steps towards knowledge (I need a much-larger accumulation of research over time before I trust them). They're definitely better than "magic" or homeopathy or fad diets or taking veterinary deworming meds, but still require some healthy skepticism, at least until they've been reviewed and reproduced many times.

In this case, it's irrelevant from a practical point of view as I mentioned before. Because of the value of physical activity for general health and side-effect mitigation, it's is the right choice for people with advanced prostate cancer *regardless* of whether it turns out that it actually reduces the risk of progression or just correlates with a reduced risk of progression.

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@handera
Most of my exercising prior being dignosed with prostate cancer would be considered vigorous. When working for Air Force I was on a SWAT Team that participated in competitions with other Air Force Air Bases and finally if picked a World Wide competition with other Air Bases and other countries. There were so many differenty competitions in firearms won't go into them as irrelevant to discussion. The physical part was doing a 25 obstacle course and then a 2 mile run while wearning yoiur SWAT uniform and boots.

When I went to work with FEMA I did 10Ks. All this time and up until 2016 was avid tennis player playing in tournaments. When had issues with ICD/Pacemaker started doing Sprint Triathlons and training for them.

I mentioned this again as you pointed out that exercise of the vigorus level I was doing all along but my cancer was not the agressive type it was per my Decipher test low risk and localized.

So guess the bottom line is that vigorus exercise all my life might not have prevented me from getting cancer but could have help me not get the aggresive type.
Thanks for information and I will keep on exercising.

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Profile picture for northoftheborder @northoftheborder

❝Well…if you prefer magic to RCT’s…it’s a free country….give it a spin❞

🙂 Not at all. I just treat individual RCTs as important but non-definitive steps towards knowledge (I need a much-larger accumulation of research over time before I trust them). They're definitely better than "magic" or homeopathy or fad diets or taking veterinary deworming meds, but still require some healthy skepticism, at least until they've been reviewed and reproduced many times.

In this case, it's irrelevant from a practical point of view as I mentioned before. Because of the value of physical activity for general health and side-effect mitigation, it's is the right choice for people with advanced prostate cancer *regardless* of whether it turns out that it actually reduces the risk of progression or just correlates with a reduced risk of progression.

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My comment to yours was really “tongue-in-cheek”…I know we basically agree 👍

I also approach new information with a healthy level of skepticism…. probably because I spent the majority of my 45 year chemical engineering career doing research and development.

I’ve seen, first hand, how “science” can be manipulated for a whole host of reasons…scientists have biases (usually a product of their presuppositions), don’t let anyone try to convince you otherwise 🤔

I am, by no means, advocating that “exercise oncology” is the absolute “end all and be all” regarding PCa treatment.

That said, in my review of scores of medical research studies and probably hundreds of video presentations, regarding the many aspects of vigorous exercise, I am convinced there is much more solid science to the implementation of this “exercise treatment”, as it relates to slowing the progression of prostate cancer (with little downside), as compared to anything one cares to put in their mouth and swallow…just my studied opinion.

Obviously RCT’s are preferred reading; but when it comes to observational studies, the evidence is legion…literally hundreds of studies show evidence of benefit.

Rather than boring folks with a detailed list, I’ll refer to a recent February 2024 review that narrowed the list to the best studies….for those so inclined to read such information.
https://pmc.ncbi.nlm.nih.gov/articles/PMC10854832/
All the best!

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Like others, have seen and read literature on exercise and PCa.

First thought, does exercise play a role in "preventing" or "reducing" one's chance of joining this club? Study of one, no, I have been active all my life, played multiple sports in high schools, 22 years in the Army so ran, lifted weights, played basketball, played gold (I walked, no cart) swam, went skiing, hiked in the mountains... After I retired, what changed, nothing. Last year my gym reported out I had visited 270 times, each visit was 45-60 minutes on the indoor bike, weights and 1000 meters swimming. For the 5th year in a row, I rode in the Garmin Unbound, a 50+ gravel bike ride in the Flint Hills of Kansas near Emporia.

And yet, there I was 23 January 2014, my urologist reviewing the TRUS biopsy report with me.

2nd thought, can exercise mitigate the side effects of PCa treatment, study of one, yes, to a degree. I am not sure it made a darn bit of difference in hot flashes, genitalia shrinkage...Perhaps I would have gained more weight when no T sunk my metabolism!!

What I think is exercise plays a role in one's CV health, bone health and a host of other systems which all of us can benefit from. I have read through literature which talks about the role exercise plays in our immune system systems (like liture on its role in testosterone) and that may be a factor as a stronger immune system may better fight off PCa in its weakened state brought on by treatments.

Again, study of one, but high risk, GS 8, GG 4, 18 months to BCR, rapid PSADT and PSAV...yet, 11+ years, here I am, three of those 11 on treatment, the other eight plus off. As I type, 15 months since my last treatment.

Kevin

Shared files

PCa and Exercise (PCa-and-Exercise.pdf)

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Yes, I think we're all in loud agreement in this thread. I just wanted to add a reality check for anyone reading this who might think that exercising is like pushing a button to reduce the risk of metastatic prostate cancer recurrence by 30%.

Those of us who happen to have had frequent contact with research in our work (even in a non-medical context) know that's not what the trial result actually means, just like a drug trial result that shows a 7 month improvement in median survival doesn't mean that you'll live 7 months longer by taking it (it just means that half of the participants taking the drug were dead — from any cause — 7 months later than half of the participants taking the placebo, but it tells us little/nothing about the halves who weren't dead — they might go on to live 7 more years, or 17, or even 57, for all we know).

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Movement, exercise stats with movement. Tiny, intentional movements. For me counting too much takes my focus away from my internality of movements and breathing. For example today, I will walk, swim, talk, and yoga. I try to do three different types of exercise movements per day. That's the goal, each day, three different types of exercise. Time? I try for 30 mins per exercise, doesn't always happen but many days it does.

Love this topic. Keep moving.

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