Exercising safely and effectively with prostate cancer 

Expert Tips from Dr Brea Kunstler on Managing Fitness During Treatment

Cancer is unfortunately very common in Australians. Over 1,000,000 Australians currently alive are either living with or have lived with cancer. In 2021, 413 Australians were expected to be diagnosed with cancer daily and 135 people would die. Indigenous Australians are 14% more likely compared to non-indigenous Australians to be diagnosed with cancer and are 20% more likely to die from cancer. Prostate cancer in men and breast cancer in women was projected to be the most commonly diagnosed cancers in 2021. Read more about these data here. 

Key Prostate Cancer Stats In 2024: 

  • 26,368 men were expected to be diagnosed with prostate cancer, and 3,901 were expected to die (13% of all male cancer deaths) 
  • 28% of all new male cancers were expected to be prostate cancer 
  • 96% of men diagnosed with prostate cancer were expected to survive at least 5 years 

Many men diagnosed with prostate cancer will experience intense treatment regimens, making living a ‘regular life’ challenging. Since many men are living with prostate cancer, it is important to ensure the years lived are high quality.  

This blog post will explore the importance of exercise to help men experiencing prostate cancer to live a better life, as well as some considerations needed.

What are the benefits of exercise for men with prostate cancer? 

Quality of life 

Treatment for prostate cancer (including surgery, chemotherapy, radiation, and hormone therapy), albeit necessary, can negatively impact quality of life (i.e., the amount a man enjoys his life).  

A recent review of 12 studies, including 1256 men, found that both aerobic (e.g. walking, running and cycling) and strength training can significantly improve quality of life in men undergoing treatment for prostate cancer. These benefits are seen for aerobic and strength activities taken separately (e.g. completing a walking program or a strength program session) or together (e.g. completing a walking program and a strength program together in a session).   

Fitness 

Androgen-deprivation therapy is a common therapy used to treat prostate cancer, but it can also negatively impact muscle mass, consequently negatively impacting fitness and strength.  

Exercise can have a positive effect on cardiovascular fitness and strength for men with prostate cancer. A recent review of 33 studies, including 2567 men, found, again, that exercise can have a small positive effect on quality of life but a moderate to large effect on cardiovascular fitness.  

Exercise was also found to positively impact lower body strength, fat mass, mental health, blood pressure, and fatigue. Importantly, aerobic exercise was considered more important for enhancing fitness, whereas strength training was considered more important for enhancing strength. 

Pelvic floor function 

Men can experience urinary incontinence after undergoing surgery for prostate cancer (e.g. prostatectomy). It is important to enhance pelvic floor function to help minimise incontinence.  

A recent review of four studies found that pelvic floor exercises (e.g., 3 sets of 10 pelvic floor contractions daily held for 10s with 10s rest in between completed in different positions [e.g., standing, sitting, lying]) can improve continence after prostatectomy. High-impact exercises, such as running and jumping, rely on a strong pelvic floor to prevent incontinence during the activity. Therefore, pelvic floor muscle training becomes especially important for people participating in high-impact exercise. 

Can men with prostate cancer run?  

The Prostate Cancer Foundation of Australia recommends that, each week, men participate in 150-300 minutes of aerobic and/or strength training in bouts of at least 10 minutes. Those who experience fatigue after an exercise session might like to avoid exercising on consecutive days. 

All exercise programs should be designed by the person with cancer and their exercise specialist (e.g., physiotherapist). It is important that the person’s exercise preferences and cancer treatment modalities and stage are considered when determining what their exercise program will look like.  

Someone might prefer to run but might experience uncomfortable side effects of treatment that prevent running or make it unpleasant. Talk with an exercise expert to choose the right type of workout. Monitor how your body responds and adjust as needed.

What should men with prostate cancer consider before commencing an exercise program? 

The benefits of exercise for men with prostate cancer outweigh the potential risks. Still, everyone diagnosed with prostate cancer should always discuss the commencement of any exercise program with their medical team to ensure safety during exercising. 

It’s important to remember that some exercise is better than none, and short but intense strength training sessions have been found to be enough to improve fatigue and quality of life in men with prostate cancer. So, exercise sessions don’t have to be long to be effective. This is important to keep in mind on ‘bad days’ (e.g., days after chemotherapy) when a person’s regular exercise session might be unachievable. 

People with prostate cancer might be new to exercise, meaning they should start slowly and build up with any new program. New or experienced exercisers may want to start with lower-intensity activities like walking. This is especially helpful if they feel discomfort due to cancer or unrelated issues like knee arthritis, not necessarily just that associated with prostate cancer (e.g., incontinence, fatigue) but also other conditions (e.g., knee arthritis). 

It’s important to stop exercise and consult a medical professional if the following are experienced: 

  • Dizziness 
  • Nausea 
  • Chest pain 
  • Blurred vision 
  • Sudden and/or continued shortness of breath or breathing difficulties 
  • Weakness or fatigue that appears suddenly 
  • Numbness in hands or feet 
  • Confusion or disorientation 
  • Sudden muscle, joint, or bone pain. Those undergoing prostate cancer treatment can experience bone weakening, making bone and joint problems a specific concern. 

Bottom line 

Exercise is safe and important for people undergoing treatment for prostate cancer to participate in exercise. It can help people to manage side effects of treatment, including minimising the impacts of treatment on quality of life, fitness, fatigue, and strength. All exercise programs should be tailored to the person and designed with an exercise professional who is familiar with the person’s treatment regime, medical history, capabilities, and personal preferences. 

Need some help achieving your running goals? Book a telehealth appointment with Performance Medicine’s exercise and run coach, Dr Brea Kunstler, to see how she can help you achieve your goals. She can provide a referral to a trusted shoe provider who will give you 10% off the RRP of your new shoes. 

Dr Brea Kunstler