Advertisement

Physical Activity and Genitourinary Cancer Survivorship

  • Daniel A. GalvãoEmail author
  • Dennis R. Taaffe
  • Nigel Spry
  • Robert U. Newton
Chapter
Part of the Recent Results in Cancer Research book series (RECENTCANCER, volume 186)

Abstract

In this chapter we discuss common toxicities arising from genitourinary cancer treatments, in particular the adverse effects from androgen deprivation therapy (ADT) for prostate cancer given its well established detrimental effects on physical, physiological, and psychological function, and existing physical activity research in the postdiagnosis period including studies focusing on supportive care and some limited data on disease outcomes. Overall, consistent positive outcomes have been reported across studies showing that exercise is beneficial to reduce a number of treatment-related toxicities and improve symptoms. Additional studies are needed in genitourinary cancers other than prostate to establish specific physical activity requirements and implementation strategies.

Keywords

Prostate Cancer Bladder Cancer Cancer Survivor Radical Prostatectomy Resistance Training 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Basaria S, Lieb J 2nd, Tang AM et al (2002) Long-term effects of androgen deprivation therapy in prostate cancer patients. Clin Endocrinol (Oxf) 56(6):779–786CrossRefGoogle Scholar
  2. Basaria S, Muller DC, Carducci MA, Egan J, Dobs AS (2006) Hyperglycemia and insulin resistance in men with prostate carcinoma who receive androgen-deprivation therapy. Cancer 106(3): 581–588PubMedCrossRefGoogle Scholar
  3. Blanchard MC, Stein KD, Baker F et al (2004) Association between current lifestyle behaviors and health-related quality of life in breast, colorectal, and prostate cancer survivors. Psychol Health 19(1):1–13CrossRefGoogle Scholar
  4. Bong GW, Clarke HS Jr, Hancock WC, Keane TE (2008) Serum testosterone recovery after cessation of long-term luteinizing hormone-releasing hormone agonist in patients with prostate cancer. Urology 71(6):1177–1180PubMedCrossRefGoogle Scholar
  5. Braga-Basaria M, Dobs AS, Muller DC et al (2006a) Metabolic syndrome in men with prostate cancer undergoing long-term androgen-deprivation therapy. J Clin Oncol 24(24):3979–3983PubMedCrossRefGoogle Scholar
  6. Braga-Basaria M, Muller DC, Carducci MA, Dobs AS, Basaria S (2006b) Lipoprotein profile in men with prostate cancer undergoing androgen deprivation therapy. Int J Impot Res 18: 494–498PubMedCrossRefGoogle Scholar
  7. Carmack Taylor CL, Demoor C, Smith MA et al (2006) Active for life after cancer: a randomized trial examining a lifestyle physical activity program for prostate cancer patients. Psychooncology 15(10):847–862PubMedCrossRefGoogle Scholar
  8. Catalona WJ, Ramos CG, Carvalhal GF (1999) Contemporary results of anatomic radical prostatectomy. CA Cancer J Clin 49(5):282–296PubMedCrossRefGoogle Scholar
  9. Chen Z, Maricic M, Nguyen P et al (2002) Low bone density and high percentage of body fat among men who were treated with androgen deprivation therapy for prostate carcinoma. Cancer 95(10):2136–2144PubMedCrossRefGoogle Scholar
  10. Chodak GW (1998) Comparing treatments for localized prostate cancer–persisting uncertainty. JAMA 280(11):1008–1010PubMedCrossRefGoogle Scholar
  11. Courneya KS (2003) Exercise in cancer survivors: an overview of research. Med Sci Sports Exerc 35(11):1846–1852PubMedCrossRefGoogle Scholar
