Benefits of Aerobic High-Intensity Training for Men with Prostate Cancer on Active Surveillance
By Dr. David Samadi
Recent research has highlighted the positive impact of high-intensity aerobic training on key cardiometabolic markers for men undergoing active surveillance for prostate cancer. According to the Exercise During Active Surveillance for Prostate Cancer (ERASE) trial, a 12-week regimen of high-intensity interval training (HIIT) notably improved levels of total cholesterol, non-high-density lipoprotein cholesterol (non-HDL-C), and insulin among participants.
Published in Prostate Cancer and Prostatic Diseases, the ERASE trial demonstrates that a structured HIIT program—consisting of sessions at 85 to 95% VO2peak for 28 to 40 minutes, three times a week—can lead to significant improvements in cardiometabolic health. Researchers suggest that these benefits might also affect cancer progression by influencing cardiovascular health, which could potentially alter cancer-related signaling pathways.
Study methods and results
In the study, 52 men on active surveillance were divided into an exercise group and a usual care group. The participants, with an average age of 63.4 years and an average body mass index (BMI) of 29.0 kg/m², had various comorbidities, including arthritis, hypertension, and diabetes. Despite the small sample size, the exercise group showed a notable reduction in total cholesterol (−0.40 mmol/L) and non-HDL-C (−0.35 mmol/L), along with improved insulin levels (−13.6 pmol/L), insulin-like growth factor 1 (−15.0 ng/mL), and insulin-like growth factor-binding protein 3 (IGFBP-3) (152.3 ng/mL).
Interestingly, the groups had no significant differences in weight or other biomarkers like fasting glucose, HbA1c, and specific lipid markers. These results underscore the potential of exercise to influence cardiometabolic markers positively. However, further research is needed to determine if these changes lead to reduced clinical events and better long-term outcomes.
Key points
The study emphasizes the need for urologists to consider cardiovascular health alongside prostate cancer progression when recommending lifestyle interventions. Given that cardiovascular disease (CVD) is the leading cause of death among men, including those with prostate cancer, integrating exercise into care plans for patients on active surveillance could be a crucial strategy for enhancing overall health.
Although this study does not provide conclusive evidence on mortality reduction, it strengthens the argument for exercise as a beneficial intervention. More extensive studies are necessary to explore whether exercise can directly influence survival rates and how cardiovascular health might impact prostate cancer progression.
In the meantime, while men with low-risk prostate cancer have a very low chance of dying from the disease itself, they remain at risk for CVD. Addressing lifestyle factors, including exercise, is vital in managing their overall health and potentially mitigating risks associated with both cardiovascular issues and prostate cancer.
Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board-certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy. Dr. Samadi is a medical contributor to NewsMax TV and is also the author of The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncology and prostate cancer 911.