My clinical/genomic data is summarized below:

May 2023: PSA was 7.8

October 2023: mpMRI showed 3, 4 & 5 PIRADS lesions and a MRI targeted TRUS biopsy indicated 7/15 cores positive, five 3+3 (5-10%) & two 3+4 (10-20%), my Decipher GRID Clinical-Model rated my tumor “Low Risk" @ 0.22 (attached)

November 2023: Initiated a running program involving 8-10 miles a week and occasional HIIT and also began a whole plant food diet (WPFD). Garmin VO2 Max was 40

February 2024: Lost 25 lbs (BMI=22.5) and stopped the WPFD, reintroducing salmon, chicken and beef, my first post-biopsy PSA dropped to 5.95

Between Feb '24 - Jul '25: Weight was constant at 162 lbs +/- 2 lbs and PSA fluctuated between 5.76 - 6.60

October 2024: 12 month follow-up mpMRI shows that the PIRADS 3 & 4 lesions were no longer visible and the PIRADS 5 lesion had shrunk and its T2 & DWI/ADC signals were reduced from “moderate” to “mild”

March 2025: Increased running to 12-15 miles/week and increase HIIT to 2-3x/week. VO2 Max fluctuates between 48 - 50

May 2025: PSA dropped to 5.76, lowest level since biopsy

So, 21 months after being diagnosed with Gleason 3+4 PCA, my VO2 max has increased 20-25%, my PSA has dropped 2.04 units (down 26%, demonstrating a negative PSA velocity) and my 12 month follow-up mpMRI (same MRI machine and same radiologist's interpretation) demonstrated lesion reversal.

Some may say that it is mere coincidence that after 21 months on active surveillance for my localized PCa that my VO2 Max would increase 20-25%, my PSA level decrease 26% and my PSA velocity and prostate cancer cell growth reverse (based on a comparative 12 month follow-up mpMRI)...well let's see what the science says:

"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."

Well isn't science magical! 🙂

I'm not skeptical at all — I think it's very promising. And thanks for sharing the link to the lit review. They're a little more cautious than you, but do think the research trends are very promising (and I agree; we're really not disagreeing here, except on the level of confidence which we apply to a causal link):

"the clinical studies included in this review have yielded conflicting results. Some authors have found no correlation between engaging in physical exercise and the risk of tumor progression. Specifically, two RCTs failed to demonstrate a link between PA and PSA kinetics. However, after observing the participants of the Prostate Cancer Lifestyle Trial for two years, it was noted that the rate of definitive treatment was significantly lower among active men compared to the control group (5% vs. 27%, p = 0.005). "

… and …

"To accurately assess the impact of exercise on the risk of PCa progression in patients managed with AS, further randomized clinical trials with extended follow-up periods, incorporating the use of wearable devices for daily PA measurement, are warranted."

In other words, it looks like we're onto something here, so let's tighten up the methodologies and keep pushing ahead. If I were betting, I'd bet that the evidence will keep accumulating until they decide to make physical activity a core part of cancer treatment rather than a secondary recommendation.