Older prostate cancer survivors’ motives for physical activity

BY Asmita Patel

Prostate cancer is one of the most diagnosed male cancers in many developed countries. With early detection, through a prostate specific antigen (PSA) test and advancements in treatment options, many men are living longer post-diagnosis. With increased life expectancy post-diagnosis, a growing focus is being placed on modifiable lifestyle factors, such as regular physical activity that can help improve the physical and psychological health and wellbeing of survivors.

Regular physical activity is beneficial throughout the prostate cancer journey, from diagnosis and treatment, through to remission and survivorship. A number of studies have found that engaging in regular physical activity is associated with a lower risk for prostate cancer progression, lower PSA levels, and a delay in the use of hormone suppression treatment, such as that of androgen deprivation therapy (ADT). Aerobic and resistance exercise can help alleviate some of the negative treatment-related side-effects associated with ADT, such as loss in muscle and bone mass and weight gain, which can become risk factors for osteoporosis and type 2 diabetes. Physical activity can help counteract cancer-related fatigue and may protect against depression.

Sixteen men diagnosed with prostate cancer from Auckland, New Zealand took part in our interview-based study. The men were aged between 57 and 88 years of age. Ten men were in remission and had not received radiation or chemotherapy or had prostate-related surgery in the previous 12 months. The remaining six men were receiving ADT. Our study was designed to identify motives for physical activity in this cross-section of prostate cancer survivors (men in remission and men receiving treatment for their prostate cancer).

The men in our study were motivated to engage in physical activity post-diagnosis to obtain and experience the physical, mental, and cognitive health-related benefits associated with regular physical activity. Men receiving ADT were motivated to engage in physical activity as it was perceived to slow the progression of their prostate cancer. Men in remission were motivated to engage in physical activity as they perceived it to be beneficial in helping keep them healthy and alive. Both groups of men were motivated to engage in physical activity for general health related reasons, such as for weight control, the management of pre-existing chronic health conditions, sleep improvement, and to maintain physical fitness.

Men receiving ADT were motivated to engage in physical activity for stress relief, relaxation, and mental happiness. Being physically active provided these men with a sense of achievement, and the perception of feeling strong through engaging in certain types of physical activity. Both groups of men engaged in physical activity as it provided them with a sense of wellbeing. Men in both groups were motivated to engage in physical activity to obtain cognitive health-related benefits, mental stimulation, and to keep their brain healthy. Research from earlier studies has found that physical activity can improve cognitive function by changing brain structure that positively influences memory.

The findings from our study provide important insights into how prostate cancer survivors (including men receiving ADT) perceive the benefits of physical activity as part of their cancer survivorship. Our study also discussed the role that healthcare practitioners (cancer specialists, general practitioners) can have in providing some degree of physical activity advice or referral. Prostate cancer survivors are receptive to receiving physical activity advice from their healthcare practitioner(s).

While most of the men in our study were physically active pre and post treatment, the majority of prostate cancer survivors are not engaging in sufficient physical activity to achieve health-related gain. Regular physical activity is an important component of prostate survivorship, as it can provide many protective benefits for prostate cancer survivors, who as a group are at increased risk for prostate cancer recurrence, secondary cancers, cardiovascular disease, and poor quality of life. Our study concluded that collaborative practice between healthcare practitioners and exercise physiologists and physiotherapists would benefit the health and well-being of low-active and sedentary prostate cancer survivors.