Lower Death Rates in Men With Prostate Cancer Who Exercise

Pam Harrison

December 23, 2014

Yet another study is confirming the benefits of physical activity following the diagnosis of cancer, this time of prostate cancer, on all-cause and prostate-specific survival, Swedish researchers report.

The study was published online December 19 in Cancer Epidemiology, Biomarkers & Prevention.

"Being physically active has many positive effects on health, and now we can see that it has specific effects on survival among prostate cancer patients as well," Stephanie Bonn, MSc, Karolinska Institute, Stockholm, Sweden, told Medscape Medical News.

"Since a man's physical activity level is something he himself can change, there is great potential for men to improve their own survival by being physically active and we believe that physical activity after a prostate cancer diagnosis is beneficial for survival regardless of the patient's activity level before the diagnosis," she said.

Investigators used data from 4623 men involved in the National Prostate Cancer Register of Sweden Follow-up study, a nationwide cohort study of men with localized prostate cancer who were alive in 2007.

Men had been diagnosed with localized prostate cancer between 1997 and 2002 and were followed up until 2012.

Mean age at diagnosis was 63.1 years, and most men included the analysis had a body mass index between 25 and 30 kg/m2.

Participants were asked to report how much time they spent walking or cycling, exercising, or carrying out household work after the diagnosis of prostate cancer.

Each activity was assigned a metabolic equivalent (MET) level based on MET values specified in the Compendium of Physical Activities.

As Bonn explained, a MET represents the ratio between the energy expenditure from a specific activity and the energy expenditure from basal metabolism. For example, an activity with a MET of 1 (sitting still) does not result in any increased energy expenditure compared with basal metabolism, whereas an activity with a MET of 2 (standing) results in twice the energy expenditure.

"The higher the MET value of an activity, the higher the energy expended when performing that activity," Bonn added.

During follow-up, investigators identified 561 deaths from any cause and 194 deaths from prostate cancer.

Men who walked or cycled for 20 minutes a day or more had a 30% lower risk for all-cause mortality and a 39% decreased risk for prostate cancer–specific mortality compared with men who walked or cycled less than 20 minutes a day, investigators report.

For those exercising 1 or more hours a week, all-cause mortality was reduced by 26% and prostate cancer–specific mortality by 32% compared with men who reported exercising less than 1 hour a week.

After considering all time spent walking, cycling, exercising, and doing household work, researchers found that all-cause mortality was 37% lower while prostate cancer–specific mortality was 22% lower for men who had a total MET of 5 or more hours a day compared with those who had a total MET of less than 5 hours a day.

Table. Hazard Ratios After Multivariable Adjustment for Overall and Prostate Cancer–Specific Mortality

Activity After Prostate Cancer Diagnosis Overall Mortality Prostate Cancer–Specific Mortality
Walking/cycling <20 min/day vs ≥20 min/day 0.70 0.61
Household work <1 h/day vs ≥1 h/day 0.71 0.86
Exercise < 1 h/wk vs ≥1 h/wk 0.74 0.68

 

"I would recommend physicians advise men to follow the current recommendations for physical activity that are available, and to advise them to be as active as is possible for them to be," Bonn said.

"They need to find an activity that is enjoyable and remember that any physical activity is better than none and is likely to have positive health effects," she added.

The study was funded by the Swedish Cancer Society and the Swedish Research Council for Health, Working Life and Welfare. Ms Bonn has disclosed no relevant financial relationships.

Cancer Epidemiol Biomarkers Prev. Published online December 19, 2014. Abstract

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