Physical activity (PA) is a safe and feasible intervention for prostate cancer (PCa) patients undergoing radiotherapy (RT) and may improve cancer-related fatigue, physical function, and quality of life (QoL). However, evidence specifically addressing PA delivered during RT and the biological mechanisms supporting potential radiosensitisation or normal-tissue protection remains heterogeneous.
We conducted a narrative review of studies published in the last 10 years evaluating PA interventions in men receiving RT for PCa or in survivors previously treated with RT, focusing on feasibility/adherence, safety, treatment-related toxicity, physical function, body composition/metabolic outcomes, and patient-reported QoL.
Supervised PA, both cardiovascular and strength-based, is safe and feasible during RT, with high adherence and low risk. Across trials, PA is associated with reduced short-term fatigue, better maintenance of muscle mass and physical performance, and improved QoL, including in men receiving concomitant androgen deprivation therapy. Evidence suggesting positive effects on urinary and bowel symptoms and the therapeutic index is emerging, although mechanistic data in humans during RT are limited and largely indirect.
Current evidence supports integrating structured, individualised PA as an adjunct to RT for PCa, given its consistent functional and quality-of-life benefits and favourable safety profile. Future trials should standardise PA dose and outcomes and further clarify dose-response relationships and biological mechanisms during RT.
Archivos espanoles de urologia. 2026 Jun [Epub]
Ana Maria Serradilla Gil, Aida Tórtola-Navarro, Manuel Luis Blanco-Villar, Raquel Correa Generoso, Antonio Lazo Prados, Nuria Azahara Linares Mesa, Angeles Sanchez Galvez
Department of Radiation Oncology, Jaen University Hospital, 23007 Jaen, Spain., Faculty of Humanities, Education and Sport, University CEU Fernando III (CEU Universities), 41930 Bormujos, Sevilla, Spain., Department of Radiation Oncology, Virgen de las Nieves University Hospital, 18014 Granada, Spain., Department of Radiation Oncology, Virgen de la Victoria University Hospital, 29010 Malaga, Spain., Department of Radiation Oncology, Juan Ramon Jimenez University Hospital, 21005 Huelva, Spain.