We know that exercise is a great idea for anyone recovering from, or living with, cancer. Specifically, in men with prostate cancer, it’s proven to be really effective – it can help reduce the risk of cancer coming back. In men living with prostate cancer it can help slow down disease progression – by as much as a whopping 57%.
Life after prostate treatment
I’ve had the privilege of training many men who’ve had prostate cancer treatment, and what’s struck me is how their lives can be so very affected by side effects – the more common side effects of cancer treatment such as fatigue, weakness after surgery, hair loss, weight loss or gain, and all of the physical and emotional effects of chemo.
Specifically though, and despite maintaining a classic ‘stiff upper lip’ and not grumbling about it, I know that there are many men living with the impact of hormone treatment – weight gain, muscle loss, mood swings, hot flushes, tearfulness. Losing much of what makes men different from women. If you’re reading this and it’s sounding familiar, please know that you’re not alone.
Stereotypically, men can be more reluctant to seek support for stuff like this than women. However being in touch with other men in the same boat as you might just help this to feel less isolating. The good people at Prostate Cancer UK can put you in touch Click here.
Hormone therapies, bone density and loss of strength
Hormonal therapies often used in men with advancing prostate cancer can have a detrimental effect on muscle, leading to muscle wasting. This can make you feel like you’ve got no strength, can change your appearance, and everyday activities like climbing the stairs can suddenly feel difficult. Another side effect of treatment can be a reduction in bone density and this, plus the effect of enforced periods of inactivity, can lead to the bones becoming more brittle and prone to breakage.
The best type of exercise to support bone density is weight-bearing, where you transfer your bodyweight from one foot to the other – think walking or jogging, rather than cycling or swimming.
You can train your muscles to be stronger after cancer treatment.
The secret is to start by just using the weight of your own body or light weights or resistance bands. Learn good technique so that your time is well spent and you avoid injury. Gradually work up to heavier weights and more repetitions.
Won’t training increase my testosterone levels?
Good question, and one that is currently being asked by a clinical trial. One of the effects of heavy weight lifting is that it can increase your testosterone levels – which could be unhelpful for men who’ve had prostate cancer. The current best advice is that this is only likely to be problematic in men who are doing very, very heavy lifting. Regular training is not currently believed to impact upon testosterone levels in a harmful way. Plus the benefits of exercise far outweigh this theoretical risk.
The dreaded problem of leakage
Many men experience incontinence after treatment for prostate cancer and this can understandably affect one’s confidence to get active. Don’t be put off – incontinence is usually not permanent and can be helped by training your pelvic floor muscles.
Now, fellas, we need to call a spade a spade. Try this:
Imagine you are right in the middle of urinating, and must suddenly stop the flow. Squeeze the little muscles that you’d use to stop peeing. Hold them for a few seconds and then gently release them. This is a really specific, localised movement and nowhere else should move – not your buttocks, legs, or your tummy muscles or your face. Learn how to find those muscles and contract and release them. Try holding them for a little longer before you release. Make sure that you keep breathing naturally throughout. Do this regularly, several times a day. Then, try working on your ‘back’ muscles: imagine you are trying to stifle an urge to pass wind. Again squeeze the muscles that you’d need to use to do that. Squeeze and contract, several times, and for differing amounts of time.
Aside from training your pelvic floor, if you’re worried about leakage, choose exercises that avoid bringing the knees up close to the chest, as that can squash the bladder and cause leaks. To train your trunk, opt for press ups, the plank and side plank. For your lower body, use the Glute bridge and wide, sumo squats.
Have a look at current research: Pantera
“Evidence suggests that men who are physically active after a prostate cancer diagnosis have better cancer survival than men who aren’t active.” – Dr Liam Bourke
A newly launched Cancer Research UK study could be the first step towards exercise training being introduced as a new NHS treatment for prostate cancer.
Half of the men in the study will carry out two-and-a-half hours of aerobic exercise every week for 12 months – initially with the support of a qualified trainer and then with free access to local gyms. The other half will be given information about the benefits of exercise for cancer patients but will have no supervised sessions.
Prostate cancer that has not spread is sometimes treated with surgery or radiotherapy. But this can have side-effects so many men opt for active surveillance instead, which involves monitoring the disease. All the men in the PANTERA study are and will remain on active surveillance – and they will also be closely monitored as part of the study itself.
If the participants can successfully keep up their exercise regime for 12 months, the study is expected to lead to a full-scale trial to look at the potential benefits of combining active surveillance and exercise for some prostate cancer patients.
This trial – believed to be the first of its kind in the world – would aim to test whether regular exercise can help keep prostate cancer from spreading to other parts of the body and could be a viable NHS treatment.
Fitness plan – without squashing the belly.
- Get out of puff
For your heart, lungs, bones, emotional health and energy levels, walk every day. Walk tall, with good posture, and with purpose – this should be brisk but comfortable, as if you’re marching. Walk quickly enough so that you’re a bit out of puff. Aim for 20-30 minutes a day.
Some people like a yardstick , so how about a mile a day, or 10,000 steps as a goal? If you like measurement, try marking out a one-mile route (or longer, once you’re ready) and record how quickly you can do it. If you’re not so bothered about measurement, look at the seasonal changes as you walk. Note the smells and sounds. Identify the birds and trees. This will all help to restore a sense of well-being.
- Get strong – do this body weight strength session 3 times a week, on non-consecutive days
- Warm up by walking briskly
- 5 walkout/ pike
- 10 good, deep squats. If you’re worried about leaking, make them wide sumo squats
- 10 triceps dips
- 10 press ups
- Plank – holding for as long as you can
- 10 shoulder taps
- 10 side planks (5 on each side)
- 10 side lunges
- 10 glute bridges.
- Have a rest, then if you’ve still got energy, repeat
- Once you’re really comfortable using your body weight, progress on to using weights.