Advantages of exercises for men in active monitoring

reference

Guy de, Vandersluis A, Klotz LH, et al. The total energy consumption and the physical activity with high intensity are associated with a less likelihood of new classification in men under active monitoring. (Link away). 2018; 21 (2): 187-195.

draft

retrospective comparison study

objective

The connection between intensive physical activity and the progression of the disease in men should be examined under active monitoring for prostate cancer.

participant

This study combines data from 2 cohorts of men. A group was recruited by the Sunnybrook Health Sciences Center in Canada (SHSC) and the second group from the Royal Marsden Hospital in the United Kingdom (RMH). The SHSC group consisted of 131 men with prostate cancer at a favorable risk and the RMH group consisted of 112 men with prostate cancer with similar risk.

These 2 groups were divided into 2 subgroups: a) those who were subjected to active surveillance, and b) those who were initially treated with active surveillance, but were later classified at a higher risk and then subjected to radical treatment. Those from both hospitals whose cancer progress and which have been switched to radical treatment have been "approved".

study parameters evaluated

The physical activity was recorded by questionnaires. The connection with physical activity was examined as a variable for the risk of reclassification of the status from monitoring for treatment. Demographic and lifestyle covariates were also analyzed to evaluate a possible confusion and modification of the training effect.

important knowledge

The entire physical activity (leisure exercises plus work -related exercises) was associated with the probability of a new classification during active surveillance ( p trend = 0.027). The trend for an inverse connection that was only observed with physical training in leisure time did not achieve statistical significance ( p trend = 0.30). Men who took part in the weekly intensive physical activity have been newly classified with significantly less probability than men who did not do this (ODDS Ratio [or]: 0.42; 95% confidence interval [CI]: 0.20-0.85). These inverse associations with the overall burden were only significant if the data from both hospital cohorts were added. When each cohort was examined separately, the associations were only strong trends. Strong, highly intensive physical activity was significantly associated in both cohorts with a reduction in the likelihood of new classification.

practice implications

In men, in which prostate cancer was diagnosed with a low progression risk, it is increasingly common today to delay radical treatments (radiation or operation) and instead simply wait and see whether the disease progresses, a strategy that is known as active surveillance. Activity for men with prostate cancer examined under active monitoring, and the results give the reason to assume that they will benefit from physical activity. Prostate cancer often opposes our well -founded assumptions about what benefits or not, so we prefer not to make any assumptions based on other types of cancer.

The conclusion that these patients should hear and remember is that men who move intensively every week have a 58 % lower risk of disease progression than men who do not.

Based on this study, we should encourage men under active surveillance, to do Sports, and these results indicate that intensive training will bring a greater benefit.

Several mechanisms have been proposed to explain the effects of physical activity on the progression of prostate cancer. ^{2 Increased physical activity reduces the availability of androgens and insulin -like growth factors. 3.4 These hormones stimulate and androgen receptors on prostate tumor cells and solve cell proliferation and Cancer progression.}

This was not a perfect study. It was retrospective and is based on patient memories for training intensity, duration and fraud. It is also based on the patient's recall campaign in order to take possible disruptive factors, in particular other lifestyle factors such as smoking or nutrition that could affect the risk. However, until they are refuted by larger, careful studies, these are our only data that deals specifically with the risk of physical activity and the progression of prostate cancer in active monitoring population.

The conclusion that these patients should hear and remember is that men who move intensively every week are 58 % lower risk of disease progression than men who do not. If you round off these figures for the sake of simplicity, you could say: "Exercise reduces the risk of disease progression by more than half."