Does Post-diagnosis Physical Activity Prolong the Duration of Active Surveillance in Men With Prostate Cancer?

Abstract

PURPOSE: In this retrospective cohort study, we examined the effect of post-diagnosis physical activity on active surveillance (AS) termination in men with low-risk prostate cancer. METHODS: 630 participants on AS were included in the analysis. Post-diagnosis physical activity was measured using the Godin Leisure-Time Exercise Questionnaire and expressed in metabolic equivalent-minutes per week (MET-min/wk). Four physical activity categories were created to classify participants throughout the study: inactive (<210 MET-min/wk), insufficiently active (210-500 MET-min/wk), active/meeting physical activity guidelines (500-1000 MET-min/wk), or highly active (>1000 MET-min/wk). Using Cox regression models, we evaluated the relationship between post-diagnosis physical activity and risk of terminating AS, adjusting for age, prostate-specific antigen (PSA) and number of positive cores most proximal to AS initiation. RESULTS: Of the 630 participants, 198 underwent active treatment and 432 were censored. The earliest and latest events of AS termination, indicated by active treatment initiation occurred at 5 and 116 months, respectively. In this cohort, post-diagnosis physical activity was not significantly associated with time to AS termination. PSA (HR, 1.11; 95% CI, 1.03 to 1.20) and the number of positive cores (HR, 1.34; 95% CI, 1.12 to 1.61) most proximal to AS initiation were associated with a significantly increased risk of initiating active treatment. CONCLUSIONS: The findings of this study suggest that termination of AS and initiation of active treatment is not influenced by post-diagnosis, self-reported physical activity status.