The American Cancer Society estimates that one in eight men will face a prostate cancer diagnosis. While prostate cancer accounts for the second leading cancer-related cause of death among American men, most prostate cancer patients do not die from the disease. In fact, prostate cancer has almost a 98% five-year survival rate and, in 2018, there were over three million prostate cancer survivors alive in the United States.
Treatment for prostate cancer depends on the stage and aggressiveness of the disease in an individual and can include surgery, radiation, or hormone therapy. These treatments can induce side effects like sexual and urinary dysfunction and fatigue, which can lead to a reduced quality of life. Due to these side effects and the often slow-growing nature of prostate cancer, some patients may opt for observation of active surveillance (AS) to delay treatment and associated side effects.
Observation, sometimes called watchful waiting, includes testing and monitoring of symptoms. AS can include:
- Regular prostate-specific antigen (PSA) testing.
- Rectal exams.
- Biopsies.
- Imaging to monitor the progression of the disease.
With either observation or AS, treatment may become warranted if monitoring suggests that the cancer is spreading or it begins to progress more rapidly.
As you may expect, many patients on AS experience significant anxiety impacting their quality of life. Such stress can encourage some men to undergo medically unnecessary treatments sooner than necessary. Thus, developing interventions to reduce fear of cancer progress could improve quality of life and limit radical treatments among prostate cancer survivors. A team of researchers from the University of Alberta investigated using expertise to reduce anxiety in prostate cancer patients. They recently published their findings in the Journal of Urology.
The research team enrolled 52 men with prostate cancer to the ERASE (Exercise during Active Surveillance for Prostate Cancer) Trial. Half of the patients were randomized to the high-intensity interval training (HIIT) group, where they participated in supervised exercise using a treadmill three times a week. The remaining half of the participants received usual care (UC) and did not exercise.
The patients reported outcomes at the start of the study and following a twelve-week intervention period. Measures included prostate cancer-specific anxiety, fear of cancer progression, prostate cancer symptoms, and quality of life. In addition, the participants assessed psychological indicators such as fatigue, stress, and self-esteem. The research team then compared the outcomes between the HIIT and UC groups.
Men in the HIIT group displayed improved prostate cancer-specific anxiety and less fear of prostate cancer progression. Further, men in the exercise group perceived less stress and fatigue and reported higher self-esteem than those in the UC group.
The authors conclude that their study could support a subset of AS prostate cancer patients who opt for medically unnecessary treatments because of psychological distress associated with their cancer diagnosis. Additional large-scale studies are needed to confirm these findings and investigate the long-term impact of exercise on AS prostate cancer patients.
Sources: CA, N Eng J Med, Lancet Oncol, BJI Int, J Urolog, J Urolog, Cancer, Support Care Cancer, Urolog, J Nat Cancer Inst
