In Argentina, prostate cancer is the most common cancer in men: it is estimated that it produces more than 11,000 new cases per year and nearly 3,600 deaths. The main risk factor is age (it is more common after age 50). That cannot be modified, nor can genetic predisposition. But there are variables that do help reduce the chances of developing it: physical exercise is one of them.
A recent study published in British Journal of Sports Medicinewhose authors suggest that ” improvements in cardiorespiratory fitness in adult menwhich may reduce the risk of prostate cancer.”
Unlike other very common tumors such as those of the breast, colon and lung, there are relatively few preventable risk factors that have solid evidence to reduce the risk of developing prostate cancer, highlighted researchers from the Swedish School of Sports Sciences and Health, Stockholm.
And while there is evidence of the beneficial effects of physical activity on reducing the risk of developing several types of cancer, the associations with prostate cancer found in previous studies were less clear and, at some point, contradictory.
To find out whether improvements in cardiorespiratory fitness could lead to a reduction in risk over time, Swedish researchers analyzed information related to physical activity, lifestyle and body mass index of more than 180,000 men contained in a health database of the Nordic country.
Almost a quarter of them also performed two tests on a stationary bicycle to evaluate their cardiorespiratory fitness, a measurement whose result was expressed as absolute and relative maximum V02 (the amount of oxygen the body uses when exercising at the highest possible intensity).
The participants were divided into three groups according to whether in the results of these tests their cardiorespiratory fitness had increased annually by 3%, decreased by 3%, or had remained stable.
After a 7-year follow-up, the researchers observed that, regardless of other potentially influential factors (such as age, educational level, weight, smoking, among others), those who had improved by 3% or more per year had 35% less likely to develop prostate cancer than those whose physical condition had decreased.
Although this is an observational study and, as such, cannot establish cause (doing physical exercise)-effect (preventing cancer), especially taking into account that genetic factors play an important role, the authors highlighted that ” the results highlight the importance of cardiorespiratory fitness for prostate cancer risk.
Inverse relationship
“This is a large study in which we really see an inverse relationship between functional cardiorespiratory capacity and the incidence of prostate cancer. It is important because to date there was no other one so specific aimed at this type of cancer,” he highlighted Clarion Gonzalo Vitagliano, head of Uro-Oncology of the Urology service of the German Hospital of Buenos Aires.
Along the same lines, Juan Pablo Sade, head of the Genitourinary Tumors area at the Alexander Fleming Institute (IAF) and at the Austral University Hospital, stated that “this article adds even more evidence on exercise and its relationship with the reduction in the diagnosis of prostate cancer”.
And he stressed that “above all it is the difference is very noticeable between those men who improve their cardiovascular fitness versus those who deteriorate this same characteristic”.
The contradictory findings obtained in previous studies mentioned by the authors of the article respond, according to Vitagliano, to a “diagnostic bias.”
It turns out that in some studies a higher incidence of prostate cancer had been reported among men with better physical condition. “What happens is that men with a lifestyle that leads them to increase their cardiorespiratory capacity also tend to monitor themselves more. Since prostate cancer is asymptomatic, greater control increases detection.”
From the age of 50, an annual urological check-up is recommended, which favors early diagnosis and allows us to establish whether or not it is necessary to start treatment (in some men it is indicated to monitor and treat only in case it progresses). Men with a history should begin screening earlier.
More than losing weight
If non-modifiable factors such as age and genetic load are left aside, overweight and obesity are among the main risk factors for developing prostate cancer.
Would the improvements attributed to physical exercise then be due to an associated weight loss?
“It’s not just about that, because when cardiorespiratory fitness improves what goes down is the level of general inflammation of the body, which translates into a reduction of noxas (factors) that are related to the generation of cancer,” explained Vitagliano.
And he insisted: “It is not just about losing weight: with the improvement in physical condition obtained through exercise, vascularization and the immune system improve, which reduces the chances of developing tumors.”
At the German Hospital they started a prehabilitation program. “We give patients dietary and cardiovascular conditioning guidelines before starting treatment for prostate cancer,” said the specialist.
The reason? Many arrive without information or tools to incorporate healthy habits, so the urology service refers them to consultations with cardiologists and nutritionists who offer them personalized behavioral guidelines, designed based on the possibilities and limitations of each one.
Sade explained that during treatment and/or surveillance, “we try to influence patients to make behavioral modifications that not only result in better prostate health, but also in better general health, such as doing physical activity on a regular basis, lose weight and have more muscle mass and less body fatand increase the intake of some specific foods such as tomatoes, broccoli, pomegranate, turmeric, green tea, all within the framework of a healthy diet.
Physical activity guidelines suggest a aerobic exercise combination (such as brisk walking, running, swimming, cycling) and muscle strength training.
Benefits also for treatment
But the benefits of physical exercise are not limited to the prevention of prostate cancer, professionals highlighted.
“There is already enough evidence to show that physical exercise not only reduces the incidence of prostate cancer, but also some studies show that it reduces mortality and also helps to cope with the consequences of treatment“said Sade to Clarín.
“Complications are minor. Patients do much better when they are in good physical condition,” Vitagliano stressed. “Those who exercise and are well conditioned tolerate chemotherapy and radiotherapy better, deteriorate less, have fewer adverse effects from hormone therapy and even surgeries. They are simpler.”
The doctor recalled that the mortality of prostate cancer 30% is due to cardiovascular disease. “Faced with the same oncological disease, a patient with good cardiorespiratory fitness has a better prognosis than one with obesity, hypertension, diabetes, a sedentary lifestyle, or a smoker.”
However, he stressed that “this patient will live longer not because the tumor will be treated differently, but because he will have fewer complications.”
And he summarized: “Not only will a healthy life reduce the chances of getting sick, but it will also mean that if it happens to you (due to genetic or other non-modifiable causes, for example), you are going to take it much easier“.
“Among the different measures that are recommended to reduce the risk of global cancer, in addition to some better known ones such as quitting smoking, not sunbathing, not consuming alcohol, there are also weight control and regular physical activity. These are also preventive measures that help reduce the risk not only of prostate cancer, but of many other types of very common tumors such as breast cancer and colon cancer,” Sade concluded.
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