Exercise and weight loss have a significant impact on overall prostate health including reducing your risk of cancer, BPH and prostatitis. Maintaining a healthy weight and getting enough exercise is also fundamental to recovery after prostate treatment. Exercise increases your immunity and overall wellness while maintaining a healthy weight decreases your the inflammation response in your body that can cause or contribute to prostate disease.
In March 2007, the journal Cancer released a report on obesity and prostate cancer. It stated that that “men who have prostate cancer have more than double the risk of dying of the disease if they are obese than if they were of normal weight”. This threat of death remained regardless of whether the men underwent radical prostatectomy or hormone therapy, if they had low- or high-grade cancer, or if the cancer had spread. (Gong 2007)
The study noted that men who had been obese one year before receiving their diagnosis were 2.6 times more likely than men who had a normal BMI to die of prostate cancer. The odds were even worse for men who were diagnosed with prostate cancer that had not spread far beyond the prostate: those who were obese one year prior to diagnosis were more than three times more likely to have cancer that spread during the study.
Recent studies at Henry Ford’s Vattikuti Urology Institute and Department of Radiology have also shown that heavier patients, or those with the highest body mass index (BMI), also had the largest prostate cancer tumors. They discovered the connection after studying 3,327 patients who had undergone robotic removal of their cancerous prostate glands and surrounding tissue.
Inflammation, Obesity and Prostate Cancer
Being overweight and having excess fat can cause the release of growth factors called adipokines, some of which promote inflammation in the body leading to prostate and other disease.
Chronic, low-grade inflammation appears to be a key player in prostate disease. Nearly all surgically removed prostate cancer tissue contains inflammatory cells, and inflammation leads to the wasting away of healthy prostate tissue that lies next to the cancerous tissue. Inflammation in the body is also one of the most common ways that protective antioxidants are lost.
Dr. Stephen J. Freedland, of the Duke University Prostate Center and the VA Medical Center in Durham, North Carolina evaluated 190 men who underwent biopsies for possible prostate cancer. When they looked at the results, and accounted for factors such as age, weight, race, body mass index, PSA, and several others, they found that those who exercised the equivalent of three to six hours of walking per week were less likely to be diagnosed with prostate cancer. More specifically, compared with their more sedentary peers, these men were two-thirds less likely to have a biopsy positive for prostate cancer. In addition, men who exercised the equivalent of only one to three hours of walking each week had an 86 percent lower risk of having an aggressive form of the cancer.
One of the latest studies of the impact of exercise on prostate health was published in January 2011 by researchers at the Harvard School of Public Health in collaboration with those at the University of California-San Francisco. Stacey A. Kenfield and his colleagues conducted an 18-year study in which they evaluated 2,705 men who had been diagnosed with prostate cancer. They found that men who were involved in three or more hours of vigorous exercise had a 61 percent lower risk of prostate cancer-specific death when compared with men who exercised less than one hour each week. Among men who walked at a normal to brisk pace for more than 90 minutes each week had a 46 percent lower risk of dying from any cause when compared to men who did not walk as much. (Kenfield 2010)
Exercise is beneficial not only for helping to prevent prostate cancer, but also for improving quality of life following prostatectomy. In a recent Canadian study, 60 men who were scheduled for radical prostatectomy were interviewed two weeks before and four weeks after surgery regarding their level of physical activity. The researchers found that men who had higher levels of physical activity during the year before their surgery had lesser declines in health-related quality of life both before and after surgery. This finding suggests that declines in health-related quality of life after radical prostatectomy may be reduced or avoided in men who participate in exercise before surgery. (Mina 2010)
Exercise also appears to help men who undergo external beam radiation for prostate cancer. In a study from the University of Dundee, experts evaluated radiation toxicity data for 65 men who were treated with radiation therapy over a four-week period. Thirty-three men were assigned to a control group and 32 participated in 30 minutes of walking at least three times per week during treatment. Among men who exercised, there was a significant difference in mean toxicity scores regarding rectal side effects when compared with controls, but there was no significant difference regarding bladder side effects. These findings suggest that men who exercise may experience less severe rectal side effects during radiation treatment for prostate cancer. (Kapur 2010)
Exercise and Inflammation
It is well established that regular exercise is an inflammation fighter, and the reasons appear to be its ability to reduce pro-inflammation substances as well as increase production of anti-inflammatory factors. (Timmerman 2008; Pedersen 2006; Buford 2009)
In a study of the effects of physical exercise on markers of inflammation, 29 men and 23 women who had stable coronary heart disease were divided into two groups. (Rankovic 2009) For six weeks, one group participated in a moderate aerobic exercise program while the other group remained sedentary. At the end of the six weeks, the individuals who had exercised had a significant reduction in both obesity and inflammation.
