Exercise and diet in prostate cancer treatment

Deborah A. Bradley, MD, Novant Health Cancer Specialists

Prostate cancer comes with a lot of questions — but with better outcomes than in the past. We can now rein in the progress of prostate cancer for many patients so that it can be managed as a chronic condition. The downside is that the cornerstone of treatment — androgen deprivation therapy (ADT) — can bring with it side effects that impact your body image and quality of life.

But there’s good news. Diet, exercise and the support of others can make a big difference. Novant Health has recognized this and provides a comprehensive cancer wellness program for our patients. This program includes supervised exercise, nutritional counseling and social support. And we also offer cardiovascular prevention services that can help prostate cancer patients avoid a decline in heart health.

Androgen deprivation therapy (ADT) remains the cornerstone of treatment and has been shown to increase overall survival. The goal of ADT is to decrease testosterone, which can fuel cancer growth. ADT originally was used just to treat advanced cases, but now some men receive ADT as their first treatment after diagnosis or if, after treatment, they have rising levels of prostate-specific antigen (PSA), a warning flag for cancer.

Well-known side effects of ADT include fatigue, hot flashes, sexual dysfunction (loss of libido and erectile dysfunction), and weight gain. Less common side effects include emotional and cognitive changes, anemia (usually mild), decreased size of penis and or testes, and thinning of body hair. These side effects can affect patients’ sense of well-being and quality of life. It is important that doctors and patients talk about these issues as often there are interventions that can be helpful.

ADT has some other, longer-term side effects. It can lead to increased bone turnover, lose of bone density and raise the risk of fracture. Often patients who are on ADT get close monitoring of their levels of vitamin D — important for bone strength — and of their bone density.

ADT can also cause a loss of lean body mass and gain fat, and can make you more susceptible to diabetes. For patients who already have diabetes, ADT can make it harder to control blood sugar. Add in the medicine’s tendency to increase cholesterol count, and you have a combination that may cause harm to your heart.

But patients can improve their body image, functioning and health outlook with a program that keeps them active, focuses on healthy eating, and offers a supportive atmosphere. Men receiving ADT who take part in structured exercise have shown increased muscular strength, cardiorespiratory fitness, improvement in functional tasks, a leaner body mass and less fatigue.

However, despite these benefits, I find most patients I ask are not exercising regularly. Sometimes getting started can be hard. That’s why we offer guidance and support — because living a full life during prostate cancer treatment is worth the effort.

For information regarding the Novant Health cancer wellness program, please ask your doctor for referral or call 704-384-6953, option 1.