Active surveillance has emerged as a valid therapeutic option in patients with low-risk prostate cancer, allowing for the deferral of definitive treatment until the time of possible disease progression. Although it is known that physical activity plays a protective role in the onset and progression of this tumor, its impact on patients with low-risk disease who are managed with active surveillance remains unclear. Our scoping review aims to summarize the existing evidence on this subject.
On 9 April 2023, a systematic search was conducted using the PubMed and Scopus databases. The search employed the combination of the following terms: ("prostate cancer" OR "prostate tumor") AND ("active surveillance") AND ("physical activity" OR "physical exercise" OR "physical intensive activity" OR "intensive exercise") AND ("lifestyle"). Out of the 506 identified articles, 9 were used for the present scoping review, and their results were reported according to the PRISMA-ScR statement.
We discovered a lack of uniformity in the assessment of PA and its stratification by intensity. There was no consensus regarding what constitutes cancer progression in patients choosing expectant management. In terms of the impact of PA on AS outcomes, conflicting results were reported: some authors found no correlation, while others (six of total studies included) revealed that active men experience smaller increases in PSA levels compared to their sedentary counterparts. Additionally, higher levels of exercise were associated with a significantly reduced risk of PCa reclassification.
Due to the heterogeneity of the methodologies used in the available studies and the conflicting results reported, it is not possible to draw definitive conclusions concerning the role physical activity may play in the risk of prostate cancer progression in men managed with active surveillance.
Cancers. 2024 Feb 01*** epublish ***
Aldo Brassetti, Loris Cacciatore, Alfredo Maria Bove, Umberto Anceschi, Flavia Proietti, Leonardo Misuraca, Gabriele Tuderti, Rocco Simone Flammia, Riccardo Mastroianni, Maria Consiglia Ferriero, Giuseppe Chiacchio, Simone D'Annunzio, Rigoberto Pallares-Mendez, Riccardo Lombardo, Costantino Leonardo, Cosimo De Nunzio, Giuseppe Simone
IRCCS "Regina Elena" National Cancer Institute, Department of Urology, Via Elio Chianesi 53, 00144 Rome, Italy., "Sapienza" University of Rome, Department of Urology, Via di Grottarossa 1035, 00189 Rome, Italy.