  12. Culos-Reed SN, Robinson JL, Lau H, O’Connor K, Keats MR (2007) Benefits of a physical activity intervention for men with prostate cancer. J Sport Exerc Psychol 29(1):118–127PubMedGoogle Scholar
  13. Culos-Reed SN, Robinson JW, Lau H et al (2009) Physical activity for men receiving androgen deprivation therapy for prostate cancer: benefits from a 16-week intervention. Support Care Cancer 18(5):591–599PubMedCrossRefGoogle Scholar
  14. D’Amico AV, Denham JW, Crook J et al (2007) Influence of androgen suppression therapy for prostate cancer on the frequency and timing of fatal myocardial infarctions. J Clin Oncol 25(17):2420–2425PubMedCrossRefGoogle Scholar
  15. Dahn JR, Penedo FJ, Molton I et al (2005) Physical activity and sexual functioning after radiotherapy for prostate cancer: beneficial effects for patients undergoing external beam radiotherapy. Urology 65(5):953–958PubMedCrossRefGoogle Scholar
  16. Demark-Wahnefried W, Clipp EC, Lipkus IM et al (2007) Main outcomes of the FRESH START trial: a sequentially tailored, diet and exercise mailed print intervention among breast and prostate cancer survivors. J Clin Oncol 25(19): 2709–2718PubMedCrossRefGoogle Scholar
  17. Demark-Wahnefried W, Clipp EC, Morey MC et al (2004) Physical function and associations with diet and exercise: Results of a cross-sectional survey among elders with breast or prostate cancer. Int J Behav Nutr Phys Act 1(1):16PubMedCrossRefGoogle Scholar
  18. Demark-Wahnefried W, Clipp EC, Morey MC et al (2006) Lifestyle intervention development study to improve physical function in older adults with cancer: outcomes from Project LEAD. J Clin Oncol 24(21):3465–3473PubMedCrossRefGoogle Scholar
  19. Doyle C, Kushi LH, Byers T et al (2006) Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin 56(6): 323–353PubMedCrossRefGoogle Scholar
  20. Fowler FJ Jr, McNaughton Collins M, Walker Corkery E, Elliott DB, Barry MJ (2002) The impact of androgen deprivation on quality of life after radical prostatectomy for prostate carcinoma. Cancer 95(2):287–295PubMedCrossRefGoogle Scholar
  21. Galvão DA, Newton RU (2005) Review of exercise intervention studies in cancer patients. J Clin Oncol 23(4):899–909PubMedCrossRefGoogle Scholar
  22. Galvão DA, Newton RU, Taaffe DR, Spry N (2008a) Can exercise ameliorate the increased risk of cardiovascular disease and diabetes associated with ADT? Nat Clin Pract Urol 5(6):306–307PubMedGoogle Scholar
  23. Galvão DA, Nosaka K, Taaffe DR et al (2008b) Endocrine and immune responses to resistance training in prostate cancer patients. Prostate Cancer Prostatic Dis 11(2):160–165PubMedCrossRefGoogle Scholar
  24. Galvão DA, Nosaka K, Taaffe DR et al (2006) Resistance training and reduction of treatment side effects in prostate cancer patients. Med Sci Sports Exerc 38(12):2045–2052PubMedCrossRefGoogle Scholar
  25. Galvão DA, Spry N, Taaffe DR et al (2009a) A randomized controlled trial of an exercise intervention targeting cardiovascular and metabolic risk factors for prostate cancer patients from the RADAR trial. BMC Cancer 9(1):419PubMedCrossRefGoogle Scholar
  26. Galvão DA, Spry NA, Taaffe DR et al (2008c) Changes in muscle, fat and bone mass after 36 weeks of maximal androgen blockade for prostate cancer. BJU Int 102(1):44–47PubMedCrossRefGoogle Scholar
