Physical activity, sedentary behavior, and health-related quality of life in prostate cancer survivors in the health professionals follow-up study
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Many prostate cancer survivors experience compromised health-related quality of life (HRQOL) as a result of prostate cancer. We examined relationships between types and intensities of activity and sedentary behavior and prostate cancer-related HRQOL, overall, and by demographic, disease, and treatment characteristics.
Associations between post-diagnosis activity and sedentary behavior and HRQOL domains (urinary incontinence, urinary irritation/obstruction, bowel, sexual, and vitality/hormonal) were prospectively examined in men diagnosed with non-metastatic prostate cancer in the Health Professionals Follow-up Study (n = 1917) using generalized linear models.
After adjusting for potential confounders, higher duration of total, non-vigorous, and walking activity was associated with higher vitality/hormonal functioning scores (p-trends, <0.0001). Effects were small (d = 0.16–0.20) but approached clinical significance for men in the highest vs. lowest activity categories. Survivors who walked ≥90 min/week at a normal pace, or faster, reported higher hormone/vitality scores (p = 0.001) than men walking <90 min at an easy pace. Weightlifting was associated with increased urinary incontinence (p-trend, 0.02). Total activity was associated with higher hormone/vitality functioning in men who were ≥5 years post-treatment, had more advanced disease (Gleason score ≥7), and had ≥1 comorbid condition. No relationships were observed between vigorous activity or sedentary behavior and HRQOL.
Increased duration of non-vigorous activity and walking post-diagnosis was positively associated with better hormone/vitality functioning. Specifically, engaging in ≥5 h of non-vigorous activity or ≥3 h of walking per week may be beneficial.
Implications for Cancer Survivors
Encouraging men to engage in non-vigorous activity and walking may be helpful for managing prostate cancer-related HRQOL.
KeywordsBowel functioning Hormone functioning Physical activity Prostate cancer survivors Sedentary behavior Sexual functioning Urinary functioning
We thank the participants, Lauren McLaughlin, and other staff of the Health Professionals Follow-up Study for their valuable contributions as well as the following state cancer registries for their help: AL, AZ, AR, CA, CO, CT, DE, FL, GA, ID, IL, IN, IA, KY, LA, ME, MD, MA, MI, NE, NH, NJ, NY, NC, ND, OH, OK, OR, PA, RI, SC, TN, TX, VA, WA, and WY. The authors assume full responsibility for analyses and interpretation of these data.
The research for this article was funded by the NIH/NCI UM1 CA167552 to Harvard University and a UCSF Research Evaluation and Allocation Committee Award (Fund 38107). Edward Giovannucci is also supported by NIH R01 CA133891. Siobhan Phillips was supported by the National Cancer Institute Cancer Prevention Fellowship Program during her work on this project.
Conflict of interest
The authors have no conflict of interest or financial disclosures to report.
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