Hostname: page-component-76fb5796d-22dnz Total loading time: 0 Render date: 2024-04-26T18:20:28.626Z Has data issue: false hasContentIssue false

Physical activity and dietary considerations for prostate cancer patients: future research directions

Published online by Cambridge University Press:  06 January 2023

Andrew J Hamblen
Affiliation:
School of Sport, Exercise and Rehabilitation Sciences, University of Hull, Kingston upon Hull, UK
James W Bray
Affiliation:
School of Sport, Exercise and Rehabilitation Sciences, University of Hull, Kingston upon Hull, UK
Mohan Hingorani
Affiliation:
Department of Clinical Oncology, Queen's Centre of Oncology, Castle Hill Hospital, Hull Teaching Hospitals NHS Trust, Cottingham, UK
John M Saxton*
Affiliation:
School of Sport, Exercise and Rehabilitation Sciences, University of Hull, Kingston upon Hull, UK
*
*Corresponding author: John M Saxton, email john.saxton@hull.ac.uk

Abstract

This review considers current evidence on physical activity and dietary behaviours in the context of prostate cancer prevention and survivorship outcomes. Prostate cancer is the second most common cancer amongst men, with over 1⋅4 million newly diagnosed cases globally each year. Due to earlier detection via screening and advances in treatments, survival rates are amongst the highest of all cancer populations. However, hormone treatments (i.e. androgen deprivation therapy) can lead to undesirable body composition changes, increased fatigue and reduced health-related quality of life, which can impair the overall wellbeing of men living with and beyond prostate cancer. Existing research has only provided limited evidence that physical activity and nutrition can impact a man's risk of prostate cancer but cohort studies suggest they can influence survival outcomes after diagnosis. Additionally, data from observational and intervention studies suggest that habitual physical activity (or structured exercise) and healthy diets can help to ameliorate hormone-related treatment side-effects. Current physical activity guidelines state that prostate cancer patients should complete at least three sessions of moderate-intensity aerobic exercise per week, along with two resistance exercise sessions, but dietary guidelines for prostate cancer patients are less well defined. In conclusion, regular physical activity and nutritional interventions may improve survival outcomes and attenuate some adverse side-effects of hormone treatments in men with prostate cancer. However, further research is required to improve our understanding of the health impacts of physical activity (including structured exercise) and nutrition in relation to prostate cancer prevention and survivorship.

Type
Conference on ‘Food and nutrition: Pathways to a sustainable future’
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of The Nutrition Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Sung, H, Ferlay, J, Siegel, RL et al. (2021) Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 71, 209249.CrossRefGoogle ScholarPubMed
Cancer Research UK (2021) Cancer incidence for common cancers (2016–18). https://www.cancerresearchuk.org/health-professional/cancer-statistics/incidence/common-cancers-compared#heading-Zero (accessed August 2022).Google Scholar
Teoh, JY, Hirai, HW, Ho, JM et al. (2019) Global incidence of prostate cancer in developing and developed countries with changing age structures. PLoS ONE 14, e0221775.CrossRefGoogle ScholarPubMed
Kvåle, R, Auvinen, A, Adami, H-O et al. (2007) Interpreting trends in prostate cancer incidence and mortality in the five Nordic countries. J Natl Cancer Inst 99, 18811887.CrossRefGoogle ScholarPubMed
U.S Department of Health and Human Services (2018) 2018 Physical Activity Guidelines Advisory Committee Scientific Report. https://health.gov/sites/default/files/2019-09/PAG_Advisory_Committee_Report.pdf (accessed September 2022).Google Scholar
McTiernan, A, Friedenreich, CM, Katzmarzyk, PT et al. (2019) Physical activity in cancer prevention and survival: a systematic review. Med Sci Sports Exerc 51, 12521261.CrossRefGoogle ScholarPubMed
Benke, IN, Leitzmann, M, Behrens, G et al. (2018) Physical activity in relation to risk of prostate cancer: a systematic review and meta-analysis. Ann Oncol 29, 11541179.CrossRefGoogle ScholarPubMed