  27. Galvão DA, Taaffe DR, Spry N, Joseph D, Newton RU (2010) Combined resistance and aerobic exercise program reverses muscle loss in men undergoing androgen suppression therapy for prostate cancer without bone metastases: a randomized controlled trial. J Clin Oncol 28(2): 340–347PubMedCrossRefGoogle Scholar
  28. Galvão DA, Taaffe DR, Spry N et al (2009b) Reduced muscle strength and functional performance in men with prostate cancer undergoing androgen suppression: a comprehensive cross-sectional investigation. Prostate Cancer Prostatic Dis 12(2):198–203PubMedCrossRefGoogle Scholar
  29. Galvão DA, Taaffe DR, Spry N, Newton RU (2007) Exercise can prevent and even reverse adverse effects of androgen suppression treatment in men with prostate cancer. Prostate Cancer Prostatic Dis 10(4):340–346PubMedCrossRefGoogle Scholar
  30. Greenspan SL, Coates P, Sereika SM et al (2005) Bone loss after initiation of androgen deprivation therapy in patients with prostate cancer. J Clin Endocrinol Metab 90(12):6410–6417PubMedCrossRefGoogle Scholar
  31. Gronberg H (2003) Prostate cancer epidemiology. Lancet 361(9360):859–864PubMedCrossRefGoogle Scholar
  32. Hakkinen K, Pakarinen A, Kraemer WJ, Newton RU, Alen M (2000) Basal concentrations and acute responses of serum hormones and strength development during heavy resistance training in middle-aged and elderly men and women. J Gerontol A Biol Sci Med Sci 55(2):B95–B105PubMedCrossRefGoogle Scholar
  33. Hara I, Miyake H, Hara S et al (2002) Health-related quality of life after radical cystectomy for bladder cancer: a comparison of ileal conduit and orthotopic bladder replacement. BJU Int 89(1): 10–13PubMedCrossRefGoogle Scholar
  34. Herr HW (1997) Quality of life in prostate cancer patients. CA Cancer J Clin 47(4):207–217PubMedCrossRefGoogle Scholar
  35. Hickok JT, Roscoe JA, Morrow GR et al (2005) Frequency, severity, clinical course, and correlates of fatigue in 372 patients during 5 weeks of radiotherapy for cancer. Cancer 104(8): 1772–1778PubMedCrossRefGoogle Scholar
  36. Higano CS (2003) Bone loss and the evolving role of bisphosphonate therapy in prostate cancer. Urol Oncol 21(5):392–398PubMedCrossRefGoogle Scholar
  37. Hussain MH, Wood DP, Bajorin DF et al (2009) Bladder cancer: narrowing the gap between evidence and practice. J Clin Oncol 27(34): 5680–5684PubMedCrossRefGoogle Scholar
  38. Jemal A, Siegel R, Ward E et al (2008) Cancer statistics, 2008. CA Cancer J Clin 58(2):71–96PubMedCrossRefGoogle Scholar
  39. Kaisary AV (2005) Evaluating the use of early hormonal therapy in patients with localised or locally advanced prostate cancer. Prostate Cancer Prostatic Dis 8(2):140–151PubMedCrossRefGoogle Scholar
  40. Kaku H, Saika T, Tsushima T et al (2006) Time course of serum testosterone and luteinizing hormone levels after cessation of long-term luteinizing hormone-releasing hormone agonist treatment in patients with prostate cancer. Prostate 66(4):439–444PubMedCrossRefGoogle Scholar
  41. Karvinen KH, Courneya KS, North S, Venner P (2007a) Associations between exercise and quality of life in bladder cancer survivors: a population-based study. Cancer Epidemiol Biomark Prev 16(5):984–990CrossRefGoogle Scholar
  42. Karvinen KH, Courneya KS, Plotnikoff RC et al (2009) A prospective study of the determinants of exercise in bladder cancer survivors using the Theory of Planned Behavior. Support Care Cancer 17(2):171–179PubMedCrossRefGoogle Scholar
  43. Karvinen KH, Courneya KS, Venner P, North S (2007b) Exercise programming and counseling preferences in bladder cancer survivors: a population-based study. J Cancer Surviv 1(1): 27–34PubMedCrossRefGoogle Scholar
