Exercise has many benefits for men with prostate cancer, both during and after treatment. Staying active helps you manage treatment side effects like incontinence, builds your strength, and lifts your spirits.
Regular exercise and healthy eating may even lower the risk that your cancer will come back after treatment, especially if you have early-stage prostate cancer, says Evan Pisick, MD, an oncologist at the Cancer Treatment Centers of America hospital in Zion, IL.
The type of exercise you do is up to you, he says.
“The research on activity’s benefits for men with prostate cancer doesn’t go into the specific exercises to do. Your doctor may tell you to eat healthy and exercise, but some men don’t know where to start,” Pisick says.
He suggests that you vary your exercise routine to include both aerobic and strength training. Choose activities you enjoy, so you'll want to keep doing them.
“Do the workouts that work for you," he says. "Some of my patients lift weights at the gym. Others do cross-training. Some walk or run.”
What to Do Before You Start an Exercise Routine
Before you start an exercise program, talk with your oncologist. Ask what activities are best for you right now, to lower your risk for injury or embarrassment. Your doctor may also refer you to a physical therapist.
“It depends where you are in the treatment process," Pisick says. "Guys who are having radiation treatments can work out. If you’re a man who has just had prostate surgery, then you may not be able to do pelvic floor training or ride a bicycle at first, because you might pee your pants.
"But 2 or 3 weeks after surgery, once your catheter is out, go see a physical therapist who will guide you on how to exercise safely. They can show you how to do pelvic floor training exercises to practice at home, all day, every day.”
Pelvic floor training, also called Kegel exercises, strengthen muscles that control your bladder and bowel function. They can ease incontinence for men who've had surgery to remove the prostate, called radical prostatectomy.
“Work with your therapist to learn how to do your pelvic floor training exercises properly. They can insert a small monitor device up your butt. When you contract your pelvic floor muscles, the monitor detects it, and your therapist can show you on a graph that you’re working the right muscles,” Pisick says.
Once you learn to contract the correct muscles, slowly build up to doing a set of 20 pelvic floor exercises at least three times a day. In a few weeks, you’ll notice better control of your urine flow and fewer leaks. Don’t stop doing your daily sets.
Exercise Fights Medication Side Effects
Androgen suppression therapy (AST), or drugs that lower male hormones to suppress the growth of prostate tumors, may cause side effects like:
- Loss of muscle strength
- Loss of bone density
- Weight gain
- Increased levels of fats, or lipids, in your blood
- Emotional ups and downs
Exercise can tackle many of these negative effects.
“When you take away someone’s testosterone, their muscles can turn to mush. Men may also have hot flashes and depression," Pisick says. "Doing cardio and strength training can help you maintain your muscle mass and prevent weight gain. Some guys even lose weight.”
If you're overweight or obese, prostate cancer is more likely to come back after treatment. Cardio exercise, the type that gets your heart pumping like biking or fast-paced walking, helps manage your weight. This not only improves your chances for long-term survival with prostate cancer, but lowers your risk of heart disease.
Further, exercise can improve your mood and outlook. It helps ease anxiety and depression from having prostate cancer or dealing with treatment side effects.
“You’re going to feel better overall if you exercise. There is an endorphin release with exercise. It can even help you sleep better,” Pisick says.
Pisick's father, a 78-year-old recovering from prostate cancer, takes brisk walks every day. “He is in the best shape of his life and says that since he became more active, he feels happier,” Pisick says.
How Much Exercise Do You Need?
Start slowly and build up your strength and stamina, Pisick suggests.
A physical therapist or personal trainer can assess your condition, create an exercise routine that’s safe and appropriate for you, and help you stay motivated to stick with it.
“I have some patients who start to work out, overdo it and have sore muscles, and then they don’t go back to the gym for a few weeks,” he says. “It’s important to exercise safely. A therapist or trainer can help you learn how to do the exercises correctly. Some hospitals even have gyms with physical therapists on staff to train you.”
Aim for 30 minutes of physical activity 5 days per week, or more if you feel up to it. Include a mix of:
- Cardio activities, like walking, swimming, cycling, or jogging, to improve heart health and manage weight
- Weight-bearing exercises, like walking, stair climbing, lifting weights, or dancing, to prevent bone loss
- Strength-training, like lifting weights and pelvic floor training, to build muscle strength and reduce bladder leaks
“Yoga is also a good exercise for improving your strength and flexibility. Pilates is also a good option, and I also like to recommend meditation,” Pisick says. Slow movements like yoga, tai chi, or Pilates may be a good choice on days when you’re fatigued, he says.
On days when you feel crummy or tired, try to do even a small amount of cardio, he suggests.
“The best treatment for fatigue is do get up and so something," he says. "You may get tired. But any amount of activity will make you feel better. Pull that stationary bike in front of the TV, remove the clothes you have hanging on it, get on and ride for a little while. You’ll do better long term if you do.”
Evan Pisick, MD, oncologist, Cancer Treatment Centers of America, Zion, IL.
Exercise Is Medicine Australia: “Prostate cancer and exercise.”
Mayo Clinic: “Kegel exercises for men: understand the benefits.”
Regional Cancer Care Associates: “Physical and Mental Benefits of Exercise in Prostate Cancer.”
National Cancer Institute: “Hormone Therapy for Prostate Cancer.”
Cedars-Sinai Hospital: “Explaining the Link Between Prostate Cancer and Obesity.”