Wiseman, M (2008) The second world cancer research fund/American institute for cancer research expert report. Food, nutrition, physical activity, and the prevention of cancer: a global perspective: nutrition society and BAPEN Medical Symposium on ‘nutrition support in cancer therapy’. Proc Nutr Soc 67, 253256.CrossRefGoogle Scholar
World Cancer Research Fund/American Institute for Cancer Research (2018) Continuous update project expert report. https://www.wcrf.org/diet-activity-and-cancer/cancer-types/prostate-cancer/ (accessed August 2022).Google Scholar
Richman, EL, Kenfield, SA, Stampfer, MJ et al. (2011) Physical activity after diagnosis and risk of prostate cancer progression: data from the cancer of the prostate strategic urologic research endeavor. Cancer Res 71, 38893895.CrossRefGoogle ScholarPubMed
Friedenreich, CM, Wang, Q, Neilson, HK et al. (2016) Physical activity and survival after prostate cancer. Eur Urol 70, 576585.CrossRefGoogle ScholarPubMed
Campbell, KL, Winters-Stone, K, Wiskemann, J et al. (2019) Exercise guidelines for cancer survivors: consensus statement from international multidisciplinary roundtable. Med Sci Sports Exerc 51, 23752390.CrossRefGoogle ScholarPubMed
Galvão, DA, Newton, RU, Gardiner, RA et al. (2015) Compliance to exercise-oncology guidelines in prostate cancer survivors and associations with psychological distress, unmet supportive care needs, and quality of life. Psychooncology 24, 12411249.CrossRefGoogle ScholarPubMed
Richman, EL, Kenfield, SA, Chavarro, JE et al. (2013) Fat intake after diagnosis and risk of lethal prostate cancer and all-cause mortality. JAMA Intern Med 173, 13181326.CrossRefGoogle ScholarPubMed
Peisch, SF, Van Blarigan, EL, Chan, JM et al. (2017) Prostate cancer progression and mortality: a review of diet and lifestyle factors. World J Urol 35, 867874.CrossRefGoogle ScholarPubMed
Troeschel, AN, Hartman, TJ, Jacobs, E et al. (2020) Postdiagnosis body mass index, weight change, and mortality from prostate cancer, cardiovascular disease, and all causes among survivors of nonmetastatic prostate cancer. J Clin Oncol 38, 20182037.CrossRefGoogle ScholarPubMed
Liede, A, Hallett, DC, Hope, K et al. (2016) International survey of androgen deprivation therapy (ADT) for non-metastatic prostate cancer in 19 countries. ESMO Open 1, e000040.CrossRefGoogle ScholarPubMed
Ridgway, AJ & Aning, JJ (2021) Role of primary care in the management of prostate cancer. Prescriber 32, 1117.CrossRefGoogle Scholar
National Institute for Health and Care Excellence (2021) Prostate cancer: diagnosis and management. https://www.nice.org.uk/guidance/ng131 (accessed August 2022).Google Scholar
Saigal, CS, Gore, JL, Krupski, TL et al. (2007) Androgen deprivation therapy increases cardiovascular morbidity in men with prostate cancer. Cancer 110, 14931500.CrossRefGoogle ScholarPubMed
Nguyen, PL, Je, Y, Schutz, FA et al. (2011) Association of androgen deprivation therapy with cardiovascular death in patients with prostate cancer: a meta-analysis of randomized trials. JAMA 306, 23592366.CrossRefGoogle ScholarPubMed
Perrone, V, Degli Esposti, L, Giacomini, E et al. (2020) Cardiovascular risk profile in prostate cancer patients treated with GnRH agonists versus antagonists: an Italian real-world analysis. Ther Clin Risk Manag 16, 393401.CrossRefGoogle ScholarPubMed
Langston, B, Armes, J, Levy, A et al. (2013) The prevalence and severity of fatigue in men with prostate cancer: a systematic review of the literature. Support Care Cancer 21, 17611771.CrossRefGoogle ScholarPubMed
Nguyen, PL, Alibhai, SM, Basaria, S et al. (2015) Adverse effects of androgen deprivation therapy and strategies to mitigate them. Eur Urol 67, 825836.CrossRefGoogle Scholar
Nguyen, C, Lairson, DR, Swartz, MD et al. (2018) Risks of major long-term side effects associated with androgen-deprivation therapy in men with prostate cancer. Pharmacotherapy 38, 9991009.CrossRefGoogle ScholarPubMed
Galvão, DA, Spry, NA, Taaffe, DR et al. (2008) Changes in muscle, fat and bone mass after 36 weeks of maximal androgen blockade for prostate cancer. BJU Int 102, 4447.CrossRefGoogle ScholarPubMed
Wong, R, Wong, H, Zhang, N et al. (2019) The relationship between sarcopenia and fragility fracture – a systematic review. Osteoporos Int 30, 541553.CrossRefGoogle ScholarPubMed