  44. Keating NL, O’Malley AJ, Freedland SJ, Smith MR (2009) Diabetes and cardiovascular disease during androgen deprivation therapy: observational study of veterans with prostate cancer. J Natl Cancer Inst 102(1):39–46PubMedCrossRefGoogle Scholar
  45. Keating NL, O’Malley AJ, Smith MR (2006) Diabetes and cardiovascular disease during androgen deprivation therapy for prostate cancer. J Clin Oncol 24(27):4448–4456PubMedCrossRefGoogle Scholar
  46. Kraemer WJ, Hakkinen K, Newton RU et al (1999) Effects of heavy-resistance training on hormonal response patterns in younger vs. older men. J Appl Physiol 87(3):982–992PubMedGoogle Scholar
  47. Lee H, McGovern K, Finkelstein JS, Smith MR (2005) Changes in bone mineral density and body composition during initial and long-term gonadotropin-releasing hormone agonist treatment for prostate carcinoma. Cancer 104(8): 1633–1637PubMedCrossRefGoogle Scholar
  48. Lu-Yao GL, Yao SL (1997) Population-based study of long-term survival in patients with clinically localised prostate cancer. Lancet 349(9056): 906–910PubMedCrossRefGoogle Scholar
  49. McCredie M, Cox B (1998) Prostate-specific antigen testing for prostate cancer: the case for informed consent. Med J Aust 169(1):9–10PubMedGoogle Scholar
  50. Michaelson MD, Cotter SE, Gargollo PC et al (2008) Management of complications of prostate cancer treatment. CA Cancer J Clin 58(4): 196–213PubMedCrossRefGoogle Scholar
  51. Miller DC, Sanda MG, Dunn RL et al (2005) Long-term outcomes among localized prostate cancer survivors: health-related quality-of-life changes after radical prostatectomy, external radiation, and brachytherapy. J Clin Oncol 23(12): 2772–2780PubMedCrossRefGoogle Scholar
  52. Monga U, Garber SL, Thornby J et al (2007) Exercise prevents fatigue and improves quality of life in prostate cancer patients undergoing radiotherapy. Arch Phys Med Rehabil 88(11): 1416–1422PubMedCrossRefGoogle Scholar
  53. Morey MC, Snyder DC, Sloane R et al (2009) Effects of home-based diet and exercise on functional outcomes among older, overweight long-term cancer survivors: RENEW: a randomized controlled trial. Jama 301(18):1883–1891PubMedCrossRefGoogle Scholar
  54. Moul JW (2000) Prostate specific antigen only progression of prostate cancer. J Urol 163(6): 1632–1642PubMedCrossRefGoogle Scholar
  55. Newton RU, Taaffe DR, Spry N et al (2009) A phase III clinical trial of exercise modalities on treatment side-effects in men receiving therapy for prostate cancer. BMC Cancer 9:210PubMedCrossRefGoogle Scholar
  56. Oudard S, Banu E, Beuzeboc P et al (2005) Multicenter randomized phase II study of two schedules of docetaxel, estramustine, and prednisone versus mitoxantrone plus prednisone in patients with metastatic hormone-refrac-tory prostate cancer. J Clin Oncol 23(15): 3343–3351PubMedCrossRefGoogle Scholar
  57. Petrella JK, Kim JS, Tuggle SC, Hall SR, Bamman MM (2005) Age differences in knee extension power, contractile velocity, and fatigability. J Appl Physiol 98(1):211–220PubMedCrossRefGoogle Scholar
  58. Petrylak DP, Tangen CM, Hussain MH et al (2004) Docetaxel and estramustine compared with mitoxantrone and prednisone for advanced refractory prostate cancer. N Engl J Med 351(15): 1513–1520PubMedCrossRefGoogle Scholar
  59. Ransohoff DF, McNaughton Collins M, Fowler FJ (2002) Why is prostate cancer screening so common when the evidence is so uncertain? A system without negative feedback. Am J Med 113(8):663–667PubMedCrossRefGoogle Scholar