Another study found that resistance exercise (in which muscles move against the resistance of weights, water, gravity, or your own body weight) actually increases production of substances within the skeletal muscle that helps keep inflammation at a more normal level. (Buford 2009)
Exercise and Adiponectin
When you exercise you also increase your adiponectin levels, which in turn reduces your risk of developing serious prostate cancer.
A large, 25-year prospective study looked at the association between the levels of adiponectin (a hormone produced by fat cells and that increases the effectiveness of insulin) and the risk of prostate cancer. (Li 2009) The participants in the study included 654 men from the Physicians’ Health Study, who were diagnosed with prostate cancer between 1982 and 2000, and 644 age-matched controls. Among the men who had cancer, the risk of dying was assessed in 2007. The researchers found that men who had higher adiponectin concentrations had a lower risk of developing high-grade or deadly cancer.
As a bonus, adiponectin also increases the effectiveness of insulin, which then allows for better blood sugar control and decreases the risk of diabetes and heart disease. (Kriketos 2004)
A study published in 2007 in the Journal of Urology showed that aerobic exercise reduced the symptoms of non-bacterial prostatitis. The study enrolled 213 men, ages 20 to 50, and randomly assigned them to 18 weeks of either aerobic exercise or stretching and motion exercises. At the end of the treatment period, the researchers noted that based on the men’s scores on the National Institutes of Health Chronic Prostatitis Symptom Index, those who were in the aerobic exercise group had greater improvement in their scores. The researchers concluded that “improvements in the aerobic exercise group were significantly superior compared to those in the placebo/stretching and motion exercises group”.
At the University of California, San Diego School of Medicine, two experts conducted a meta-analysis of eleven studies that evaluated exercise, BPH, and lower urinary tract symptoms (LUTS) among a total of 43,083 participants. The reviewers classified the activity levels into light, moderate, and vigorous categories. Compared with a sedentary lifestyle, men who engaged in moderate or vigorous exercise experienced up to a 25 percent reduced risk of BPH and LUTS. Light exercise was found to provide a slight but not significant reduction in risk for BPH or LUTS. (Parsons 2008) In a subsequent review by the same researcher, exercise was named as a strategy to help reduce the risk of BPH. (Parsons 2010)
In a report from the University of California, Los Angeles, researchers pointed out there is evidence that BPH is associated with elevated insulin levels, insulin-like growth factor-1 levels, and a plasma estradiol/testosterone ratio, and that daily aerobic exercise can lower these factors, especially when men also follow a low-fat, high-fiber diet. (Barnard 2010)
Experts have several theories about why exercise may reduce the risk of BPH and LUTS. One is that physical activity impacts prostate growth through changes in hormone levels, while others believe the benefits arise from an improvement in cardiovascular health. That’s because there is some evidence that cardiovascular disease may promote BPH and LUTS. In addition, men who suffer from obesity, diabetes, and hypertension—all risk factors for cardiovascular disease—are more likely to have BPH and LUTS. (Parsons 2007; Rohrmann 2005)
In a review study from the University of British Columbia, the authors noted that “most of the literature supports a clinically significant, independent, and strong inverse relationship between exercise and the development of BPH/LUTS.” (Sea 2009)
Generally, any activity that fights inflammation is good for the prostate, and both aerobic and resistance exercises are great when it comes to anti-inflammatory effects. Both types of exercise also can ease the fatigue experienced by men who receive radiation therapy for prostate cancer, although resistance exercise “generated longer-term improvements and additional benefits for quality of life, strength, triglycerides and body fat.” (Segel 2009). Kegel exercises also strengthen the pelvic muscles to aid in continence, erectile dysfunction, sexual health and pre and post treatment for prostate cancer.
Aerobic v Resistance Exercise
Aerobic exercise is also referred to as cardiovascular exercise, and it includes brisk walking, jogging, running, cycling, basketball, calisthenics, rowing, use of stepping machines, and jumping rope. If you want to burn off excess fat, strengthen your heart, and increase your lung capacity, aerobic exercise is the choice.