Smith, MR, Saad, F, Egerdie, B et al. (2012) Sarcopenia during androgen-deprivation therapy for prostate cancer. J Clin Oncol 30, 32713276.CrossRefGoogle ScholarPubMed
Cormie, P, Galvão, DA, Spry, N et al. (2015) Can supervised exercise prevent treatment toxicity in patients with prostate cancer initiating androgen-deprivation therapy: a randomised controlled trial. BJU Int 115, 256266.CrossRefGoogle ScholarPubMed
Wall, BA, Galvao, DA, Fatehee, N et al. (2017) Exercise improves VO2max and body composition in ADT-treated prostate cancer patients. Med Sci Sports Exerc 49, 15031510.CrossRefGoogle Scholar
Bigaran, A, Zopf, E, Gardner, J et al. (2021) The effect of exercise training on cardiometabolic health in men with prostate cancer receiving androgen deprivation therapy: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis 24, 3548.CrossRefGoogle ScholarPubMed
Cormie, P & Zopf, EM (2020) Exercise medicine for the management of androgen deprivation therapy-related side effects in prostate cancer. Urol Oncol 38, 6270.CrossRefGoogle ScholarPubMed
Edmunds, K, Tuffaha, H, Scuffham, P et al. (2020) The role of exercise in the management of adverse effects of androgen deprivation therapy for prostate cancer: a rapid review. Support Care Cancer 28, 56615671.CrossRefGoogle ScholarPubMed
Bourke, L, Smith, D, Steed, L et al. (2016) Exercise for men with prostate cancer: a systematic review and meta-analysis. Eur Urol 69, 693703.CrossRefGoogle ScholarPubMed
Yarasheski, KE, Zachwieja, JJ & Bier, DM (1993) Acute effects of resistance exercise on muscle protein synthesis rate in young and elderly men and women. Am J Physiol Endocrinol Metab 265, E210E214.CrossRefGoogle Scholar
Fry, CS, Drummond, MJ, Glynn, EL et al. (2011) Aging impairs contraction-induced human skeletal muscle mTORC1 signaling and protein synthesis. Skelet Muscle 1, 111.CrossRefGoogle ScholarPubMed
Galvao, DA, Nosaka, K, Taaffe, DR et al. (2006) Resistance training and reduction of treatment side effects in prostate cancer patients. Med Sci Sports Exerc 38, 4552.CrossRefGoogle ScholarPubMed
Nilsen, TS, Raastad, T, Skovlund, E et al. (2015) Effects of strength training on body composition, physical functioning, and quality of life in prostate cancer patients during androgen deprivation therapy. Acta Oncol 54, 18051813.CrossRefGoogle ScholarPubMed
Tang, JE & Phillips, SM (2009) Maximizing muscle protein anabolism: the role of protein quality. Curr Opin Clin Nutr Metab Care 12, 6671.CrossRefGoogle ScholarPubMed
Tieland, M, Dirks, ML, van der Zwaluw, N et al. (2012) Protein supplementation increases muscle mass gain during prolonged resistance-type exercise training in frail elderly people: a randomized, double-blind, placebo-controlled trial. J Am Med Dir Assoc 13, 713719.CrossRefGoogle ScholarPubMed
Via, JD, Owen, PJ, Daly, RM et al. (2021) Musculoskeletal responses to exercise plus nutrition in men with prostate cancer on androgen deprivation: a 12-month RCT. Med Sci Sports Exerc 53, 20542065.Google ScholarPubMed
Umlauff, L, Weber, M, Freitag, N et al. (2022) Dietary interventions to improve body composition in men treated with androgen deprivation therapy for prostate cancer: a solution for the growing problem? Prostate Cancer Prostatic Dis 25, 149158.CrossRefGoogle ScholarPubMed
Dupont, J, Dedeyne, L, Dalle, S et al. (2019) The role of omega-3 in the prevention and treatment of sarcopenia. Aging Clin Exp Res 31, 825836.CrossRefGoogle ScholarPubMed
Huang, Y-H, Chiu, W-C, Hsu, Y-P et al. (2020) Effects of omega-3 fatty acids on muscle mass, muscle strength and muscle performance among the elderly: a meta-analysis. Nutrients 12, 3739.CrossRefGoogle ScholarPubMed
Zuniga, KB, Chan, JM, Ryan, CJ et al. (2020) Diet and lifestyle considerations for patients with prostate cancer. Urol Oncol 38, 105117.CrossRefGoogle ScholarPubMed
Aronson, WJ, Kobayashi, N, Barnard, RJ et al. (2011) Phase II prospective randomized trial of a low-fat diet with fish oil supplementation in men undergoing radical prostatectomy. Cancer Prev Res 4, 20622071.CrossRefGoogle ScholarPubMed
Lam, T, Cheema, B, Hayden, A et al. (2020) Androgen deprivation in prostate cancer: benefits of home-based resistance training. Sports Med Open 6, 112.Google ScholarPubMed