  60. Rashid MH, Chaudhary UB (2004) Intermittent androgen deprivation therapy for prostate cancer. Oncologist 9(3):295–301PubMedCrossRefGoogle Scholar
  61. Saigal CS, Gore JL, Krupski TL et al (2007) Androgen deprivation therapy increases cardiovascular morbidity in men with prostate cancer. Cancer 110(7):1493–500PubMedCrossRefGoogle Scholar
  62. Schmitz KH, Holtzman J, Courneya KS et al (2005) Controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. Cancer Epidemiol Biomark Prev 14(7): 1588–1595CrossRefGoogle Scholar
  63. Segal RJ, Reid RD, Courneya KS et al (2003) Resistance exercise in men receiving androgen deprivation therapy for prostate cancer. J Clin Oncol 21(9):1653–1659PubMedCrossRefGoogle Scholar
  64. Segal RJ, Reid RD, Courneya KS et al (2009) Randomized controlled trial of resistance or aerobic exercise in men receiving radiation therapy for prostate cancer. J Clin Oncol 27(3): 344–351PubMedCrossRefGoogle Scholar
  65. Shahinian VB, Kuo YF, Freeman JL, Goodwin JS (2005a) Risk of fracture after androgen deprivation for prostate cancer. N Engl J Med 352(2): 154–164PubMedCrossRefGoogle Scholar
  66. Shahinian VB, Kuo YF, Freeman JL, Goodwin JS (2006) Risk of the “androgen deprivation syndrome” in men receiving androgen deprivation for prostate cancer. Arch Intern Med 166(4): 465–471PubMedGoogle Scholar
  67. Shahinian VB, Kuo YF, Freeman JL, Orihuela E, Goodwin JS (2005b) Increasing use of gonadotropin-releasing hormone agonists for the treatment of localized prostate carcinoma. Cancer 103(8):1615–1624PubMedCrossRefGoogle Scholar
  68. Sharifi N, Gulley JL, Dahut WL (2005) Androgen deprivation therapy for prostate cancer. Jama 294(2):238–244PubMedCrossRefGoogle Scholar
  69. Smith JC, Bennett S, Evans LM et al (2001) The effects of induced hypogonadism on arterial stiffness, body composition, and metabolic parameters in males with prostate cancer. J Clin Endocrinol Metab 86(9):4261–4267PubMedCrossRefGoogle Scholar
  70. Smith MR (2004) Changes in fat and lean body mass during androgen-deprivation therapy for prostate cancer. Urology 63(4):742–745PubMedCrossRefGoogle Scholar
  71. Smith MR, Finkelstein JS, McGovern FJ et al (2002) Changes in body composition during androgen deprivation therapy for prostate cancer. J Clin Endocrinol Metab 87(2):599–603PubMedCrossRefGoogle Scholar
  72. Smith MR, Lee H, McGovern F et al (2008) Metabolic changes during gonadotropin-releasing hormone agonist therapy for prostate cancer: differences from the classic metabolic syndrome. Cancer 112(10):2188–2194PubMedCrossRefGoogle Scholar
  73. Smith MR, Lee H, Nathan DM (2006) Insulin sensitivity during combined androgen blockade for prostate cancer. J Clin Endocrinol Metab 91(4): 1305–1308PubMedCrossRefGoogle Scholar
  74. Smith MR, Lee WC, Brandman J et al (2005) Gonadotropin-releasing hormone agonists and fracture risk: a claims-based cohort study of men with nonmetastatic prostate cancer. J Clin Oncol 23(31):7897–7903PubMedCrossRefGoogle Scholar
  75. Spry NA, Galvão DA, Davies R et al (2009) Long-term effects of intermittent androgen suppression on testosterone recovery and bone mineral density: results of a 33-month observational study. BJU Int 104(6):806–812PubMedCrossRefGoogle Scholar
