Exercise for Men with Prostate Cancer
Physical Therapy Can Help
Physical activity can improve your physical and emotional health. It is important for managing weight, maintaining muscle, reducing your risk of heart disease, and keeping bones strong. Staying active can help with balance, improve your sleep, and reduce fatigue and anxiety. Exercise can also help with potential side effects of prostate cancer treatment.
The Link Between Exercise, Prostate Cancer, and Treatment
Studies have found that men who get regular physical activity have a slightly lower risk of prostate cancer. Vigorous activity may have a greater effect, especially on the risk of advanced prostate cancer. Also, in men with prostate cancer, physical activity is associated with better survival, and a modest amount of vigorous activity, about three hours a week, may substantially improve prostate cancer survival.
Many treatments for prostate cancer can have detrimental effects on your body. Hormone therapy can lead to osteoporosis and loss of muscle mass, both of which can be improved through exercise and strength training. Other treatments, such as surgery, can cause urinary incontinence (inability to control urine flow). Kegel exercises before and after prostate cancer treatment strengthen the pelvic-floor muscles, which can improve incontinence.
Any plan for physical activity should fit your personal situation and fitness level. Talk with your medical team before starting any exercise regimen.
Kegel Exercises (Strengthening the Pelvic-Floor Muscles)
The pelvic-floor muscles run from your pubic bone at the front of your groin to your tailbone in the back. They sit just under the prostate. Along with serving as a valve to the bladder, they support your bladder, prostate, and rectum in your pelvis. With prostate surgery, some muscle weakness is inevitable due to the proximity of these muscles to the prostate. By starting to strengthen your pelvic muscles before surgery, you can minimize your muscle weakness and also your risk for incontinence.
Your pelvic floor muscles can be engaged by contracting as if you want to stop your urine stream. Think of lifting up your perineum, the area of tissue between the testes and rectum. To tell whether you’re using the right muscles, you can look for a lifting of your penis during the contraction. Avoid bearing down.
Try to isolate the pelvic-floor muscles by not tensing your anus or abdominal muscles. When locating these muscles for the first time, lie down on your back and place your hands on your lower stomach. You should not feel movement under your hands as you tense your pelvic floor.
If you leak more when performing Kegels, you may be doing them incorrectly. A physical therapist may be able to help with and optimize your pelvic-floor strengthening program by providing assessment, observation, and biofeedback.
You can do Kegel exercises while lying down or sitting in a chair, depending on your comfort. Contract your pelvic floor for 10 seconds, followed by a 10-second rest. Repeat this five times. Perform this exercise three times a day until your surgery.
After your catheter is removed, talk with your nurse or doctor about when to resume doing Kegel exercises (or when to begin them, if you weren’t doing them before surgery).
- Start with a gentle contraction (less that 100 percent effort) while lying down. Hold the contraction for three seconds, and then relax for 15 seconds. Do five repetitions, three times a day. Increase the intensity of the contraction each day. Also, increase the contraction time by one second and reduce the relaxation time by one second per day until you reach a 10-second hold and a 10-second rest. Continue doing five repetitions, three times a day.
- The next step is to perform the exercises while sitting or standing. Repeat the same intervals as above, starting with a five-second hold and 15-second relax and working up to a 10-second hold and 10-second relax.
You should notice a gradual decrease in urine leakage and an increase in your ability to wait longer between times you need to urinate. You should also be able to delay an urge to void for at least 15 minutes and get to the bathroom without leakage. Talk to your doctor if you continue to have difficulty with increased frequency of urination or leakage.
The Role of Resting Metabolic Rate in Weight Maintenance
You can lose extra weight and keep it off by increasing your resting metabolic rate (RMR)—the rate at which your body burns calories when you are resting. Your RMR accounts for 60 to 75 percent of your daily calorie expenditure, so even a small increase in RMR will help burn more calories.
Your RMR is closely linked to the amount of muscle you have. Muscle burns 35 to 50 times more calories than fat. So if you increase your muscle mass with strength training and aerobic exercise, you will raise your RMR. This can prevent weight gain or even help you lose weight.
Strength training, also known as resistance exercise, can help you increase your muscle mass and RMR, and it’s also important for maintaining healthy bones and for improving balance, which helps prevent falls.
Types of strength training include weight training, push-ups, and pull-ups. Abdominal crunches (sit-ups) may aggravate leakage that is due to stress incontinence. Talk with your medical team or a physical therapist about the level and types of strength training that are safe for you.
Aerobic exercise (such as fast walking, dancing, hiking, swimming, running, bicycling, tennis, and cross-country skiing) causes your calorie expenditure to increase during the workout and for a few hours after the workout. By doing aerobic exercise, your body burns calories at your RMR plus the additional calories needed to fuel the aerobic exercise.
In addition to burning calories, aerobic exercises are particularly effective at increasing the body’s natural levels of antioxidants and eliminating inflammatory molecules that drive cancer.
How Much Exercise?
The health benefits of physical activity are directly related to the amount of activity you get on a regular basis. Generally, the more you are able to do, the better. The intensity matters, too, but physical activity does not need to be vigorous to provide benefits. Physical activity includes not only working out at the gym or playing sports but also engaging in hobbies like bicycling, dancing, and gardening, as well as doing active household chores, climbing stairs, and working at a job that has physical demands.
The American College of Sports Medicine recommends that healthy adults do at least two-and-a-half hours of moderate-intensity aerobic exercise per week; strength training two to three days a week; and exercises for balance, agility, coordination, and flexibility two to three days a week. Ask your medical team about the types of exercises that are right for you, the intensity you should aim for, and how often and how long you should exercise.