Hanson, ED, Alzer, M, Carver, J et al. Feasibility of home-based exercise training in men with metastatic castration-resistant prostate cancer. Prostate Cancer Prostatic Dis Published online: 19 March 2022. doi: 10.1038/s41391-022-00523-8Google Scholar
Barnes, KA, Ball, LE, Galvao, DA et al. (2019) Nutrition care guidelines for men with prostate cancer undergoing androgen deprivation therapy: do we have enough evidence? Prostate Cancer Prostatic Dis 22, 221234.CrossRefGoogle ScholarPubMed
Baguley, BJ, Skinner, TL, Jenkins, DG et al. (2021) Mediterranean-style dietary pattern improves cancer-related fatigue and quality of life in men with prostate cancer treated with androgen deprivation therapy: a pilot randomised control trial. Clin Nutr 40, 245254.CrossRefGoogle ScholarPubMed
Inglis, JE, Fernandez, ID, van Wijngaarden, E et al. (2021) Effects of high-dose vitamin D supplementation on phase angle and physical function in patients with prostate cancer on ADT. Nutr Cancer 73, 18821889.CrossRefGoogle ScholarPubMed
Hackshaw-McGeagh, LE, Perry, RE, Leach, VA et al. (2015) A systematic review of dietary, nutritional, and physical activity interventions for the prevention of prostate cancer progression and mortality. Cancer Causes Control 26, 15211550.CrossRefGoogle ScholarPubMed
James, ND, Sydes, MR, Clarke, NW et al. (2016) Addition of docetaxel, zoledronic acid, or both to first-line long-term hormone therapy in prostate cancer (STAMPEDE): survival results from an adaptive, multiarm, multistage, platform randomised controlled trial. Lancet 387, 11631177.CrossRefGoogle ScholarPubMed
Campbell, KL, Cormie, P, Weller, S et al. (2022) Exercise recommendation for people with bone metastases: expert consensus for health care providers and exercise professionals. JCO Oncol Pract 18, e697e709.CrossRefGoogle ScholarPubMed
Cormie, P, Newton, RU, Spry, N et al. (2013) Safety and efficacy of resistance exercise in prostate cancer patients with bone metastases. Prostate Cancer Prostatic Dis 16, 328335.CrossRefGoogle ScholarPubMed
Cormie, P, Galvão, DA, Spry, N et al. (2014) Functional benefits are sustained after a program of supervised resistance exercise in cancer patients with bone metastases: longitudinal results of a pilot study. Support Care Cancer 22, 15371548.CrossRefGoogle ScholarPubMed
Galvao, DA, Taaffe, DR, Spry, N et al. (2018) Exercise preserves physical function in prostate cancer patients with bone metastases. Med Sci Sports Exerc 50, 393399.CrossRefGoogle ScholarPubMed
Zopf, EM, Newton, RU, Taaffe, DR et al. Associations between aerobic exercise levels and physical and mental health outcomes in men with bone metastatic prostate cancer: a cross-sectional investigation. Eur J Cancer Care 26, e12575. doi: 10.1111/ecc.12575Google Scholar
Newton, RU, Kenfield, SA, Hart, NH et al. Intense exercise for survival among men with metastatic castrate-resistant prostate cancer (INTERVAL-GAP4): a multicentre, randomised, controlled phase III study protocol. BMJ Open 8, e022899. doi: 10.1136/bmjopen-2018-022899CrossRefGoogle Scholar
Evans, HE, Forbes, CC, Galvão, DA et al. (2021) Evaluating a web-and telephone-based personalised exercise intervention for individuals living with metastatic prostate cancer (ExerciseGuide): protocol for a pilot randomised controlled trial. Pilot Feasibility Stud 7, 116.CrossRefGoogle ScholarPubMed
Brown, M, Murphy, M, McDermott, L et al. (2019) Exercise for advanced prostate cancer: a multicomponent, feasibility, trial protocol for men with metastatic castrate-resistant prostate cancer (EXACT). Pilot Feasibility Stud 5, 111.CrossRefGoogle ScholarPubMed
Bourke, L, Doll, H, Crank, H et al. (2011) Lifestyle intervention in men with advanced prostate cancer receiving androgen suppression therapy: a feasibility study. Cancer Epidemiol Biomarkers Prev 20, 647657.CrossRefGoogle ScholarPubMed
Bourke, L, Gilbert, S, Hooper, R et al. (2014) Lifestyle changes for improving disease-specific quality of life in sedentary men on long-term androgen-deprivation therapy for advanced prostate cancer: a randomised controlled trial. Eur Urol 65, 865872.CrossRefGoogle ScholarPubMed
Maroni, P, Bendinelli, P, Fulgenzi, A et al. (2021) Mediterranean diet food components as possible adjuvant therapies to counteract breast and prostate cancer progression to bone metastasis. Biomolecules 11, 1336.CrossRefGoogle ScholarPubMed