  76. Spry NA, Kristjanson L, Hooton B et al (2006) Adverse effects to quality of life arising from treatment can recover with intermittent androgen suppression in men with prostate cancer. Eur J Cancer 42(8):1083–1092PubMedCrossRefGoogle Scholar
  77. Stanford JL, Feng Z, Hamilton AS et al (2000) Urinary and sexual function after radical prostatectomy for clinically localized prostate cancer: the Prostate Cancer Outcomes Study. Jama 283(3):354–360PubMedCrossRefGoogle Scholar
  78. Thompson IM, Pauler DK, Goodman PJ et al (2004) Prevalence of prostate cancer among men with a prostate-specific antigen level < or =4.0 ng per milliliter. N Engl J Med 350(22):2239–2246PubMedCrossRefGoogle Scholar
  79. Tsai HK, D’Amico AV, Sadetsky N, Chen MH, Carroll PR (2007) Androgen deprivation therapy for localized prostate cancer and the risk of cardiovascular mortality. J Natl Cancer Inst 99(20): 1516–1524PubMedCrossRefGoogle Scholar
  80. Van Kampen M, De Weerdt W, Van Poppel H et al (2000) Effect of pelvic-floor re-education on duration and degree of incontinence after radical prostatectomy: a randomised controlled trial. Lancet 355(9198):98–102PubMedCrossRefGoogle Scholar
  81. van Londen GJ, Levy ME, Perera S, Nelson JB, Greenspan SL (2008) Body composition changes during androgen deprivation therapy for prostate cancer: a 2-year prospective study. Crit Rev Oncol Hematol 68(2):172–177PubMedCrossRefGoogle Scholar
  82. Vogelzang NJ, Stadler WM (1998) Kidney cancer. Lancet 352(9141):1691–1696PubMedCrossRefGoogle Scholar
  83. von der Maase H, Hansen SW, Roberts JT et al (2000) Gemcitabine and cisplatin versus methotrexate, vinblastine, doxorubicin, and cisplatin in advanced or metastatic bladder cancer: results of a large, randomized, multinational, multicenter, phase III study. J Clin Oncol 18(17):3068–3077PubMedGoogle Scholar
  84. Windsor PM, Nicol KF, Potter J (2004) A randomized, controlled trial of aerobic exercise for treatment-related fatigue in men receiving radical external beam radiotherapy for localized prostate carcinoma. Cancer 101(3):550–557PubMedCrossRefGoogle Scholar
  85. Winer E, Gralow J, Diller L et al (2009) Clinical cancer advances 2008: major research advances in cancer treatment, prevention, and screening–a report from the American Society of Clinical Oncology. J Clin Oncol 27(5):812–826PubMedCrossRefGoogle Scholar
  86. Wolin KY, Luly J, Sutcliffe S, Andriole GL, Kibel AS (2010) Risk of urinary incontinence following prostatectomy: the role of physical activity and obesity. J Urol 183(2):629–633PubMedCrossRefGoogle Scholar
  87. Yan Y, Carvalhal GF, Catalona WJ, Young JD (2000) Primary treatment choices for men with clinically localized prostate carcinoma detected by screening. Cancer 88(5):1122–1130PubMedCrossRefGoogle Scholar
  88. Yancik R, Ganz PA, Varricchio CG, Conley B (2001) Perspectives on comorbidity and cancer in older patients: approaches to exp-and the knowledge base. J Clin Oncol 19(4): 1147–1151PubMedGoogle Scholar

Copyright information

© Springer Berlin Heidelberg 2010

Authors and Affiliations

  • Daniel A. Galvão
    • 1
    Email author
  • Dennis R. Taaffe
    • 2
  • Nigel Spry
    • 3
  • Robert U. Newton
    • 1
  1. 1.Edith Cowan University Health and Wellness Institute, School of Exercise, Biomedical and Health SciencesEdith Cowan UniversityJoondalupAustralia
  2. 2.School of Human Movement StudiesUniversity of QueenslandBrisbaneAustralia
  3. 3.Department of Radiation OncologySir Charles Gairdner HospitalNedlandsAustralia

Personalised recommendations