Does Physical Activity Regulate Prostate Carcinogenesis and Prostate Cancer Outcomes? A Narrative Review

Marco Capece,Massimiliano Creta,Nicola Carlomagno,Francesco Mangiapia,Nicola Longo,Antonello Sica,Concetta Dodaro,Ferdinando Fusco,Felice Crocetto,Michele Santangelo,Biagio Barone,Caterina Sagnelli,Armando Calogero,Roberto La Rocca,Luigi Napolitano,Gianluigi Califano

doi:10.3390/ijerph17041441

Abstract

Background: Prostate cancer (PCa) represents a common disease in men aged >65 years. The role of physical activity (PA) in patients at risk or diagnosed with PCa represents an evolving issue. We aimed to summarize available evidences about the impact of PA on the pathophysiology and clinical outcomes of PCa. Methods: We performed a narrative review. Evidences about the role of PA in elderly patients in terms of PCa biology, epidemiology, oncological and functional outcomes, as well as in terms of impact on the outcomes of androgen deprivation therapy (ADT) were summarized. Results: Potential pathophysiological pathways hypothesized to explain the benefits of PA in terms of prostate carcinogenesis include circulating levels of Insulin-like growth factor-1 (IGF-1), oxidative stress, systemic inflammation, sex hormones, and myokines. Clinically, emerging evidences support the hypothesis that PA is associated with decreased PCa risk, improved PCa-related survival, improved functional outcomes, and reduced ADT-related adverse events.

Highlights

Prostate cancer (PCa) is the most common malignancy among elderly men [1]
Kruk et al found an overall PCa risk reduction ranging from 5% to 65% associated with recreational physical activity (PA) and from 10% to 56% associated with occupational PA [18]
Patients diagnosed with non-metastatic PCa and receiving whichever treatment may benefit from PA in terms of urinary continence and sexual function

Summary

Introduction

Prostate cancer (PCa) is the most common malignancy among elderly men [1]. The incidence and mortality of PCa worldwide correlate with increasing age, with the average age at the time of diagnosis being 66 years. Ninety percent of the patients with PCa in the USA are aged 60 years or older [2]. Prostate cancer (PCa) represents a common disease in men aged >65 years. We aimed to summarize available evidences about the impact of PA on the pathophysiology and clinical outcomes of PCa. Methods: We performed a narrative review. Evidences about the role of PA in elderly patients in terms of PCa biology, epidemiology, oncological and functional outcomes, as well as in terms of impact on the outcomes of androgen deprivation therapy (ADT). Emerging evidences support the hypothesis that PA is associated with decreased PCa risk, improved

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Discussion

Conclusion