If you want to strengthen, build, and tone your muscles, tendons, ligaments, and bones, resistance exercise is for you. Resistance exercise increases the force your muscles can exert and the length of time they can exert that force. The basic principle behind resistance exercises is that your muscles work in opposition to a force that pushes or pulls against them. You don’t need any special equipment to do resistance exercises, as that force can be your own body, or it can be weights, gravity, or water. Examples of resistance exercises are push-ups, swimming, leg lifts, weight lifting, and isometric exercises (e.g., putting your palms together and pushing against your own resistance).
Kegel exercises, generally seen as an exercise for women, also work for men too, especially if you need some help controlling your urine flow due to a weakening of your pelvic muscles (i.e., incontinence). This is a troublesome side effect of prostate surgery (especially after radical prostatectomy), but it can happen even if you do not have surgery. Kegel exercises can help your prostate and urinary control, as well as help achieve better arousal, more enjoyable orgasms, and better ejaculation control. Kegel exercises are great for any man to practice regularly, because they not only help keep the PC muscle strengthened and toned, they also help reduce or eliminate prostate inflammation not related to cancer or bacterial infections.
Kegel exercises involve the repetitive tightening or clenching of the pubococcygeus (PC) muscle, which is what you do when you try to prevent the flow or urine or the passing of gas.
How to do Kegel Exercises
You can get the feel of the PC muscle if you practice stopping and starting your urine stream a few times in mid-urination. When you do this, do not tighten your abdominal, buttock, or thigh muscles, just the PC muscle. Contract the PC muscle and hold for five seconds, then relax. That’s one rep. Now do 20 to 40 repetitions twice a day to start, and work your way up to 60 reps twice a day. You can do these exercises anywhere and at any time, sitting, standing, or lying down. No one will even know you are doing them. If you do them lying down, choose a firm surface and tilt your pelvis upward. If you do Kegel exercises regularly (preferably daily), you can strengthen and tone the muscles of the urinary system and gain better control of your urine flow. Once you start doing Kegels, you should experience results in about four to six weeks.
Kegel before Surgery
If you are planning to undergo radical prostatectomy, it is recommended that you begin doing Kegel exercises in advance so you can strengthen the muscles before surgery. Performing Kegel exercises after surgery (although not until your doctor gives the okay) is also an excellent way to rebuild the strength of the muscles important for controlling urine flow.
More on Kegel Exercises for Men
How quickly can you get back on the tennis court or into the pool after surgery? That depends on the type of surgery you’ve had, how extensive it was, and the state of your health in general. Your doctor should be your guide. In most cases it takes six to eight weeks to return to doing the things you’ve always done, and so you should take it slow and gradually build back to your former level of fitness.
Generally, exercises that involves the entire body, such as walking or swimming, may be a good choice, but it’s best to avoid any exercises that involve jarring or pounding, like running, tennis or jumping rope, or any activity that puts pressure on the pelvic area (e.g., horseback riding, bicycling).
Are there any exercises that healthy men should not do if they want to avoid prostate problems in the future? Some men claim that bicycling puts an undue amount of pressure on the prostate region and aggravates symptoms, but most medical professionals doubt that cycling causes or exacerbates prostatitis or BPH, and there is no link between cancer of the prostate and cycling.
It is possible, though, that specific exercise, such as cycling or riding a horse, can aggravate the prostate if there is pressure on the area. If you are scheduled for a checkup that may include a PSA test, it might be an idea to avoid any exercise that may lead to a false or increased PSA level, potentially caused by the effect of any short-term inflammation.
Overall, if there is an exercise or activity that is irritating or aggravating your prostate area—or any other area of your body for that matter—then it’s probably best to avoid it.
Barnard RJ, Aronson WJ. Benign prostatic hyperplasia: does lifestyle play a role? Phys Sportsmed 2009 Dec; 37(4): 141-46
Kapur G et al. The effect of aerobic exercise on treatment-related acute toxicity in men receiving radical external beam radiotherapy for localized prostate cancer. Eur J Cancer Care (Engl) 2010 Sep; 19(5): 643-47
Kenfield SA et al. Physical activity and survival after prostate cancer diagnosis in the health professionals follow-up study. J Clin Oncol2011 Jan 4
Mina DS et al. Physical activity and quality of life after radical prostatectomy. Can Urol Assoc J 2010 Jun; 4(3): 180-86